In a previous column, I explained how the Americans with Disabilities Act (ADA) protects invisible disabilities, including inflammatory bowel disease (IBD) and IBD-related disorders and conditions. Under the ADA, employees with Crohn’s disease or ulcerative colitis can request workplace accommodations. Even minor adjustments, such as flexible working hours or the ability to telecommute, allow IBD patients with mild to moderate symptoms to have a career while managing their disease.
Unfortunately, the severe symptoms can become so debilitating that someone can no longer do their job or work at all. When this happens, a patient with IBD may be able to receive Social security disability insurance advantages.
What is social security disability insurance?
President Franklin D. Roosevelt enacted the Social Security Act 85 years ago, on August 14, 1935. Almost 21 years later, on August 1, 1956, President Dwight D. Eisenhower amended the law to include disability insurance benefits for disabled workers. 50 years and over, as well as for children of full age. Coincidentally, doctors had diagnosed Eisenhower with Crohn’s disease three months earlier.
In 1960, Eisenhower extended the law to cover disabled workers of all ages and their dependents.
I didn’t know much about Social Security disability insurance except that I contributed to the system with federal taxes deducted from my paychecks. I had no idea that I might be entitled to benefits until my liver transplant in 2017. My social worker explained to me that I could apply for disability to take time off work to recover. I didn’t look into this because I was earning my full pay off sick leave.
When my sick pay was exhausted months later, I told my gastroenterologist that I was considering submitting a disability claim. He laughed and told me that I might not be eligible anymore because I was doing great after my transplant.
Who is eligible for social security disability insurance?
The Social Security Administration (SSA) uses a five-step process to determine eligibility. The first step examines a candidate’s recent employment history and salary. For someone who worked in 2020, their monthly salary must have been $ 1,260 or less to qualify. If a person has not worked, the SSA sends the request to the Disability Determination Services office for approval.
The second step examines the severity of a person’s disability. The disability of the applicant must have prevented him from exercising a gainful activity for at least one year. If this is the case, the administration then verifies that the disability is a covered medical condition.
Once the SSA confirms the disability, the last two steps examine the likelihood of the applicant’s ability to return to work. A person with partial or short-term disability will not meet the administration’s strict definition of disability. To be considered disabled, the applicant cannot perform their current job, they cannot find other or different jobs, and the disability has lasted or is expected to last at least one year or result in death.
Is IBD a Qualifying Disability?
ITNs are specifically covered by section 5.06 of the SSA-eligible digestive system medical conditions. However, a Crohn’s or ulcerative colitis patient is not automatically eligible with a diagnosis of IBD alone. The applicant must also meet one of the two additional criteria.
The first qualifying condition is to have a bowel obstruction in the small intestine or colon. The patient must have been hospitalized for the obstruction at least twice in 60 days within a six month period.
The other deciding factor is to experience at least two of the following symptoms within a six month period despite continued treatment:
- Anemia caused by hemoglobin level below 10 g / dL at least twice and at least 60 days apart
- A serum albumin level of 3.0 g / dL or less at least twice and at least 60 days apart
- An abdominal mass with uncontrollable pain or cramping during two or more assessments, at least 60 days apart
- Unintentional weight loss of at least 10% at least twice and at least 60 days apart
- Receive daily supplemental nutrition by feeding tube or catheter
If a patient with IBD is not eligible under section 5.06, they may be eligible under section 5.08. This criterion determines disability when the applicant’s body mass index unintentionally falls below 17.50 during two or more assessments at least 60 days apart, within a six-month period.
Application and determination of payment
Patients with IBD can apply for Social Security disability insurance in person or online at the administration’s website. The website provides a checklist and answers common questions to help applicants. The Crohn’s and Colitis Foundation also offers resources to help IBD patients through the process.
If approved, the SSA will calculate the benefit amount by looking at the applicant’s average lifetime earnings and years of employment and the date a person recently worked before becoming disabled.
Never too old to learn something new
I want doctors to employ a patient advocate specifically to explain the legal and financial protections that IBD patients can access. I may have learned about my rights mid-career, but I still have 18 years to exercise them before I can retire.
To note: EIA News Today is strictly a disease news and information site. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional with any questions you may have regarding a health problem. Never disregard professional medical advice or be slow to seek it because of something you have read on this website. The opinions expressed in this column are not those of EIA News Today, or its parent company, BioNews, and are intended to spark discussion on issues relating to IBD.