CROHN’S DISEASE & SSD BENEFITS
WHAT IS CROHN’S DISEASE?
Crohn’s disease is a type of inflammatory bowel disease (IBD) which can affect the gastrointestinal tract. Most often, Crohn’s disease occurs in the small intestine and the colon. Symptoms often include pain, diarrhea, and fever. Additionally, you may also experience distention of your abdomen and weight loss.
Other complications from the disease can include anemia, arthritis, eye pain, skin rashes, and fatigue. Bowel obstruction can also occur due to chronic inflammation. Individuals who have Crohn’s disease are at greater risk of colon cancer, small bowel cancer, and short bowel syndrome.
According to the Crohn’s & Colitis Foundation, almost 1.6 million Americans have inflammatory bowel disease (IBD), which includes both Crohn’s disease and ulcerative colitis. Of this number, around 780,000 Americans have Crohn’s disease specifically.
WHAT CAUSES CROHN’S DISEASE?
The causes of Crohn’s disease are unknown. However, it is believed to be caused by a combination of factors. Scientists state those causes are environmental and genetic. Additionally, Crohn’s disease can also be due to immune factors.
It results in a chronic inflammatory disorder, in which the body’s immune system defends the gastrointestinal tract, possibly targeting microbial antigens. While Crohn’s is an immune related disease, it does not appear to be an autoimmune disease.
In an autoimmune disease, like Lupus, the immune system is not being triggered by the body itself. The exact underlying immune problem is not clear. However, it may be an immunodeficiency state.
THE ROLE OF GENETICS IN CROHN’S DISEASE
According to the Crohn’s & Colitis Foundation of America (CCFA), twenty percent of people with Crohn’s disease also have a parent, sibling, or other relative with the disease. Your risk of getting Crohn’s disease increases if both of your parents have IBD.
The National Human Genome Research Institute Trusted Source notes if one parent has Crohn’s disease, a child has a 7–9% risk of also getting the disease. However, if both parents have IBD, that risk increases to about 35%. Other studies show that in identical twins, if one twin has Crohn’s disease, the other twin has a 50% chance of having the condition.
Even if you do not have a genetic predisposition for Crohn’s disease, you can still have it. A study done from 1940 to 2011 in Olmsted County, Minnesota, looked at how many people get IBD.
The total number of new cases of Crohn’s disease found each year is 10.7 per 100,000 people. Or, almost 33,000 new cases per year. See Loftus EV, Jr., Shivashankar R, Tremaine WJ, Harmsen WS, Zinsmeiseter AR. Updated Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota (1970- 2011). ACG 2014 Annual Scientific Meeting. October 2014.
OTHER FACTORS THAT CONTRIBUTE TO CROHN’S DISEASE
Gender is one factor that scientists study to determine how it effects Crohn’s disease. In general, the disease affects men and women equally. However, most North American studies show that ulcerative colitis is more common in men than in women. Additionally, men are more likely than women to suffer from ulcerative colitis in their 50’s and 60’s.
Age is another factor that contributes to Crohn’s disease. Although Crohn’s disease and ulcerative colitis can occur at any age, people usually get the disease between the ages of 15 and 35. According to the Olmsted County study cited above, the median age of diagnosis for Crohn’s disease was 34.9 years.
In a person with Crohn’s disease, their immune system may go into overdrive. The immune system may mistake gut bacteria, which do not cause harm, as invaders and try to destroy them. This response leads to the symptoms of Crohn’s disease.
ENVIRONMENTAL FACTORS THAT CONTRIBUTE TO CROHN’S DISEASE
Several potential environmental risk factors have been linked to Crohn’s disease. However, more studies need to be done to really understand the risk factors for Crohn’s disease. Nevertheless, the following factors do contribute to having Crohn’s disease.
• SMOKING: Active smokers are twice as likely as those who do not smoke to develop Crohn’s disease. Surprisingly, the risk of ulcerative colitis is lower in smokers versus people who have never smoked. However, the numerous potential harmful health effects of smoking, like cancer and heart disease, outweigh any benefits of smoking for people with ulcerative colitis.
• ANTIBIOTICS: May increase the risk for IBD.
• NONSTEROIDAL ANTI-INFLAMMATORY DRUGS: Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen may increase the risk for getting IBD. These drugs may also cause Crohn’s disease flares.
• APPENDICITIS: Children who undergo an appendectomy are less likely to develop ulcerative colitis later in life, but may be at a higher risk of getting Crohn’s disease. However, the benefits of the procedure for those who need it outweighs the risks. Especially if those risks include having Crohn’s disease.
• DAILY DIET: Crohn’s disease is not triggered by eating any one food. But for some people, certain foods can make your symptoms worse. The role of diet in Crohn’s disease is important. Research is ongoing as to how diet may impact this disease.
THE SYMPTOMS OF CROHN’S DISEASE
The symptoms of Crohn’s disease usually become worse over time. Although possible, it is rare for symptoms to develop suddenly. The early symptoms of Crohn’s disease can include:
- diarrhea
- cramps
- blood in your stool
- fever
- fatigue
- loss of appetite
- weight loss
- feeling as if your bowels aren’t empty after a bowel movement
- feeling a frequent need for bowel movements
You should see a doctor if experience these symptoms. People with Crohn’s disease of the colon or ulcerative colitis have a higher risk for colorectal cancer than the general population. Colorectal cancer rarely occurs in the first eight to ten years after initial diagnosis of IBD.
The risk increases the longer a person lives with the disease. An analysis of all current studies found that as many as 18% of people with IBD may develop colorectal cancer by the time they have had IBD for 30 years.
If you do not have health insurance to see a doctor and you are without income, you can apply for Medicaid. Medicaid benefits are available in each state, but whether you can get them depends on your income and assets. Review information about Medicaid benefits.
CROHN’S DISEASE & COMPLICATIONS WITHIN THE BOWEL
Severe Crohn’s disease can sometimes cause medical problems within the bowel. These problems may include strictures, perforations, and fistulas.
STRICTURES
Ongoing inflammation and then healing in the bowel can cause scar tissue to form. This scar tissue can create a narrow section of the bowel that can start to block the bowel. This is known as a stricture. A stricture can make it difficult for food to pass through the bowel. If it becomes more severe, it causes a blockage or obstruction. Strictures are usually treated by an operation known as a stricturoplasty. Some people have “inflammatory” strictures. This is when the bowel becomes narrow due inflammation, not scar tissue. If this happens, then medication can reduce the inflammation.
PERFORATIONS
Inflammation deep in the bowel wall or a severe blockage may lead to a perforation or rupture of the bowel. The contents of the bowel can then leak through the rupture. A perforation requires surgery. The symptoms include severe pain, fever, nausea, and vomiting.
FISTULAS
Some people with Crohn’s develop a fistula. A fistula is an abnormal passageway that connects one internal organ to another. A fistula can also connect to the outside of the body. Most fistulas start in the wall of the intestine. Then the fistula can connect the bowel to other parts of the bowel or the bowel to the vagina. Likewise, the fistula can connect the bowel to the bladder or skin. Fistulas may be treated with medication or with surgery.
TREATMENT FOR CROHN’S DISEASE
The treatment for Crohn’s disease depends on the location and severity of the inflammation in the digestive tract. Therefore, treatment can vary from person to person. However, some common treatments for Crohn’s disease include:
- Medications: Anti-inflammatory drugs, such as steroids, can help reduce inflammation in the digestive tract. Immunosuppressive drugs and therapy can also be used to suppress the immune system and reduce inflammation.
- Nutrition Therapy: Some people with Crohn’s disease may benefit from a special diet to manage symptoms and promote healing.
- Lifestyle Changes: Some life changes, such as reducing stress, getting regular exercise, and no longer smoking, may help manage Crohn’s disease symptoms. For example, during a Crohn’s flare it can be helpful to eat a low fiber diet, as this can reduce irritation. Additionally, some people with Crohn’s disease may have trouble digesting lactose, a sugar found in dairy products. Limiting or avoiding dairy products may help reduce symptoms like bloating, gas, and diarrhea.
- Surgery: In severe cases, surgery may be necessary to remove damaged portions of the digestive tract.
- Biologic Therapy: One newer area of research is the development of biologic therapy that targets specific molecules involved in the inflammatory process. For example, some biologics that target the protein tumor (TNF-alpha) have been shown to reduce inflammation and improve symptoms in some people with Crohn’s disease.
DOES CROHN’S DISEASE REQUIRE SURGERY?
About 70% of people with Crohn’s disease eventually require surgery. There are different types of operations that a doctor may recommend for Crohn’s disease. The kind of surgery you receive will depend on the reason you need surgery. It will also depend on how severe your Crohn’s symptoms are. Crohn’s surgery is usually done to remove portions of the intestine that have the disease. If you undergo surgery, then you may end up getting short bowel syndrome.
Some common procedures for Crohn’s disease include:
- Strictureplasty: This surgery is performed to widen a narrowed portion of the intestine (stricture) that is causing a blockage. The surgeon will make incisions in the narrowed portion and fold the tissue back on itself to widen the opening.
- Bowel Resection: In some cases, a portion of the intestine may be removed if it has been damaged by infection. The remaining ends of the intestine will be reconnected during the surgery.
- Colectomy: A colectomy removes all or part of the large intestine or colon. This procedure may be necessary if Crohn’s disease is affecting the colon.
- Proctocolectomy: This surgery involves removing both the colon and the rectum. This kind of surgery may be needed if the Crohn’s disease has led to colon cancer.
- Ostomy: In some cases, an ostomy may be necessary to divert stool from the intestines to a pouch on the outside of the body. This may be temporary or permanent and depends on the needs of the person.
Unfortunately, about 30% of patients who have surgery for Crohn’s disease experience their symptoms again within three years. Likewise, up to 60% will have their symptoms return within ten years. See Article from Sachar.
SSA’S DEFINES CROHN’S DISEASE UNDER LISTING 5.06
The SSA looks at Crohn’s disease under the rubric of inflammatory bowel disease. The SSA’s introduction to the listing states:
Inflammatory bowel disease includes, but is not limited to, Crohn’s disease and ulcerative colitis. These conditions share many lab and imaging findings, as well as similar treatments. Remissions and exacerbations of variable duration are the hallmark of IBD.
Crohn’s disease may involve the entire alimentary tract from the mouth to the anus. Obstruction, stenosis, fistulization, perineal involvement, and extraintestinal symptoms are common. Crohn’s disease is rarely curable and it may be a problem throughout your life, even after surgical resection. In contrast, ulcerative colitis only affects the colon. The inflammatory process may be limited to the rectum, extend to include any contiguous segment or involve the entire colon. Ulcerative colitis may be cured by total colectomy.
LISTING 5.06 – FOR CROHN’S DISEASE & IBD
5.06 Inflammatory bowel disease (IBD) documented by endoscopy, biopsy, appropriate medically acceptable imaging, or operative findings with:
A. Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation, confirmed by appropriate medically acceptable imaging or in surgery, requiring hospitalization for intestinal decompression or for surgery, and occurring on at least two occasions at least 60 days apart within a consecutive 6-month period.
OR
B. Two of the following despite continuing treatment as prescribed and occurring within the same consecutive 6-month period:
1. Anemia with hemoglobin of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart; or
2. Serum albumin of 3.0 g/dL or less, present on at least two evaluations at least 60 days apart; or
3. Clinically documented tender abdominal mass palpable on physical examination with abdominal pain or cramping that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
4. Perineal disease with a draining abscess or fistula, with pain that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
5. Involuntary weight loss of at least 10 percent from baseline, as computed in pounds, kilograms, or BMI, present on at least two evaluations at least 60 days apart; or
6. Need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central line.
As you can see from the above listing, in order to win benefits, the SSA requires very specific symptoms and treatment for your Crohn’s disease. At your hearing, the ALJ may call a medical expert to testify about whether your Crohn’s disease meets a listing. Find out about the medical expert.
IF YOU HAVE CROHN’S DISEASE YOU MAY NOT BE ABLE TO SUSTAIN FULL TIME WORK
The SSA listing is about Crohn’s disease in its most severe form. For example, the listing talks about weight loss of 10% of your body weight over a two month period, despite treatment for the disease. But it also includes 6 months of severe Crohn’s disease symptoms. These are the kind of symptoms that, despite medical treatment, would prevent you from working at a job for 40 hours a week.
For example, people who don’t have Crohn’s disease do not understand that you need to take extra bathroom breaks during the work day. While some employers can give you those extra breaks, other employers cannot.
Much of your ability to work will depend upon the kind of job you have. If you have a desk job, perhaps your employer will allow those extra breaks. However, if you work in a factory, then chances are there is not room for a few extra breaks in your work schedule.
If you have Crohn’s disease, but your symptoms do not meet or equal listing 5.06, then it is still possible to win your benefits. If you cannot work any job, then you need to prove that to the SSA.
You can prove your Crohn’s disease prevents you from working by having a residual functional capacity (RFC) form filled out by your treating doctor. The medical opinion of your treating doctor matters to the SSA. Find out how your RFC can prove to the SSA that you cannot work.
RESOURCES FOR THOSE WITH CROHN’S DISEASE
There are many resources available for people with Crohn’s disease, ranging from support groups and materials to online forums. Here are some examples:
- Crohn’s & Colitis Foundation: The Crohn’s & Colitis Foundation is an organization that provides education, support, and research funding for people with Crohn’s disease. Their website includes information on symptoms, treatment options, as well as a list of local support groups and events.
- Mayo Clinic: The Mayo Clinic is a leading medical center that provides information on Crohn’s disease, including symptoms, causes, and treatment. Their website also includes videos, tools, and patient stories to help people better understand and manage their condition.
- CCFA Community: CCFA Community is an online forum and support group for people with Crohn’s disease and other bowel disease. The site allows users to connect with others who share their experiences, ask questions, and share advice.
- Healio Gastroenterology: This is a website that provides news and research on Crohn’s disease. The site includes articles and videos from leading experts in the field.
Your experience with Crohn’s disease is unique. The above resources may or may not help you. However, you can pick and choose what works for you. Remember to find a doctor who is an expert in treating bowel disease to help you treat your disease and protect your health.
WE CAN HELP YOU WIN BENEFITS FOR CROHN’S DISEASE
At our law firm, we can help you apply for Social Security benefits if you cannot work due to Crohn’s disease. You will need to be off work for over one year in order to win SSD and SSI benefits.
Also, we can help you appeal a denial from the SSA. Likewise, we can represent you in court. If necessary, we can also appeal your case to the Appeals Council. Additionally, we can file an appeal in Federal Court and represent you not matter where you live.
Not only do we attempt to win your ongoing benefits, we also try to win all of your past due Social Security benefits. When you file your application, it can take so long to get through the appeal process that you will be due back benefits. Also, if you have previous applications, you might be able to win past due benefits on those prior applications. Learn about past due benefits.
Also, we bring over 30 years of legal experience to your SSD and SSI case. For instance, Dianna Cannon has been helping clients win SSA hearings for over thirty years. Brett Bunkall and Andria Summers also have many years of legal experience. Together, we have won over 20,000 SSD and SSI cases for our clients. You can trust we will do everything we can to win your SSDI and SSI benefits.
HOW WILL YOU AFFORD THE ATTORNEY FEE?
We will use our skills to help you through the Social Security appeal process. It is our goal to win your case. But, it also our goal to make filing for SSDI and SSI benefits easier for you. We offer a free review of your case. There is no pressure to become a client if you call. You can simply ask questions. We will answer. Even if we don’t accept your case, we will still try to help you.
It also doesn’t cost you any money to hire us. Why? Because you only pay us an attorney fee if we win your case. This means if we win, then you pay us out of your back benefits. If you do not win, then you do not pay an attorney fee. How much is the fee? It is 25% of your back benefit.
Also, there is a fee cap set at $9200 by the SSA. You never pay more than the fee cap at the hearing stage of your case. And, 25% of your back benefit is usually less than the cap. You will pay the lesser amount between the fee cap and 25% of your back benefit.
If there are costs in your case, then you pay for those costs. But the costs are usually less than $100. Typically, if a doctor charges for copies of your medical records, then that is your cost.
You will owe the costs in your case whether we win or lose your case. But those costs include paying the doctor or copy service for your medical records and they are usually less than $100. However, your attorney fees come from your back benefit. But, you only pay an attorney fee if we win your case.
OUR LAW FIRM CAN HELP YOU WIN SSD BENEFITS
If you have Crohn’s disease, you need to hire a law firm with experience to help you win your benefits. Cannon Disability is one of the best Social Security law firms in the country. We are one of the best Social Security benefits firm in Las Vegas, Nevada. Also, we are the best Social Security law firms in Salt Lake City, Utah.
Our attorneys are also members of the National Organization of Social Security Claimant’s Representatives. Learn about Utah SSD benefits. Nevada SSI Information is also on this site. We also represent clients in Idaho. Find out about Colorado SSDI benefits. Likewise, if you are from California, California SSDI & SSI information is available for you.
Over the last 30 years, we have won thousands of SSDI and SSI claims. Additionally, we have won over $100 million in SSDI and SSI benefits for our clients. It has become more difficult to win Social Security cases. Also, SSA’s listing rules are harder to meet. That is why you need an attorney who will help you win your case.
We recommend you do not go to your hearing without an attorney. Why? Because a lawyer can prepare you for your hearing. She can explain the judge’s questions. Preparation will help you win your case.
Those who come to the hearing without counsel are usually not successful in winning benefits. You should hire an attorney with experience winning SSDI and SSI cases. Contact Cannon Disability Law. We can help you win benefits for Crohn’s disease. Call for a free review of your case. We want to help you if you cannot work due to Crohn’s disease.
