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CROHN’S DISEASE & SSD BENEFITS

Crohn’s disease is a type of inflammatory bowel disease (IBD) which can affect the gastrointestinal tract. Most commonly, Crohn’s disease occurs in the small intestine and the colon. Symptoms often include abdominal pain, diarrhea, fever, abdominal distension, and weight loss.

Other complications from the disease that are outside the gastrointestinal tract can include anemia, arthritis, inflammation of the eye, skin rashes, and fatigue. Bowel obstruction can also occur as a complication of chronic inflammation. Individuals who have Crohn’s disease are at greater risk of colon cancer and small bowel cancer.

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.

Crohn's disease and Man on blurred background using digital x-ray of human intestine holographic scan projection 3D rendering

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 developing 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 developing the disease. However, if both parents have IBD, that risk increases to about 35%.  Other studies demonstrate 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 population-based study conducted from 1940 to 2011 in Olmsted County, Minnesota, examined the incidence of IBD. The total number of new cases of Crohn’s disease diagnosed each year was 10.7 per 100,000 people, or approximately 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 contributes to 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 receive their  diagnosis of 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 and be overactive. The immune system may mistake gut bacteria, which are harmless, as invaders and try to destroy them. This response leads to inflammation and 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 environmental factors do contribute to the likelihood of having Crohn’s disease.

SMOKING: Active smokers are twice as likely as nonsmokers to develop Crohn’s disease. Surprisingly, the risk of developing ulcerative colitis is decreased 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 developing Crohn’s disease. However, the benefits of appendectomy for those who need it outweigh the risks or potentially having Crohn’s disease.

DAILY DIET: Crohn’s disease is not triggered by eating any one food. But for some people, certain foods can aggravate symptoms. The role of diet in Crohn’s dis- ease and ulcerative colitis is important. Research is ongoing as to how diet may impact these diseases.

THE SYMPTOMS OF CROHN’S DISEASE

The symptoms of Crohn’s disease often develop gradually. Certain symptoms may also become worse over time. Although possible, it’s rare for symptoms to develop suddenly and dramatically. The early symptoms of Crohn’s disease can include:

  • diarrhea
  • abdominal 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 gastroenterologist 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 published 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.

CROHN’S DISEASE CAUSES COMPLICATIONS WITHIN THE BOWEL

Severe Crohn’s disease can sometimes cause complications within the bowel. These complications 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 surgically in 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 abdominal pain, fever, nausea, and vomiting.

FISTULAS

Some people with Crohn’s develop a fistula. A fistula is an abnormal  passageway connecting one internal organ to another. A fistula can also connect  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 medically or with surgery.

DOES CROHN’S DISEASE REQUIRE SURGERY?

About 70% of people with Crohn’s disease eventually require surgery. There are different types of surgeries that a doctor may recommend for Crohn’s disease. The kind of surgery you receive will depend on  the reason you need surgery and the severity of your Crohn’s symptoms. Crohn’s surgery is usually done to remove portions of the intestine that have the disease. Unfortunately,  about 30% of patients who have surgery for Crohn’s disease experience recurrence of their symptoms within three years. Likewise, up to 60% will have recurrence of their symptoms within ten years. See Sachar DB; “The problem of post-operative recurrence of Crohn’s disease.” Med Clin North Am. 1990;74:183-188.

The word Crohn's disease on the display of a tablet

SSA’S DEFINITION OF DISABILITY DUE TO CROHN’S DISEASE UNDER LISTING 5.06

The SSA looks at Crohn’s disease under the rubric of inflammatory bowel disease. The SSA’s introductory paragraph to the listing states:

“Inflammatory bowel disease (5.06) includes, but is not limited to, Crohn’s disease and ulcerative colitis. These disorders, while distinct entities, share many clinical, laboratory, and imaging findings, as well as similar treatment regimens. 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 in a segmental, asymmetric fashion. Obstruction, stenosis, fistulization, perineal involvement, and extraintestinal manifestations are common. Crohn’s disease is rarely curable and recurrence may be a lifelong problem, even after surgical resection. In contrast, ulcerative colitis only affects the colon. The inflammatory process may be limited to the rectum, extend proximally to include any contiguous segment, or involve the entire colon. Ulcerative colitis may be cured by total colectomy.”

LISTING 5.06 – WHICH IS USED BY THE SSA TO DEFINE DISABILITY

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 venous catheter.

As you can see from the above listing, in order to be eligible for disability benefits, the SSA requires very specific symptoms and treatment for your Crohn’s disease.

IF YOU HAVE CROHN’S DISEASE YOU MAY NOT BE ABLE TO SUSTAIN FULL-TIME WORK

The SSA listing addresses Crohn’s disease in its most severe form. For example, the listing discusses weight loss of 10% of your body weight over a two month period, despite extensive 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 full-time job.

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 accommodate those 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 very little flexibility in your work schedule.

If you have Crohn’s disease, but your symptoms do not meet or equal listing 5.06, it is still possible to win your disability case. If you cannot work any full-time job, then you need to prove that to the SSA. You can prove your Crohn’s disease prevent you from working by submitting a residual functional capacity evaluation from your treating physician. Find out more here about your residual functional capacity and how it can prove disability to the SSA.

CANNON DISABILITY LAW CAN HELP YOU WIN DISABILITY BENEFITS FOR CROHN’S DISEASE

At Cannon Disability Law, we can help you apply for disability benefits if you cannot work due to Crohn’s disease. You will need to be off work for over one year in order to be eligible for disability 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.

Also, we bring over 60 years of combined legal experience to your disability case. For instance, Dianna Cannon has been representing people with disabilities for over thirty years. Brett Bunkall and Andria Summers also have many years of litigation experience. We have won over 20,000 disability cases for our clients. You can trust we will do everything we can to win your SSD and SSI benefits.

HOW WILL YOU AFFORD THE ATTORNEY FEE IN YOUR DISABILITY CASE?

We will use our skills to help you through the disability process. It is our goal to win your case. But, it also our goal to applying for disability benefits easier for you. We offer a free consultation. There is no obligation to become a client if you call. You can simply ask questions. We will answer. Even if we don’t accept representation in 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 is a contingency fee. It means if we win, you pay us out of your back benefits. If you do not win, 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 $6000 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 $6000 cap. You will pay the lesser amount.

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. We also have a small office fee that covers the expenses that we incur for your case, but that is also less than $100. You will owe the costs in your case whether we win or lose your case. However, your attorney fees come from your back benefit and only if we win your case.

CANNON DISABILITY CAN HELP YOU WIN SSD BENEFITS 

If you have Crohn’s disease, you need to hire a law firm with experience to help you with your disability case. Cannon Disability is one of the best disability law firms in the country. We are known as one of the best Social Security Disability firms in Las Vegas, Nevada. Also, we are one of the best Disability law firms in Salt Lake City, Utah. Cannon Disability’s representatives are also members of the National Organization of Social Security Claimant’s Representatives. Learn more about Utah SSD benefits here. Nevada Disability Information can also be found on this website. We also represent claimant’s in Idaho. Find out more about Colorado disability benefits here. Likewise, if you are from California, California disability information can also be found on our website.

Over the last 30 years, Cannon Disability has won thousands of disability claims. Additionally, we have won over $100 million in ongoing and past-due SSD disability benefits. It has become more difficult to win Social Security cases. Also, the listing requirements are harder to meet. That is why you need an attorney who focuses on disability law to help you win your case.

We recommend you do not go to your hearing without a representative. 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 typically not successful in winning benefits. You should hire an attorney with experience in disability law. Contact Cannon Disability Law today. We can help you win benefits for Crohn’s disease. Contact us today for your free consultation.

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