ULCERATIVE COLITIS & SSD BENEFITS
WHAT IS ULCERATIVE COLITIS?
Ulcerative colitis is a bowel disease that causes ulcers in the large intestine and also the colon. These ulcers or sores cause the colon to become thick and scarred. Because the colon is damaged it cannot properly absorb water. Also, it cannot absorb electrolytes from the food passing through the organ as stool. Additionally, the ulcers produce pus and mucous which cause pain and the need to frequently go to the bathroom.
Men and women both get ulcerative colitis equally. Also, it can effect people of any racial group. However, a recent study found significant differences in ulcerative colitis among different racial groups. White people have a rate of irritable bowel syndrome (IBS) that is 7 times higher than Black people. Also, White people are 6 times higher than Hispanics and 21 times higher than Asian Americans, to have the disease. IBS includes Crohn’s disease and ulcerative colitis.
If you have a first degree relative with the disease, then your risk of developing ulcerative colitis is between 2 percent and 30 percent. The National Institute of Health estimates there are 1 million people in the US who suffer from ulcerative colitis.
People with ulcerative colitis experience serious medical problems. For example, the disease can cause colon rupture, colon cancer, and anal abscesses. It is similar to Crohn’s disease. Severe symptoms of colitis can significantly interfere with your activities of daily living and ability to work. If you cannot work for at least one year because of the disease, then you should file an application for SSD benefits.
WHAT CAUSES ULCERATIVE COLITIS?
The cause of ulcerative colitis is not known. However, it could be the result of several factors. These factors include an abnormal immune response, genes, and environmental factors.
Research suggests that ulcerative colitis could be triggered by an interaction between a virus or bacterial infection in the colon. A normal immune response would cause temporary inflammation to fight an infection. The inflammation would then go away once the infection stops.
However, in people who have ulcerative colitis, the inflammation lasts long after the immune system is done fighting the infection. The body continues to send white blood cells into the lining of the intestines, which causes ulcers.
Genetics also appear to play a role. People who have a close family member with ulcerative colitis are more likely to develop the condition themselves. Researchers have identified several genes that may increase your risk. Although having these genes does not guarantee that you will develop the disease.
Environmental factors may also contribute to the development of ulcerative colitis. While researches have not found a single environmental cause, they continue to study factors such as infections, changes in gut bacteria, diet, stress, and exposure to substances. These factors do not directly cause ulcerative colitis, but they may trigger the disease in people who are already at risk.
Another area of research focuses on the gut microbiome, which is the community of bacteria that normally live in the digestive tract. Changes in the balance of these bacteria may affect how the immune system functions. Therefore, it could play a role in the development of ulcerative colitis.
THE SYMPTOMS OF ULCERATIVE COLITIS
Ulcerative colitis causes the immune system to attack the tissue in your rectum or colon. The main symptom of the disease is bloody diarrhea, with pain and cramps. You may also experience urgency in bowel movements. Unfortunately, this can lead to not making it to the bathroom in time. Also, you will experience fatigue and possibly weight loss.
Additional symptoms can include fever, nausea, and loss of appetite. Managing the disease involves a treatment program. You will need to take medication and adjust your diet to help your symptoms. The symptoms of the disease can be hard to control. Therefore, you must follow your treatment plan.
The SSA always looks to see if you are doing what the doctor told you to do. For example, if your doctor tells you to start a special diet because of your colitis, then your records need to show that you have done so. If you give up on the diet after a few weeks, then the SSA will say that you are not complying with treatment and deny your case.
Additionally, if your doctor asks you to take certain medication, then you need to try it. If the medication doesn’t work, you can’t quit going to the doctor and claim there is nothing they can do for you. You have to try a different medication or a different treatment. If you aren’t activity trying to improve your symptoms, then the SSA can deny your benefits.
TREATMENT FOR ULCERATIVE COLITIS
The treatment for ulcerative colitis centers around controlling your symptoms and healing your gut. Medications are the main way to do this. Drugs lessen inflammation in the colon and keep the disease under control. Steroids might be given to you to quickly reduce inflammation. But steroids are not usually used for a long time because of negative side effects.
Medications are the most common treatment for ulcerative colitis. Several types of drugs may be used to keep the disease under control. The type of medication you get depends on how severe your symptoms are. Additionally, some medications are used to treat active symptoms, while others are used to prevent future flare ups.
Doctors may also prescribe steroids to quickly control symptoms during a flare up. Steroids can be very effective, but they are usually not used for long periods because they can cause serious side effects. Once symptoms improve, other medications are often used to keep the disease under control.
Besides medication, making changes in your lifestyle can also help. This might involve changing your diet. For example, avoid foods that make your symptoms worse. Or, try to eat foods that are easier on your stomach. Finding ways to manage stress is also helpful. For example, if your symptoms are causing you to feel anxiety, then talk to a therapist.
Surgery is also a treatment. About 1 in 5 ulcerative colitis patients require total colectomy. This is the surgical removal of the colon and rectum. Then, the lower end of the small intestine is made into a pouch that serves as a rectum. For most people, the surgery successfully manages their symptoms.
MEETING LISTING 5.06 FOR ULCERATIVE COLITIS
When you file an application for SSD benefits, the SSA will use their listing of medical conditions or the Blue Book. They will use listing 5.06 and compare it to your medical records. In order to meet this listing, you must have medical records that document all of the symptoms in the listing.
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, that requires a hospital stay 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 pain or cramps that are not completely controlled by 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.
MEETING LISTING 5.08 FOR WEIGHT LOSS
If ulcerative colitis has caused you to lose a significant amount of weight, then you may qualify for benefits under listing 5.08 for weight loss. Your medical records will need to show that you have a body mass index (BMI) of less than 17.5 on two occasions at least 60 days apart within a consecutive twelve month period. Simply telling the judge in court that you lost weight due to your disease will not help you meet this listing. Your medical records must show your weight loss. When you visit the doctor, make sure they document your weight in your progress notes.
ULCERATIVE COLITIS MAY PREVENT YOU FROM WORKING
The SSA listing is about ulcerative colitis 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. 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 your job. If you have a desk job, then perhaps your employer will allow those extra breaks. However, if you work in a factory, then chances are you cannot take extra breaks during work day.
If you have ulcerative colitis, but your symptoms do not meet or equal listing 5.06, then it is still possible to win benefits. You can win by proving you cannot perform your past work or any other work.
You can prove your condition prevents you from working by having your treating doctor write a statement that you can’t work. The medical opinion of your treating doctor matters to the SSA. Your RFC can prove to the SSA that you cannot work.
APPLY FOR SSDI & SSI BENEFITS FOR ULCERATIVE COLITIS
If you have ulcerative colitis, then there are two types of benefits you can file for under the Social Security program: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. In order to receive benefits, you must first file an application. You can do this on Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you have SBS:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who have worked and paid into the SSD system. To apply, you must be no longer able work due to a severe medical condition. Additionally, your medical conditions must be expected to last longer than one year. The amount of money you will receive from SSDI benefits is based on how much Social Security tax you have paid during your work history. To qualify for SSDI, you must have earned enough work credits.
A work credit is an amount of taxable income. If you don’t have enough, then you can earn quarters of coverage by working. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits at the time you apply, then you may qualify for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit. It is for people with little to no income, such as children and the elderly. Anyone who has a large amount of money saved cannot receive SSI benefits. To qualify for SSI, you must meet strict income and asset limits set by the Social Security Administration (SSA). The SSA counts the income of those in your house, not just your income.
For example, if your spouse earns $5,000 per month, that prevents you from getting SSI benefits, even if you have no income of your own. Likewise, having too much money in savings, investments, or other assets can prevent you from getting paid SSI benefits.
It is important to understand that SSI has both medical and financial requirements. Even if your ulcerative colitis causes severe symptoms that limit your ability to work, you must still meet the income and asset limits before benefits you can get SSI benefits.
Because SSI benefits are based on financial need, many people who have a disability are denied benefits because their income or resources exceed the program limits. For this reason, it is important to review both the medical and financial requirements before filing an application. You cannot qualify for SSI benefits, no matter how severe your ulcerative colitis, if you do not meet the income and asset rules for SSI.
WHAT WE DO TO HELP YOU WIN SSDI AND SSI BENEFITS
If you have ulcerative colitis, then you need help to apply for Social Security benefits. You can call our law firm and we will help you. We can help you file your application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSDI and SSI benefits
- Inform the SSA they should pay your benefits under the Compassionate Allowance Rules
- Appeal if you receive an initial denial
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge
- Prepare you to testify at your SSA hearing
- Represent you at your hearing and question the witnesses
- Refute job expert testimony
- Explain medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits on Social Security’s website, then you have 6 months to complete it. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you don’t send it back, the SSA will not process your application. Sign it and send it back as soon as you can.
HOW WILL YOU PAY FOR AN ATTORNEY?
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 SSD 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 you case, then you pay out of your past due 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. And, 25% of your back benefit is usually less than the $9200 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. Those costs include paying the doctor or copy service for your medical records. Records usually cost less than $100. However, your attorney fees come from your back benefit. But, you only pay an attorney fee if we win your case.
WE CAN HELP YOU WIN BENEFITS FOR ULCERATIVE COLITIS
At our SSD law firm, we help you apply for SSD benefits if you cannot work due to ulcerative colitis. However, you need to be unable to work for over one year in order to win SSD 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 your past due Social Security benefits. When you file your application, the appeal process can take so long 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 SSDI and SSI cases for our clients. You can trust we will do everything we can to win your SSDI and SSI benefits.
