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DO I QUALIFY FOR SOCIAL SECURITY DISABILITY BENEFITS IF I HAVE CELIAC DISEASE?

The Social Security Administration (SSA) doesn’t always make it easy for those with celiac disease to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve.  Many claims are denied because SSA says:

(1) You won’t be disabled for at least a year,

(2) Your celiac disease only causes a minimal disruption in your activity and isn’t severe,

(3) Once you have given up gluten-containing foods, you shouldn’t be disabled,

(4) Your celiac disease is not the equivalent of a Medical Listing,

(5) You can return to the lightest job you held in the 15 years before you became disabled, or

(6) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.

Not all cases of celiac disease are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with celiac disease. She works to overcome the claims denial by working closely with you and your physician to show that:

  • Your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.

She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.

WHAT IS CELIAC DISEASE?

Celiac disease, gluten-sensitive enteropathy, is a genetically-linked autoimmune disorder that causes damage to the small intestine. Celiac disease can interfere with the ability of the small intestine to absorb nutrients from food.

WHAT ARE THE SYMPTOMS OF CELIAC DISEASE?

The symptoms of celiac disease are commonly confused with irritable bowel syndrome and lactose intolerance. The symptoms are many, more than 300, including:

  • Iron deficiency;
  • Bone or joint pain;
  • Arthritis;
  • Depression or anxiety;
  • Tingling and numbness in the hands and feet;
  • Seizures; and
  • Mouth sores.

CELIAC DISEASE AND THE LISTING OF IMPAIRMENTS

Celiac disease is not included in the SSA’s “Listing of Impairments,” so you won’t  automatically be awarded benefits. SSA will determine if your celiac disease is severe enough to equal another listing, such as inflammatory bowel disease (IBS) or weight loss due to a digestive disorder.

Your physician will have to submit a medical source statement confirming that your celiac disease impairments and limitations are the equivalent in severity to the listings for IBS or weight loss due to a digestive disorder.

An IBS Listing 5.06 requires that despite treatment you show, in the same six-month period, you have two of the following:

  • The presence of anemia along with a reading of hemoglobin that is less than 10.0 g/dL, and occurring during two evaluations at least 60 days apart.
  • A tender abdominal mass documented by physical examination along with cramping or abdominal pain that is not under control by medication, occurring during two evaluations at least 60 days apart.
  • Weight loss that is 10% less than normal that was documented occurring between two evaluations at least 60 days apart.
  • Supplemental daily nutrition through a tube in your stomach or a central venous catheter.

A weight loss Listing 5.08 requires that you show:

  • A body mass index of less than 17.5 that was present at two evaluations at least 60 days apart within a six-month period.
  • Continued medical treatment as ordered by your physician.

If you don’t equal these listings, SSA then will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.

WHEN YOUR CELIAC DISEASE MAKES IT IMPOSSIBLE TO WORK

If your Celiac disease doesn’t meet a listing, you will have to prove that you:

  • Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
  • There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).

SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your celiac disease.

RESIDUAL FUNCTIONAL CAPACITY FOR CELIAC DISEASE

The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.

SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that will explain:

  • How your abdominal cramps and pain interfere with your ability to focus and work at an acceptable pace,
  • How often you must take unscheduled restroom breaks and how long are you in the restroom at a time,
  • How your symptoms reduce your productivity by 20%,
  • What side effects of medication you have,
  • Whether you have good days and bad days and how many days per month you would miss from work, and
  • Whether you have psychological problems like depression or anxiety that would interfere with your ability to work.

This is not an exhaustive list of all of the questions on a celiac disease RFC form. But you can see that having an explanation of what you can do physically and emotionally is key to winning your case.

Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.

HOW YOUR RESIDUAL FUNCTIONAL CAPACITY IS USED AT A SOCIAL SECURITY HEARING

Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.

At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:

  • Whether you can return to the lightest job you held in the last 15 years,
  • Whether there is other work you can do or could learn to do.

It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.

HOW DO I GET THE SOCIAL SECURITY DISABILITY BENEFITS I DESERVE?

If you can’t work any longer because of celiac disease or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:

  1. File your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits.
  2. Appeal a wrongful denial of your Social Security disability application or Request for Reconsideration.
  3. File an Application for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.

The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by an experienced Social Security Disability attorney like Ms. Cavey.

CONTACT SOCIAL SECURITY DISABILITY ATTORNEY NANCY L. CAVEY, WHO CAN HELP YOU WITH YOUR CELIAC DISEASE CLAIM REGARDLESS OF WHERE YOU LIVE IN FLORIDA

You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits.  Call today for a free consultation at 727-477-3263.

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