Gastroparesis and Social Security Disabiilty

Gastroparesis and Social Security Disability Benefits

Gastroparesis, also known as delayed gastric emptying, is a disorder that prevents the body from moving food from the stomach to the small intestine. The effects of gastroparesis can be severe and unpredictable on a day-to-day basis. Because of this, an individual who has gastroparesis may find that their symptoms make it impossible for them to continue working. Fortunately, the Social Security Administration (SSA) offers disability benefits to individuals who have severe health conditions.

If you find that you need to apply for Social Security Disability benefits, the following article will provide you with a general overview of disability benefits and will provide you with the information needed to begin the application process.

Definition of Disability

Social Security Disability benefits are intended to provide financial assistance to individuals with long-term health conditions. Although Gastroparesis is not typically thought of as a disability, applicants with this condition may be able to receive benefits if they meet the SSA's definition of disability.

This definition is as follows:

• The SSA will consider you to be disabled if you cannot do work that you did prior to becoming disabled; and
• You have a physical or mental condition(s) that prevents you from adjusting to different types of work; and
• Your condition has lasted or is expected to last at least one year or result in death.

If you do not meet this definition, it is not likely that you will be approved for benefits. If you do meet this definition, you will be further evaluated based on specific technical and medical requirements.

Disability Benefit Programs

The Social Security Administration governs two different types of federal disability benefits—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program is designed to help different groups of people facing different types of circumstances. For this reason, each program has its own set of technical eligibility requirements.

SSDI is designed to offer benefits to disabled workers and their qualified family members. To qualify, applicants must be under age 65, must meet the SSA's definition of disability, and must have paid a certain amount of Social Security taxes throughout their career. This program is typically the best fit for adults with extensive employment history.

The SSA's second benefit program—SSI—is designed to offer benefits to disabled individuals who earn very little income. To qualify, applicants must meet strict financial limits. Because SSI has no work, tax, or age requirements, it is often the best fit for children or adults who have limited work history.

To learn more about SSDI and SSI eligibility, visit the following page:
http://www.disability-benefits-help.org/disability-tips/difference-between-social-security-disability-insurance-ssdi-and-ssi.

Medical Eligibility

The Social Security Administration maintains a manual of disabling conditions called Disability Evaluation Under Social Security— more commonly referred to as the Blue Book. The Blue Book—published online—contains listings for all potentially disabling conditions. Applicants must meet the specific requirements listed under their condition to qualify for benefits.

Unfortunately, there is no Blue Book listing for gastroparesis. Although this can make it slightly more difficult to qualify for benefits, it does not make it impossible.

First, you should consult the Blue Book to see if you meet the requirements of a related condition or listing. These may include the following:

• Section 5.06 - Inflammatory Bowel Disease
• Section 5.08 - Weight Loss due to any Digestive Disorder
• Section 9.00 - Endocrine Disorders
• Section 11.00 - Neurological Disorders
• Section 14.00 - Immune Disorders

If you can prove, using medical documentation, that your gastroparesis matches the symptoms and severity of a separate condition, you may qualify for disability benefits.

View all Blue Book listings, here: http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm.

It is important to note that applicants should inform the SSA of any and all health conditions that they have. This means that if your gastroparesis is caused by an overlying condition or you have another serious condition in addition to gastroparesis, you should inform the SSA. This is due to the fact that the SSA will evaluate you based on the combined effects of all conditions that you may have. For example, someone with gastroparesis may have their application denied. However, if the same person has diabetes and gastroparesis, their claim may stand a better chance of approval.

Medical-Vocational Allowance

If you do not meet any Blue Book listings, you may still be able to qualify under a medical vocational allowance.

To do so, you will be evaluated based on your ability to perform work related. You will be given a Residual Functionality Capacity (RFC) assessment, which will determine what types of work you can be expected to do. Depending on the results of your RFC, along with your age and education, you will either be awarded benefits or recommended for another line of work.

Beginning Your Application

Prior to beginning the application process, you should collect extensive medical and non-medical documentation to support your claim. Medical documentation serves as proof of your illness or disability. Without it, the SSA will likely deny your claim for disability benefits. Work with a doctor to collect copies of the following:

• Record of your diagnosis
• A history of hospitalizations and/or medical appointments
• The findings of physical and mental examinations
• A history of any treatments you've received and your body's response to these treatments
• Lab results
• A written statement from your doctor outlining your condition and the limitations that it causes you
• Non- medical documentation should include financial records, employment records, and various forms of identification.

Before submitting your application, consult the SSA's checklist to make sure that you have all necessary records and information. http://www.socialsecurity.gov/disability/Documents/Checklist%20-%20Adult.pdf

Once you are ready to begin your application—which consists of several forms—you can do so on the SSA's website or in person at your local Social Security office. Be sure to answer all questions completely and accurately. Your application should provide the SSA with an understanding of your condition and the daily limitations that it causes. Any missing or inconsistent information could cause your application to be delayed or even denied.

Receiving a Decision

The standard application is processed within three to four months; though, many applications can take much longer to process. In the event your claim is denied, you may appeal the decision. The appeal can be initiated online and should be done as soon as possible. If you do not file your appeal within 60 days of receiving your notice of denial, you will have to start the application process all over again.

Although it can be discouraging to receive a denial, the appeals process is your chance to correct any mistakes and provide further medical evidence to back up your claim. It is important to note that many more applicants are approved during the appeals processes than during the initial application.

For more information regarding Social Security Disability benefits, visit the Social Security Disability Help blog (http://www.disability-benefits-help.org/blog) or contact Ram Meyyappan at ram@ssd-help.org.