Applying for Social Security Disability Benefits with Bowel Incontinence
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 18 million Americans suffer from bowel incontinence, which is the inability to hold in a bowel movement or to leak out of the rectum without knowing.
There are many causes of bowel incontinence that affect adults of all ages.
If you have a bowel incontinence and it's interfering with your ability to work, the Social Security Administration (SSA) may be able to help you. The SSA has two benefit programs to help you support yourself with the burden of a disability.
The Financial Costs of Bowel Incontinence
Bowel incontinence costs each individual an additional $4,110 per year, according to a study done by the University of Michigan. About $2,353 was spent on direct medical and non-medical costs, like treatment and transportation, and $1,549 was due to lost productivity.
In another study presented at the American Society of Colon and Rectal Surgeons, the cost per patient was found to be much higher when treatments like surgery or biofeedback were used, at about $17,166, with follow-up care costing $65,412.
While many patients can manage their bowel incontinence with the variety of therapies offered to help gain control over bowel movements, some require surgery. Between 1998 and 2003, about 3,500 surgeries were done that cost almost $34 million in total (in 2012 dollars), the American Gastroenterological Association reported.
Medically Qualifying for Benefits with the Blue Book
When the SSA receives a disability claim, they evaluate it to determine if it meets their threshold for benefits. The Blue Book is their official listing of medical impairments.
If the medical requirements are met or equaled for a condition, the applicant will automatically qualify for disability benefits.
Bowel incontinence doesn't have a specific listing, but if your condition doesn't respond to treatment, you may apply under:
- Section 1.00—Musculoskeletal System
- Disorders of the spine, resulting in the compromise of the nerve root or spinal cord, with compression of the root nerve that causes muscle weakness.
- Soft tissue injury of the trunk, that is undergoing surgery to restore function, but normal function either isn't expected to be reported within 12 months or at all.
- Section 5.00—Digestive System
- Inflammatory Bowel Disease, with obstruction in the small intestine or colon, anemia, low serum albumin levels, a medically documented abdominal mass, Crohn's disease, involuntary weight loss, or the need to get daily nutrition via a central venous catheter.
- Bowel incontinence, which is unlisted, but the SSA will consider your symptoms and limitations to determine if they equal a medical listing.
- Section 11.00—Neurological Disorders
- Peripheral neuropathies, which affects the ability of the muscles in your rectum to correctly contract.
If you think your bowel incontinence is severe enough that you can't work, talk to your doctor.
Qualifying Without Meeting a Medical Listing
The SSA also approves applicants based on a medical-vocational allowance, by determining your Residual Functioning Capacity (RFC). In order to qualify for an RFC, your disability must be expected to last for a year or longer.
Also, you must be unable to earn the SSA's 2016 minimum monthly salary of $1,130.
Using their grid rules the SSA looks at the limitations caused by your bowel incontinence and puts you in a level of work (sedentary, light, medium, heavy, and very heavy). Then it looks at your education and work history to find jobs you available that you can do with little or no training, depending on your age.
If you have bowel incontinence, common symptoms are diarrhea, constipation, gas, bloating, leaking, the inability to hold in your stool and/or know when you need to make a bowel movement.
The constant need to use the bathroom or pain of constipation, coupled with psychological side effects, like fear and shame, can make working or even performing some normal living activities difficult.
Those who have work in high stakes jobs that are hard to take breaks from, like nursing, construction, or retail, or who don't have a college degree may have a higher chance of being approved than someone who graduated from college and worked in a sedentary job for most of their lives.
How to Apply for Social Security Disability Benefits
Applying for disability benefits can be a very long process with multiple appeals that may not even result in an approval, because only about 30 percent of applicants are approved. Many who are qualify don't start receiving benefits until two years after they applied. Because of this, it's important to talk to your doctor before you submit a claim for benefits.
If your doctor doesn't think you're likely to approved, the application may not be worth the time and effort.
If you meet a Blue Book listing or you're applying with an RFC, make sure to include all of the necessary medical evidence. The number one reason eligible applicants are denied is because they're missing key information in their claim.
Important medical evidence may include:
- Digital rectal exam, to check the strength of your sphincter muscles and look for any rectal abnormalities.
- Balloon expulsion test, to check on your ability to defecate.
- Anal manometry, to measure the tightness of your sphincter and the sensitivity and functioning of your rectum.
- Anorectal ultrasonography, to produce images to see the structure of your sphincter.
- Proctography, which X-rays your rectum while defecating to determine how much stool it can hold and how well your body defecates.
- Proctosigmoidosopy, to determine if there is inflammation, scar tissue, or tumors in your colon.
- Colonoscopy, to inspect your colon.
- Anal EMG, to check your pelvis floor muscles and their nerves.
- MRI and other imaging to view the sphincter muscles and determine if they're intact.
- A detailed statement from your doctor describing your condition, symptoms, and limitations.
- Reports of any prescribed treatments, operations, hospitalizations, or other medical information related to your bowel incontinence.
Most applications will be for Social Security Disability Insurance (SSDI) and you can apply either at your local SSA office or online at the SSA's website. If you're applying for Supplementary Security Income (SSI), you'll need to make an appointment at an SSA office.
Before you submit the application, look it over to check for any typos, misspellings, or missing information. Small mistakes can cause your application to be delayed or denied. Check the SSA's website for a complete list of documents needed for the claim.
After you apply, if there are any chances in your bowel incontinence symptoms, severity, or treatment, you must inform the SSA immediately. Changes in your condition could help you get approved or hasten a pending approval.
If you’re approved for benefits, your spouse and children may also be eligible for benefits. To learn more about the different forms about disability benefits, visit our pages on Social Security Disability Insurance.