A digestive disorder often seen in combination with other serious medical conditions like diabetes, gastroparesis can cause a range of symptoms including metabolic issues, weight loss, nausea, and GERD. Even when the disorder occurs alone, symptoms can be so severe that they make it difficult or impossible to work. When this pronounced, gastroparesis can qualify for Social Security Disability (SSD) benefits.
Medically Qualifying with Gastroparesis
Applications for disability are reviewed against listings in the Blue Book, which contains recognized disabilities and medical qualification and documentation criteria for providing severity level. While there is no listing for gastroparesis, there are a couple of listings that can apply to your claim.
The first is detailed in Section 5.08 and deals with severe weight loss due to any digestive disorder. This listing requires:
- a body mass index (BMI) at or below 17.50,
- documented on two separate occasions that are at least 60 days apart.
The two recorded incidents must additionally occur within a consecutive six-month period in order to meet this listing.
Even if you are unable to meet this listing exactly, you may still be able to get benefits in one of three ways:
- matching a listing in terms of severity
- meeting or matching another listed condition
- qualifying through a residual functional capacity (RFC) analysis
You may match the listing for severe weight loss in Section 5.08, even if your BMI falls below 17.50 outside the prescribed timeframe, and matching a listing is sufficient to qualify for benefits.
If you have a concurrent medical condition, like diabetes, you may qualify under a different listing. Diabetes appears in the Blue Book under Section 9.00.5. To meet the listing, your diabetes must be uncontrolled despite following prescribed therapies and must result in severe complications.
It is important to understand the Social Security Administration (SSA) will also take into account the affects of all your medical conditions, which means that even if you are unable to meet or match a listing in the Blue Book, they will still consider your symptoms and limitations through what is known as a residual functional capacity (RFC) analysis.
During the RFC analysis, the SSA reviews how your gastroparesis and any other concurrent medical conditions affect your ability to complete everyday tasks, including typical job functions. If the analysis shows you are severely limited and unable to maintain gainful employment, then you will receive SSD benefits.
Getting Help with Your Claim
Because there is no listing for gastroparesis, and because many who suffer from the condition are still able to maintain employment, getting benefits with the condition can be challenging. Having the help of a Social Security attorney or advocate may increase your chances and can certainly make navigating the application and review processes simpler.
It’s likely your application will initially be denied, even if your medical evidence and other documentation is very thorough. You can request a second review and provide additional supporting evidence. You can also appeal the decision, if you are denied a second time. An advocate or attorney can support you throughout these processes by helping you build a stronger claim, and potentially increasing your chances of a favorable decision in the end.