Can You be Eligible for Disability if You Have Celiac Disease?

January 22, 2024

Celiac disease is a chronic digestive and immune disorder that damages the small intestine and interferes with nutrient absorption from food. People who have celiac disease cannot tolerate gluten, a protein found in wheat, barley, and rye. The condition can lead to a wide range of symptoms and health issues, including gastrointestinal distress, weight loss, and malnourishment. Due to its impact on an individual’s health and daily functioning, those with severe symptoms may question their eligibility for disability benefits.

Determining eligibility for disability benefits due to celiac disease can be complex. To qualify for benefits like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), an individual must demonstrate that their condition significantly limits their ability to perform substantial gainful activity. The severity of the disease’s symptoms and the resultant complications are key factors in this assessment. For example, if celiac disease leads to long-term damage or other health problems that impair one’s ability to work, applying for disability might be a viable option.

It’s important to understand that not all cases of celiac disease will qualify for disability benefits. The process involves a thorough review of medical documentation and, often, a meticulous legal understanding of eligibility criteria. Those with celiac disease experiencing debilitating symptoms should consult with legal experts or advocates familiar with the nuances of disability law to explore their options and navigate the application process effectively.

Understanding Celiac Disease

Celiac disease is a serious autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. It’s crucial to recognize the signs, understand the diagnosis process, and be aware of the potential long-term health consequences.

Symptoms of Celiac Disease

Symptoms of celiac disease can vary widely and may include gastrointestinal complications such as diarrhea, bloating, and abdominal pain. Non-digestive symptoms are also common and can manifest as anemia, fatigue, and joint pain. It’s important to note that some individuals may experience no symptoms at all, which can make the condition challenging to diagnose without medical intervention.

Diagnosing Celiac Disease

To diagnose celiac disease, healthcare professionals rely on a combination of blood tests and a biopsy of the small intestine. Blood tests look for specific antibodies typically present in people with celiac disease. If the blood tests indicate celiac disease, a biopsy is often performed to confirm the diagnosis by assessing damage to the intestinal villi.

Long-Term Health Effects

If left untreated, celiac disease can lead to various long-term health issues, including osteoporosis, infertility, neurological disorders, and an increased risk of certain types of cancer. Adhering to a strict gluten-free diet is critical for managing the condition and mitigating these risks.

Disability Eligibility Criteria

Eligibility for disability benefits in the context of Celiac Disease hinges on specific criteria set by the Social Security Administration. An individual must meet the legal definition of disability, provide necessary medical documentation, and undergo an assessment of their work capacity.

Legal Definition of Disability

The Social Security Administration (SSA) stipulates that a person must exhibit a medically determinable impairment that results in the inability to engage in any substantial gainful activity (SGA). Specifically, this impairment should be expected to last for a continuous period of at least 12 months or result in death. For individuals with Celiac Disease, the condition must meet Social Security’s strict definition of disability.

Medical Documentation Requirements

Applicants are required to provide comprehensive medical records that support their disability claim. In the case of Celiac Disease, this should include a diagnosis confirmed by blood tests and intestinal biopsy, and a detailed account of how the disease impairs the applicant’s ability to work. Evidence that symptoms remain debilitating despite a strict gluten-free diet is crucial.

Assessing Work Capacity

The SSA evaluates the applicant’s residual functional capacity (RFC), which is what they can do despite their disability. For Celiac Disease sufferers, it examines how the symptoms — such as severe fatigue or gastrointestinal distress — limit their capacity for work. The SSA also considers previous job skills and if they could perform a different job, given their condition.

Celiac Disease and Disability Benefits

Individuals with severe celiac disease may qualify for disability benefits if it significantly impairs their ability to work. The Social Security Administration acknowledges celiac disease in its consideration for benefits, but specific criteria must be met.

Qualifying for Disability Benefits

To qualify for disability benefits due to celiac disease, an individual must demonstrate that the condition has caused severe health complications that prevent them from maintaining gainful employment. The impairments must be medically confirmed and meet the Social Security Administration’s criteria. This typically means that the celiac disease symptoms or related conditions have lasted, or are expected to last, at least one year or result in death.

Applying for Social Security Disability Insurance (SSDI)

When applying for SSDI, individuals must provide comprehensive medical records and evidence confirming the diagnosis of celiac disease. This includes documentation of a strict gluten-free diet adherence and records indicating that symptoms persist despite this diet. If an applicant’s celiac disease symptoms are found to be equivalent in severity to a disability listed in the SSA’s Blue Book, they may be approved for benefits.

Appealing a Disability Benefits Decision

If an application for disability benefits is denied, the decision can be appealed. The appeals process involves several stages, including reconsideration, a hearing by an administrative law judge, review by the Appeals Council, and, if necessary, a Federal Court review. It is important to provide additional evidence or information that may help in reversing the decision, and many individuals choose to consult with an attorney who specializes in disability law for assistance.

If you need help applying for benefits or appealing the fact that your benefits were denied, our attorneys can help. Reach out for a free consultation and tell us more about you and your situation. You don’t need to fight this battle alone!