May 7, 2014

Social Security Disability Benefits for Pancreatitis

The pancreas is a large gland located behind the stomach.  It is part of the endocrine and nervous systems.  The pancreas produces many important hormones that circulate in the blood.  It also produces digestive enzymes that help break down food.  Pancreatitis occurs when the pancreas becomes inflamed.  Damage to the pancreas can occur when pancreatic enzymes activate before they are secreted.   There are two main types of pancreatitis:

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  • Acute pancreatitis happens over a very short period of time.  This type of pancreatitis is usually caused by gallstones or heavy drinking.  Symptoms may include:
    • Fever
    • Nausea/vomiting
    • Upper abdominal pain/swollen or tender abdomen
    • Increased heart rate
  • Chronic pancreatitis usually results after a case of acute pancreatitis.  Chronic pancreatitis can ultimately stem from gallstones, hereditary disorders, cystic fibrosis, certain medicine, or heavy alcohol use.  Symptoms may include:
    • Any symptoms of acute pancreatitis
    • Weight loss
    • Diabetes

In order to be eligible for Social Security disability benefits, you must have a disability that has lasted at least twelve months, is expected to last at least twelve months, or is expected to end in death.  If you have chronic pancreatitis, you may be eligible for Social Security disability benefits if you can show that your condition is disabling according to Social Security’s rules.

One of the first things you must do in a Social Security disability claim is to show that you have a “medically determinable impairment.”  In other words, your condition must be diagnosed using acceptable medical clinical or laboratory techniques.  It is important to see a specialized physician such as a gastroenterologist or endocrinologist if you are diagnosed with pancreatitis.  Not only will a specialist be most likely to accurately diagnose and treat your condition, medical records from a specialized physician are likely to be given more weight by Social Security’s disability evaluators than records from a primary care doctor.  The following tests can also help document the severity of your chronic pancreatitis: 

  • CT Scan
  • Ultrasound
  • Pancreatic function test
  • Glucose tolerance test
  • Endoscopic ultrasound and biopsy

In its Listing of Impairments, the Social Security Administration (SSA) has a few listings that address the symptoms of pancreatitis.  Section 9.00 – Endocrine Disorders discusses pancreatic gland disorders, especially diabetes.  If you have diabetes related to your chronic pancreatitis, Section 9.00 (B)(5) explains how Social Security evaluates your condition.  Since chronic pancreatitis may lead to severe weight loss, Section 5.08 – Weight Loss Due to any Digestive Disorder may apply as well.

If your symptoms from chronic pancreatitis do not meet either of these listings, the SSA will look at your residual functional capacity (RFC) to determine whether your condition prevents you from being able to work.  The Social Security Administration evaluates your ability to work by assessing whether you can work an 8-hour day, 5 days a week on a continuing basis.  The opinion of your treating physician can be helpful in showing how limited your abilities are.  I send my clients questionnaires to take to their doctors.  These forms have questions about the patient’s ability to sit, stand, or walk for extended periods of time.  They also ask about postural limitations and whether the patient can use his or her hands effectively.  If my client’s doctor indicates on the questionnaire that the claimant cannot perform all these activities for an eight-hour day, we can make a case to the SSA that the client’s RFC is too low for him or her to be able to work.

The application and appeals process for Social Security disability benefits can be a long and tiring one.  Some claimants find it helpful to seek guidance from someone with experience in that process.  You can call your local Social Security office for questions you have regarding the claims process, but you may want to think about looking for representation to help you with your appeal.  Most qualified representatives and attorneys offer a free consultation if you are thinking about applying or are currently going through the claims process for Social Security disability benefits.

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