Gastroesophageal reflux disease (GERD) is a digestive disorder that affects close to 20 million Americans. GERD involves chronic acid reflux that causes heartburn, chest pain, and other serious symptoms. While some people can manage their symptoms on their own, many of those suffering with GERD are unable to work due to life-long complications. These people may be able to receive Social Security Disability (SSD) benefits for their suffering.
Recovering benefits is difficult. For help getting Social Security disability for gastroesophageal reflux disease (GERD) in Pittsburgh, call Berger and Green today: 412-661-1400.
How can I get benefits?
The Social Security Administration (SSA) will consider certain criteria when determining whether someone qualifies for Social Security Disability benefits.
First, the SSA will consider:
- Whether you are currently working
- Whether you are eligible for SSDI
- Whether you are eligible for SSI
Current Employment Status
If you are not working, Disability Determination Services will look at your application and determine whether your medical condition renders you disabled. If you are working and earning more than $1,170 every month, the SSA will likely consider you not disabled, and therefore, ineligible for benefits.
There are two disability programs in the United States: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Insurance (SSI) program.
To be eligible for benefits through the SSDI program, a claimant will need to have earned a certain number of work credits. Workers collect work credits by working for multiple years and contributing to the Social Security system through taxes. The number of work credits you need will depend on your age.
Some workers do not have enough work credits to qualify for SSDI. However, they may qualify for SSI instead. SSI is a need-based program, requiring low income and low assets.
If you earn less than the maximum allowed and you have been unable to work for the past 12 months, you may be eligible for disability benefits.
Once the SSA has determined your eligibility for either program, it will focus on your medical condition itself.
Qualifying for Disability Benefits with GERD
The SSA keeps a list of impairments and the severity criteria for each that a claimant must meet for the SSA to deem him/her disabled.
While GERD is a serious condition, it does not have its own listing in the Blue Book and will typically not qualify for benefits on its own. However, certain complications and conditions related to GERD could qualify including:
To ensure that your medical records align with the SSA requirements, you should have your doctor refer to the Blue Book when documenting your condition.
What if I do not qualify for benefits under the Blue Book listing?
Many people with GERD complications do not get approval for benefits based on the SSA’s initial review of a Blue Book listing. Instead, they must qualify based on other criteria. The SSA will often evaluate their condition based on a Residual Functional Capacity (RFC) evaluation.
A RFC evaluation allows the SSA to determine whether your condition is severe enough to keep you from working. The evaluation will consider:
- Whether your complications of GERD limit your daily activities
- Whether your complications of GERD prevent you from working a job you would normally be qualified for
- Whether you are able to do work that you previously did
- The complications and symptoms of your GERD
- How long GERD complications have been affecting you (minimum of 12 months)
The SSA will consider your age, education, and work experience to determine whether you are employable. You can have your doctor, family, and friends to fill out questionnaires to address the issues your GERD causes.
If you can prove that your GERD is severe enough to keep you out of work for a minimum of 12 months, you may be able to qualify for medical benefits.
What evidence do I need?
When you apply for disability benefits, you must support your case with medical evidence. The evidence you provide will depend on whether you qualify for benefits under a Blue Book listing or whether you are trying to qualify by RFC evaluation.
Some examples of medical records and documentation you may want to include are:
- Hospitalization records
- Surgical records
- Medical test records
- Records of medications taken and their effects
- Treatment records
- Endoscopy results
- Statement from your doctor regarding your prognosis
When it comes to complications of GERD, you will need to show that your symptoms have not responded to treatment and that your symptoms have worsened over time. You will need to show that the complications of your condition limit your ability to work and participate in daily activities.
Many people who have GERD can manage their condition with the right diet and medication. Because of this, you may have a more difficult time qualifying for benefits than with other conditions. This means a denial is a very real possibility, but you should not lose hope.
Recovering disability benefits for complications of GERD is difficult, but it is not impossible. With a dedicated, knowledge team, you can get the benefits you need.
For a free consultation with the disability attorneys at Berger and Green, call 412-661-1400.