Does Diverticulitis Qualify for Social Security Disability?
Yes but it depends. There are normally 2 ways to be approved. One way is by meeting the requirements of SSA's Blue Book Medical Listing. The other way is by proving through a residual functional capacity that you cannot do your past work and that you cannot transition to any other kinds of work.
Blue Book Medical Listing
Since diverticulitis is common condition and normally responds well to treatment, it does not have a listing in SSA's Blue Book. The closest condition to diverticulitis that is listed in the Blue Book is Inflammatory Bowel Disease (IBD). The symptoms of your diverticulitis can be compared to IBD to gain approval. You can find the requirements in section 5.06 of the Blue Book. Since diverticulitis does not have its own blue book listing, you will have to prove to the Disability Determination Services with concrete medical evidence that you are unable to continue working because of the severity of your condition. The conditions that SSA will look at for basing a disability on IBD are:
Chronic anemia with a hemoglobin of 10 g/dL or lower that has been tested two times within a two-month timeframe.
Serious abdominal pain that is not controlled with narcotic pain relievers. This must be tested two months apart on at least two separate occasions.
Documentation by medical imaging, such as a CT scan, that shows your condition.
A draining abscess or fistula.
Involuntary loss of weight that is significant or extreme.
Requirement of a catheter to meet nutritional needs.
Bowel obstructions requiring hospitalization at least two times in a six-month period. These hospitalizations must be at least two months apart.
Being Approved through a Residual Functional Capacity
Just because you may not meet the requirements of SSA's blue book listing doesnt mean you cannot get approved. There is another way! You can still get approved through a residual functional capacity (RFC) and/or the medical vocational allowance, also known as the GRID rules. This approach, is the most common, and you have to prove that you cannot return to your past work, and that you cannot transition to a any other work either. You can have your treating physician complete an RFC form, because your treating doctor has not only treated you on multiple occasions but they know more about your limitations and restrictions. For example, if your diverticulitis causes frequent blood loss, you may experience fatigue and weakness. Your doctor would then state that in their RFC form. Or maybe you have difficulty with bending, lifting, or carrying anything heavy, that can be documented in an RFC as well. Maybe you may have to frequently reposition yourself throughout the day because of abdominal pain, and that can impact your ability to work as well.
The medical vocational allowance, also known as the GRID rules, normally apply to individuals who are ages 50 and older. Under the GRID rules, SSA will consider your work experience, educational level, age, and whether you have any transferable skills to see if your condition would allow you to do other kinds of work. If your diverticulitis has impacted your energy levels, causes severe pain, and results in frequent bathroom visits, you wouldn’t be able to perform any kind of work and if you can prove all this, you could win your social security disability case.