Digestive Disorders

Navigating Digestive Disorders and Presenting Evidence for Disability Insurance Claims

Digestive disorders encompass a wide range of conditions that can significantly impact an individual’s ability to work full time. These disorders can cause symptoms such as chronic pain, gastrointestinal dysfunction, and nutritional deficiencies, making it challenging to perform job-related tasks. When filing disability insurance claims for digestive disorders, providing compelling evidence is essential. 

Common Digestive Disorders Requiring Disability Insurance Claims:

1. Inflammatory Bowel Disease (IBD): IBD, including Crohn’s disease and ulcerative colitis, involves chronic inflammation of the gastrointestinal tract. Symptoms may include severe abdominal pain, diarrhea, fatigue, and malnutrition. The unpredictable nature of flare-ups and the impact on overall health can significantly restrict an individual’s ability to maintain full-time work.
2. Irritable Bowel Syndrome (IBS): IBS is a functional disorder of the digestive system, characterized by symptoms such as abdominal pain, bloating, diarrhea, and constipation. The unpredictable nature of IBS symptoms can lead to frequent absences from work, decreased productivity, and difficulty maintaining a consistent work schedule.
3. Gastroesophageal Reflux Disease (GERD): GERD is a chronic condition caused by the abnormal reflux of stomach acid into the esophagus. It can result in symptoms such as heartburn, regurgitation, chest pain, and difficulty swallowing. These symptoms can interfere with productivity and limit an individual’s ability to perform physically demanding tasks.
4. Celiac Disease: Celiac disease is an autoimmune disorder triggered by the ingestion of gluten. It damages the small intestine, leading to malabsorption of nutrients and various gastrointestinal symptoms. Individuals with celiac disease may experience chronic fatigue, abdominal pain, diarrhea, and nutrient deficiencies, making it challenging to sustain full-time work.
5. Gastroparesis: Gastroparesis is a condition characterized by delayed emptying of the stomach, resulting in symptoms such as nausea, vomiting, bloating, and early satiety. These symptoms can significantly impact an individual’s ability to maintain regular eating patterns, leading to malnutrition and decreased energy levels necessary for full-time work.

Providing Evidence for Work Restrictions:

1. Medical Documentation: Gather comprehensive medical records, including a formal diagnosis of the digestive disorder, treatment plans, and specialist reports. These documents provide evidence of your condition and ongoing medical management.
2. Specialist Reports: Include reports from gastroenterologists or other healthcare professionals specialized in managing digestive disorders. These reports should outline the nature and severity of your symptoms, treatment strategies, and their professional opinion on the impact of the condition on your ability to work.
3. Medication and Treatment Records: Maintain records of prescribed medications, dietary modifications, and other treatments related to your digestive disorder. These records demonstrate the need for ongoing medical management and highlight the impact of the condition on your ability to function optimally.
4. Functional Assessment: Undergo a functional assessment conducted by an occupational therapist or other healthcare professional. This assessment evaluates your abilities and limitations related to work tasks, considering the impact of your digestive disorder. The resulting report can provide objective evidence of functional impairments and their impact on work performance.
5. Work Absence and Accommodation History: Maintain a record of work absences, accommodations requested, or modifications made to your work environment due to your digestive disorder. This history showcases the challenges you face in meeting work expectations and the efforts made to accommodate your condition.
6. Diet and Nutrition Reports: If your digestive disorder requires dietary modifications or nutritional supplementation, include reports from dieticians or nutritionists detailing the recommended dietary restrictions, special dietary needs, and any associated complications. These reports further support your claim for work restrictions.
7. Personal Statement and Impact Statement: Prepare a detailed personal statement describing your experience with the digestive disorder, the specific symptoms you face, and how they restrict your ability to perform work-related tasks. Include an impact statement outlining the limitations, restrictions, and challenges you encounter in the workplace due to your condition. Consider keeping a symptom diary as well to record how your symptoms affect your daily life.
8. Legal Assistance: Consider consulting with an attorney specializing in disability insurance claims. We can provide guidance on presenting evidence effectively, protect your rights throughout the claims process, and advocate for your case.

Legal Assistance for Digestive Disorders Claims

Digestive disorders can be a basis for a claim for disability. Courts do not seem to award benefits for these claims alone as often as they do for other disorders, however. In Watson v. Metro. Life Ins. Co., No. CV-11-01393-PHX-GMS, 2012 WL 5464986, at *19 (D. Ariz. Nov. 8, 2012), the court held that the insured’s Crohn’s disease caused discomfort, but no limitations on work. The court reached a similar conclusion in Perez v. Lincoln Nat’l Life Ins. Co., No. 218CV07422CASJCX, 2019 WL 4673216, at *1 (C.D. Cal. Sept. 25, 2019), aff’d, 843 F. App’x 57 (9th Cir. 2021), where the insured had a sedentary job and a non-specific digestive disorder causing abdominal pain and constant diarrhea. Claims involving digestive disorders are more often awarded benefits when the digestive issue is one of multiple disabilities.