Representing Disabled Clients for Over 25 Years

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Donald H. Peters

248-549-3485

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How do we evaluate impairments that do not meet one of the digestive disorder listings?

  1. These listings are only examples of common digestive disorders that we consider severe enough to result in marked and severe functional limitations. If your impairment(s) does not meet the criteria of any of these listings, we must also consider whether you have an impairment(s) that satisfies the criteria of a listing in another body system.

    For example:

    1. If you have hepatitis B or C and you are depressed, we will evaluate your impairment under 112.04.

    2. If you have multiple congenital abnormalities, we will evaluate your impairment(s) under the criteria in the listings for impairments that affect multiple body systems (110.00) or the criteria of listings in other affected body systems.
    3. If you have digestive disorders that interfere with intake, digestion, or absorption of nutrition, and result in a reduction in your rate of growth, and your impairment does not satisfy the criteria in the malnutrition listing (105.08), we will evaluate your impairment under the growth impairment listings (100.00).
  2. If you have a severe medically determinable impairment(s) that does not meet a listing, we will determine whether your impairment(s) medically equals a listing. (See §416.926.) If your impairment(s) does not meet or medically equal a listing, you may or may not have an impairment(s) that functionally equals the listings. (See §416.926a.) When we decide whether you continue to be disabled, we use the rules in §416.994a.

Gastrointestinal hemorrhaging from any cause, requiring blood transfusion

(With or without hospitalization) of at least 10 cc of blood/kg of body weight, and occurring at least three times during a consecutive 6-month period. The transfusions must be at least 30 days apart within the 6-month period. Consider under a disability for 1 year following the last documented transfusion; thereafter, evaluate the residual impairment(s).

Chronic liver disease, with:

  1. Hemorrhaging from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy, demonstrated by endoscopy, x-ray, or other appropriate medically acceptable imaging, resulting in hemodynamic instability as defined in 105.00D5, and requiring hospitalization for transfusion of at least 10 cc of blood/kg of body weight. Consider under a disability for 1 year following the last documented transfusion; thereafter, evaluate the residual impairment(s).
  2. OR

  3. Ascites or hydrothorax not attributable to other causes, despite continuing treatment as prescribed, present on at least two evaluations at least 60 days apart within a consecutive 6-month period. Each evaluation must be documented by:
    1. Paracentesis or thoracentesis; or
    2. Appropriate medically acceptable imaging or physical examination and one of the following:
      1. Serum albumin of 3.0 g/dL or less; or
      2. International Normalized Ratio (INR) of at least 1.5.
  4. OR

  5. Spontaneous bacterial peritonitis with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3.
  6. OR

  7. Hepatorenal syndrome as described in 105.00D8, with one of the following:
    1. Serum creatinine elevation of at least 2 mg/dL; or
    2. Oliguria with 24-hour urine output less than 1 mL/kg/hr; or
    3. Sodium retention with urine sodium less than 10 mEq per liter.
  8. OR

  9. Hepatopulmonary syndrome as described in 105.00D9, with:
    1. Arterial oxygenation (PaO2) on room air of:
      1. 60 mm Hg or less, at test sites less than 3000 feet above sea level, or
      2. 55 mm Hg or less, at test sites from 3000 to 6000 feet, or
      3. 50 mm Hg or less, at test sites above 6000 feet; or
    2. Documentation of intrapulmonary arteriovenous shunting by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan.
  10. OR

  11. Hepatic encephalopathy as described in 105.00D10, with 1 and either 2 or 3:
    1. Documentation of abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness (for example, confusion, delirium, stupor, or coma), present on at least two evaluations at least 60 days apart within a consecutive 6-month period;

      and

    2. History of transjugular intrahepatic portosystemic shunt (TIPS) or any surgical portosystemic shunt;

      or

    3. One of the following occurring on at least two evaluations at least 60 days apart within the same consecutive 6-month period as in F1:
      1. Asterixis or other fluctuating physical neurological abnormalities; or
      2. Electroencephalogram (EEG) demonstrating triphasic slow wave activity; or
      3. Serum albumin of 3.0 g/dL or less; or
      4. International Normalized Ratio (INR) of 1.5 or greater.
  12. OR

  13. End stage liver disease with:
    1. For children 12 years of age or older, SSA CLD scores of 22 or greater calculated as described in 105.00D11a. Consider under a disability from at least the date of the first score.
    2. For children who have not attained age 12, SSA CLD-P scores of 11 or greater calculated as described in 105.00D11b. Consider under a disability from at least the date of the first score.

      OR

  14. Extrahepatic biliary atresia as diagnosed on liver biopsy or intraoperative cholangiogram. Consider under a disability for 1 year following the diagnosis; thereafter, evaluate the residual liver function.

Inflammatory bowel disease (IBD)

Documented by endoscopy, biopsy, appropriate medically acceptable imaging, or operative findings with:

  1. Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation, confirmed by appropriate medically acceptable imaging or in surgery, requiring hospitalization for intestinal decompression or for surgery, and occurring on at least two occasions at least 60 days apart within a consecutive 6-month period
  2. OR

  3. Two of the following despite continuing treatment as prescribed and occurring within the same consecutive 6-month period:
    1. Anemia with hemoglobin of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart; or
    2. Serum albumin of 3.0 g/dL or less, present on at least two evaluations at least 60 days apart; or
    3. Clinically documented tender abdominal mass palpable on physical examination with abdominal pain or cramping that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
    4. Perineal disease with a draining abscess or fistula, with pain that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
    5. Need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central venous catheter. (See 105.10 for children who have not attained age 3.)

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You need no money to hire Attorney Donald H. Peters

(248) 549-3485
FREE CONSULTATION

Call Social Security Professionals now to discuss your claim for free

You need no money to hire Attorney Donald H. Peters

(248) 549-3485
FREE CONSULTATION

Southfield Lawyer Donald Peters of the Law Office of Donald H. Peters, P.C. in Southfield, Michigan, handles Social Security Disability claims throughout Michigan and in the Tri-County Metro Detroit area including Detroit, Southfield, Novi, Warren, Royal Oak, Roseville, Livonia, Mount Clemens, Sterling Heights, Farmington Hills, Birmingham, Berkley, Oak Park, West Bloomfield, Ann Arbor, Eastpointe, Waterford, Flint, Canton, Taylor, Romulus, Westland, Clinton Township, Troy, Dearborn, Brighton, Howell, Pontiac, Rochester Hills,  as well as Wayne County, Oakland County, Macomb County, Ingham County, and Livingston County, Michigan.

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