Crohn's disease

According to the CCFA (Crohn's & Colitis Foundation of America) Crohn's disease affects between 400,000 and 600,000 people in North America. Crohn's disease is broken up into two listings by Social Security. The first, Listing 5.06 for Inflammatory bowel disease (IBD), covers ulcerative colitis and Crohn's. Disability caused by weight-loss resulting from Crohn's disease is covered by Listing 5.08.

Is is very difficult to meet a listing for Crohn's disease for most individuals. Generally, the best approach is to document the existence of CD and then document the physical limitations it places on the claimant. These physical limitations are referred to as a claimant's physical residual functional capacity ("RFC"). These activities include the claimant's ability to sit, stand, walk, lift, pushing, pulling, etc. Most claimant's, if the CD, is severe enough will be successful at steps 4 and 5 of the Social Security Administration's Sequential Process mainly due to bathroom breaks that vary in frequency and duration but utlimately preclude full-time employment.

However, I have had some luck arguing that the claimant's CD is severe enough to equal the Listing 5.06. In order to meet the Listing 5.06, the claimant must have a certain laboratory profile. This includes:

1. A hemoglobin level of less than 10.0 g/dL, present on at least two lab reports at least 60 days apart.
2. A serum albumin level of less 3.0 g/dL, present on at least two lab reports at lease 60 days
apart.
3. Involuntary weight loss of at least 10 percent from baseline weight.
4. The need for supplemental enteral nutrition via a central venous catheter.

For those that are familiar with lab reports, these figures are rare to find on most CD patients. Those meeting the Listing have to have the requisite numbers DESPITE treatment; most commonly Remicade. However, it proves successful to argue the CD patient EQUALS the Listing if these number fall below the normal range for the lab results. For example, for hemoglobin levels the normal range is 13.9-16.3 g/dL. For serum albumin levels, the normal range is 3.5-5.0 g/dL. Low hemoglobin and albumin levels suggest severe anemia.

Anemia, one of the more common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low. This can lead to health problems because RBCs contain hemoglobin, which carries oxygen to the body's tissues. anemia can cause a variety of complications, including fatigue and stress on bodily organs. It is important in a Social Security hearing that the ALJ understands that although the claimant does not fully meet the Listing, the lab reports of low levels of hemoglobin and albumin lend incredibility to the claimant's chronic fatigue and low energy levels. These low levels of energy and chronic fatigue will limit the claimant to less than sedentary work and therefore the severity will equal the Listing.