Inflammatory bowel disease (IBD)

We will check your records against each of these. Every item comes straight from SSA's own listing.

• Documentation
  • First, your IBD diagnosis must be confirmed by objective medical testing — a scope exam, a tissue biopsy, imaging, or findings from surgery.
  • This is required no matter which path (A, B, or C) you use.

  Read the original wording

  First, your IBD diagnosis must be confirmed by objective medical testing — a scope exam, a tissue biopsy, imaging, or findings from surgery. This is required no matter which path (A, B, or C) you use.

  (Listing 5.06, criterion Documentation)

• A
  • This is one of three paths — you only need one (A, B, or C).
  • Path A: your bowel became blocked at narrowed (scarred) areas — not from adhesions — with widening of the bowel above the blockage, confirmed by imaging or surgery.
  • You must have needed two hospital stays for decompression or surgery within 12 months, at least 60 days apart.

  Read the original wording

  This is one of three paths — you only need one (A, B, or C). Path A: your bowel became blocked at narrowed (scarred) areas — not from adhesions — with widening of the bowel above the blockage, confirmed by imaging or surgery. You must have needed two hospital stays for decompression or surgery within 12 months, at least 60 days apart.

  (Listing 5.06, criterion A)

• B
  • This is one of three paths — you only need one. Path B: you must have two of these five problems within 12 months, at least 60 days apart:
  • Anemia with hemoglobin under 10.0 on two tests 60+ days apart
  • Albumin of 3.0 or less on two tests 60+ days apart
  • A tender lump in your belly that a doctor could feel, with pain or cramping
  • A draining abscess or fistula near the anus

  Read the original wording

  This is one of three paths — you only need one. Path B: you must have two of these five problems within 12 months, at least 60 days apart: (1) anemia with hemoglobin under 10.0 on two tests 60+ days apart; (2) albumin of 3.0 or less on two tests 60+ days apart; (3) a tender lump in your belly that a doctor could feel, with pain or cramping; (4) a draining abscess or fistula near the anus; (5) needing daily tube feeding through a surgically placed stomach or intestinal tube, or daily IV nutrition through a central line. Feeding tubes through the nose or mouth do not count for item 5.

  (Listing 5.06, criterion B)

• C
  • This is one of three paths — you only need one.
  • Path C: repeated IBD complications (like abscesses, bowel perforation, toxic megacolon, or blood clots) happening about 3 times a year — once every 4 months — with each one lasting 2 weeks or more, within a 12-month period.
  • On top of that, your IBD must seriously ('markedly') limit one of these: daily activities like chores and errands, getting along with others, or finishing tasks on time due to problems with concentration, persistence, or pace.

  Read the original wording

  This is one of three paths — you only need one. Path C: repeated IBD complications (like abscesses, bowel perforation, toxic megacolon, or blood clots) happening about 3 times a year — once every 4 months — with each one lasting 2 weeks or more, within a 12-month period. On top of that, your IBD must seriously ('markedly') limit one of these: daily activities like chores and errands, getting along with others, or finishing tasks on time due to problems with concentration, persistence, or pace.

  (Listing 5.06, criterion C)