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Acid reflux occurs when the lower esophageal sphincter (a muscle between the esophagus and stomach) does not close properly and allows stomach acid to flow back into the tube that connects your mouth and stomach, damaging the lining of the esophagus. When acid reflux symptoms occur more than twice a week, it is considered gastroesophageal reflux disease (GERD) – one of many serious, chronic gastrointestinal disorders. Occasional acid reflux is considered normal, so is GERD a disability?
When Is GERD a Disability?
According to the National Institutes of Health (NIH), about 20 percent of people in the United States are affected by gastroesophageal reflux disease, also known as acid reflux disease. For some, acid reflux symptoms can be effectively controlled through diet, lifestyle adjustments, and prescription medications. For others, however, acid reflux disease is a debilitating and disabling disease that can lead to serious – even life-threatening – complications. If your gastroesophageal reflux disease is not well controlled by available treatments or has led to severe complications, then you may qualify for long-term disability (LTD) benefits or Social Security Disability benefits for GERD.
Symptoms of GERD
Symptoms include heartburn, chest pain, difficulty swallowing, and regurgitation of food or sour liquid. Occasional heartburn is relatively normal, but it may indicate acid reflux disease if it persists. The symptoms may advance to the point where you experience a loss of productivity and work absences and may ultimately be unable to continue working.
Someone suffering from GERD may require prescriptions, frequent doctor visits, and tests to monitor the condition of the lining of the esophagus, stomach, and lungs. If you cannot work for twelve months, you may qualify for Social Security Disability benefits for GERD. Disability insurance benefits may be available even sooner.
Complications Due to GERD
Esophagitis, esophageal strictures, and Barrett’s esophagus (which increases the risk of esophageal cancer) are all common complications. If you have any of these conditions, your doctors must closely monitor them. Frequent endoscopies may be necessary, and prescription medications are bound to be your primary medical expense. Healthline statistics reveal that doctors in the U.S. write nearly 65 million GERD-related prescriptions annually. In fact, many patients must take multiple drugs to control or lessen the disease’s effects.
If your acid reflux causes respiratory complications, then you may require asthma medications or a CPAP machine in addition to the treatment for your esophagus and stomach. You may experience risk factors such as frequent infections or aspiration problems as well, which may require frequent emergency room visits.
Medically Qualifying for Disability Benefits with GERD
Gastroesophageal reflux disease alone is not usually enough to qualify for benefits. However, it is often the result of obesity, diabetes, hiatal hernia, scleroderma, or even scar tissue. If your combined symptoms from multiple medical conditions (including GERD) cause serious complications, then it may be considered disabling.
You will need to show decreased workability due to GERD or acid reflux to qualify for LTD benefits. The best evidence of your limitations may be in the form of an Attending Physician Statement (APS) or Residual Functional Capacity (RFC) form. Such a form should specifically identify how your symptoms and complications are so severe that they prevent employment.
If you can demonstrate significant limitations in your activities of daily living (ADLs), then you may be able to establish a restricted RFC and receive a medical-vocational allowance from the insurance company or the SSA.
As you can see, your physician’s input on an APS or RFC can make or break your claim. Ensure your doctor is “on board” with your claim and will finalize and submit his or her forms quickly.
Long-Term Disability Insurance and Social Security Benefits for GERD
Whether it is a claim with an insurance company or the Social Security Administration, your disability claim and/or appeal must be backed up with sufficient medical evidence. Certain medical records may play a key role in approval. Such records may include:
- Endoscopy results;
- ER and hospitalization records;
- Sleep studies;
- Respiratory evaluations;
- Surgical records, and
- Prescription drugs you’ve taken, as well as their results.
Acid reflux disease, evidenced by symptoms that do not respond well to treatment, may qualify for long-term disability or Social Security Disability benefits. The insurance adjuster or Social Security representative handling your case must understand how the damage has progressed and decreased your ability to maintain a job and earn a living. A detailed statement from your doctor explaining the progression of your complications can be especially beneficial.
Other Treatments for Acid Reflux
Mild reflux cases can usually be treated with a combination of diet and lifestyle changes, and medication can also relieve your reflux-related symptoms. Other conditions, such as a hiatal hernia, may complicate some treatments, such as surgery. Work closely with your doctor before and during your case.
Work With an Experienced Disability Attorney
If you are unable to work as a result of gastroesophageal reflux disease (GERD), you should consult with an experienced long-term disability and Social Security Disability attorney. Disability insurance carriers and the Social Security Administration do not make it easy for disabled claimants to obtain the benefits that they deserve for their disabilities. Still, an attorney can help lead you down the path to success.
Suppose your GERD makes it impossible for you to work, and you have been denied your disability benefits. In that case, the legal team at Ortiz Law Firm can help you cut through the red tape and fight for your disability benefits no matter where you live in the United States.
Call us today at (888) 321-8131 or contact us online for a free consultation so we can discuss the benefits of an attorney-client relationship and why you should choose an attorney at our firm. The initial consultation is free, and you are not obligated to work with us.