Interstitial Cystitis and Qualifying for Disability Benefits

Summary: Can I get disability benefits if I am suffering from the effects of Interstitial Cystitis?

Though interstitial cystitis is not specifically listed as an impairment in Social Security’s Blue Book, it may still be possible to qualify for Social Security Disability benefits. First you must show that you have a medically determined impairment (MDI) which means you must prove that you have IC.

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If you have interstitial cystitis and it has impacted your ability to work, you may be eligible for Social Security Disability benefits. Call 512-454-4000 for help today.

Interstitial cystitis (or IC) is part of a group of conditions known as painful bladder syndrome that causes bladder pressure, bladder pain, and sometimes pelvic pain.

IC is common, affecting between 3 million and 8 million women and between 1 and 4 million men in the United States.

It is difficult to diagnose interstitial cystitis because the condition has a wide range of symptoms.

Because of this, some researchers believe it might actually be several diseases. Urinary pain that lasts longer than six weeks and is not caused by kidney stones or other infections might be IC. Interstitial cystitis interferes with an individual’s social life, sleep, exercise, and work, negatively affecting all areas of their life.

Symptoms vary from person to person and can change daily, or weekly and continue for months or years:

•    Persistent need to urinate throughout the day in small amounts (up to 60 X per day)
•   Chronic pelvic pain
•   Bladder pressure and pain that worsens as the bladder stores urine
•   Pain between the vagina and anus in women
•   Pain between the scrotum and anus in men

The symptoms of IC can cause you to miss work, possibly jeopardizing your ability to maintain employment.

Most cases of interstitial cystitis resolve on their own, but there are several steps an individual can take to manage their condition:

•   Gradually retrain yourself to urinate less frequently
•   Avoid wearing tight clothing
•   Quit smoking
•   Reduce stress
•    Low impact exercise like walking
•   Avoiding foods that may trigger bladder irritation such as citrus fruits, tomatoes, chocolate, caffeinated beverages, carbonated drinks, alcohol, spicy foods and artificial sweeteners.

In addition to recommended lifestyle changes, a doctor may prescribe physical therapy to relax muscles and medications to control spasms, build bladder tissue and reduce the urge to urinate.

You will need to demonstrate to the SSA that you are following your doctors treatment plan to enhance your ability to qualify for disability benefits.

Interstitial Cystitis and Qualifying for Disability Benefits.

The long-term effects of interstitial cystitis can negatively impact all areas of a person’s life.

In addition to side effects of medications like drowsiness, dizziness, headaches and fatigue an individual can suffer from anxiety and depression, affecting their relationships and employment. Though interstitial cystitis is not specifically listed as an impairment in Social Security’s Blue Book, it may still be possible to qualify for Social Security Disability benefits if you have IC. First you must show that you have a medically determined impairment (MDI) which means you must prove that you have IC.

You must provide medical evidence that you are experiencing all or some of the following symptoms and that your symptoms are not caused by another condition.

•    Pain in the bladder and pelvis
•   Pinpoint bleeding on the bladder wall caused by recurring irritation after a cystoscopy
•   Hunner’s ulcers on the bladder wall after cystoscopy
•   Tenderness in the pelvic area

Results from a number of tests can be submitted as evidence including urinalysis, cystoscopy, biopsy reports, urine culture and cytology, and cystoscopy.

When Social Security is able to confirm a diagnosis of IC, there are a few ways that Social Security may evaluate your case and determine that you are disabled.

1.    Your disability matches the impairment listing for a related condition. Applicants with IC are likely to also have another condition like lupus or depression, which is either caused by IC or made worse by IC.
2.   Your IC is equal in severity and lasts the same amount of time as any listed impairment. Social Security will consider impairments closely related to IC when determining the medical equivalence of a listing.
3.   You have several impairments which, when combined, are as severe as one of the impairments listed in Social Security’s Blue Book. Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical-vocational assessment), taking into account whether or not you are able to drive, your age, and level of education.

Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable.

Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.

If you have interstitial cystitis and it has impacted your ability to work, you may be eligible for Social Security Disability benefits.

In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

1.   Are you working?   Your disability must be “total”.
2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.

More details can be found on our Qualifying for Disability page.

Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court – all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.