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Endometriosis and SSA Disability Benefits

Endometriosis can occur when endometrial cells, which generally grow inside the uterus, grow outside of the uterus, attaching themselves to others types of tissues forming endometriosis implants. These implants can be found most frequently on the ovaries, fallopian tubes, uterus or the intestines. Less often they will grow on the bladder, cervix or vagina.

[caption id="" align="alignright" width="300" caption="Ovarian cyst / Endometriosis (Photo credit: Wikipedia)"]Ovarian cyst / Endometriosis[/caption]

Although many woman have endometriosis and may be unaware they are suffering from this condition, many women often experience severe symptoms. Common symptoms of endometriosis can include:

  1. Severe abdominal pain

  2. Pain during intercourse

  3. Cramping

  4. Pain while urinating or while having bowel movements

  5. Lower back pain

  6. Blood in the urine

  7. Constipation

  8. Abnormal menstrual cycles or excessive bleeding

Medical experts estimate that endometriosis may affect 3% to 18% of women in the United States, although estimates may be low because many women who have this condition do not experience symptoms and may not get a diagnosis. This condition is also largely to blame for infertility in the United States.

Treatment for Endometriosis

The type and frequency of treatment for endometriosis will vary based on the severity of the condition. Many women may need hormone medications (contraceptive pill, Danazol, or GnRH agonists) or surgery. There are side-effects for some medications including hot flashes, headaches, depression, loss of sex drive, loss of bone density and night sweats.

Winning SSDI or SSI benefits for Endometriosis

The Social Security Administration (SSA) awards SSDI and SSI benefits to applicants who have a severe health condition which is expected to last for at least 12 continuous months and does not allow the claimant to perform substantial gainful activity.

The SSA has two methods for determining whether an applicant’s condition is so severe they cannot work. First, the SSA will evaluate a claimant’s condition to determine if it “meets or exceeds” a listing in the SSA Listing of Impairments. If it does not, the SSA will determine if the claimant’s condition is so severe that they do not have the residual capacity to work.  This process is done through what the SSA terms a medical vocational allowance.

Meeting a Listing in the SSA Listing of Impairments for Endometriosis

The SSA does not have a specific listing for endometriosis in their SSA listing of impairments. This means that unless you can prove that your condition is as severe as another listing you will most likely be denied benefits the first time you apply.

If you are denied SSI or SSDI benefits the first time you apply you can either appeal the denial within 60 days from the date of the denial letter, or you can file a new SSI or SSDI application.

Winning SSDI or SSI benefits for Endometriosis through a medical vocational allowance

To win benefits through a medical vocational allowance you will have to prove that your condition creates severe limitations to work. This can only be done if you have great medical evidence which specifically lists work functions that you cannot perform due to your condition. Claimants with endometriosis will have difficulty winning SSDI or SSI if their condition is effectively treated with medication or if it is intermittent and will not last 12 continuous.
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