Primary Sclerosing Cholangitis and Social Security Disability

Primary Sclerosing Cholangitis

The liver is the largest internal organ in the human body. It is responsible for a variety of functions. Some of these include the removal of toxic substances, hormone production, and the removal of old red blood cells. It also secretes bile, which is necessary for the body to digest fat. In some people, the ducts which carry bile out of the liver become diseased, causing them to develop inflammation and scarring; this condition is called Primary Sclerosing Cholangitis. Ultimately, it can lead to cirrhosis, liver cancer, and liver failure.

Unfortunately, early-stage Primary Sclerosing Cholangitis (or PSC) usually presents with few symptoms other than abnormal blood tests which indicate problems with liver functioning. When the disease has progressed to the point that symptoms develop, they may include:

• Fatigue
• Abdominal pain
• Chills
• Diarrhea
• Fever
• Intense itching of the skin
• Unintentional weight loss
• Jaundice (yellowing of the eyes and skin)
• Enlargement of the liver
• Dark Urine
• Malnutrition, due to the inability to absorb fat-soluble vitamins

It is not known what causes PSC, but there is evidence to suggest that it is related to the immune system’s reaction to an infection or toxin in people who have a natural susceptibility to the disease. Women are diagnosed with PSC about twice as often as men. Also, many patients with PSC also have some form of Inflammatory Bowel Disease, although the connection between the two conditions remains unclear.

Initially, PSC can be suspected if liver enzyme tests indicate some compromise of liver function. Subsequently, an MRI or X-ray of the bile ducts can confirm the diagnosis. It may be necessary to perform a biopsy on liver tissue to determine the extent of liver damage.

PSC is not curable; most treatments focus on minimizing symptoms. Anti-histamines may help with the persistent itching. There are some bile-acid medications that can help to move bile through the liver. Additional nutritional support may help to offset the effects of poor absorption of vitamins. The accumulation of bile may result in repeated infections which need to be treated with antibiotics. Ultimately, the disease results in liver failure, which can only be treated with a liver transplant.

Filing for Social Security Disability with a Primary Sclerosing Cholangitis Diagnosis

Primary Sclerosing Cholangitis is listed in the Social Security Administration’s (SSA) impairment listing manual (otherwise known as the “Blue Book”) as one of the conditions that can cause a person to qualify for Social Security Disability benefits. PSC is classified as a Chronic Liver Disease. In order to qualify, there are certain diagnostic criteria that must be met. They include:

Hemorrhaging from varices (varicose veins in the stomach or esophagus) or from portal hypertensive gastropathy (disease of the stomach from high blood pressure in the stomach arteries) resulting in unstable blood pressure and requiring admission to a hospital for transfusion of at least 2 units of blood, or one of the following:

• Accumulation of fluid in the pleural or abdominal cavities which cannot be attributed to other causes, in spite of continuing treatment, present on at least 2 occasions at least 60 days apart during a 6 month period, or
• Spontaneous bacterial peritonitis (infection of the lining of the abdominal cavity) of a pre-determined severity, or
• Failure of the kidneys due to liver disease, or
• Hepatic encephalopathy (decline of brain function which results from an accumulation of toxins in the blood due to liver disease) of a pre-determined severity, or
• End-stage liver disease of a pre-determined severity.

Your Primary Sclerosing Cholangitis Disability Case

If your doctor has given you a diagnosis of Primary Sclerosing Cholangitis, there is a strong possibility that you qualify for Social Security Disability benefits as long as you meet the necessary diagnostic criteria. Because of the complexities involved with demonstrating the presence of these conditions, it would be in your best interest to trust your case to an experienced Social Security Disability attorney.

The vast majority (as many as 70%) of Social Security Disability cases are denied when they are first submitted. Once that happens, the only recourse an applicant has is to file an appeal. Because so many claimants are initially denied disability, there are a lot of cases waiting to be heard. Not surprisingly, some applicants get so discouraged they just give up; worse yet, some don’t survive long enough to receive any benefits. Unfortunately, many cases are denied simply because the application paperwork and the accompanying documents were not completely in order. A qualified Social Security Disability attorney can help you to avoid these costly mistakes that could delay your case for months or possibly even years.

You don’t have to do this by yourself. With the guidance of a Social Security Disability lawyer who knows how the whole process works and has successfully completed it many times, you can take comfort in the knowledge that the help you and your family need will be on the way as soon as possible.