Social Security Disability Insurance (SSDI) – Interstitial Cytitis (IC)

Periodically, the Social Security Administration (SSA) produces “rulings” that clarify or discuss some policy or regulation regarding Social Security Disability Insurance (SSDI) or SSI.  For instance, in 2014 the SSA releases SSR 14-1 dealing with Chronic Fatigue Syndrome.  SSR 15-1p rescinds and replaces SSR 02-2p: “Titles II and XVI: Evaluation of Interstitial Cystitis.”

The stated purpose of the SSR is to clarify how the SSD develops evidence to establish if a claimant has a medically determinable impairment (MDI) of IC and how the SSA evaluates the impairment in disability claims and continuing disability reviews.  The full text of the SSR can be read here.

IC constitutes an MDI when producing appropriate symptoms and medical signs or laboratory findings, and may result in a disabling impairment. There are some signs and findings that could indicate IC, but there are no specific signs or findings that are universally accepted.

In accordance with the AUA guidelines, a physician should make a diagnosis of IC only after reviewing the person’s medical history and conducting a physical examination. The physician should also conduct laboratory tests to rule out certain medical conditions that may result in the same or similar symptoms. F

A person can establish that he or she has an MDI of IC by providing appropriate evidence from an acceptable medical source. A licensed physician (a medical or osteopathic doctor) is the only acceptable medical source who can provide evidence establishing an MDI of IC.  The SSA will generally will rely on the judgment of a licensed physician who has made a diagnosis of IC. The evidence must document that this physician reviewed the person’s medical history and conducted a physical examination, and that his or her diagnosis is not inconsistent with the other substantial evidence in the person’s case record.

 

In cases of alleged IC, the SSA generally needs to have longitudinal evidence because symptoms, signs, and laboratory findings of IC may fluctuate in frequency and severity and may continue over a period of months or years.

After finding that the MDI could reasonably be expected to produce the alleged symptoms, the SSA evaluates the intensity and persistence of the person’s symptoms and determine the extent to which they limit the person’s functional capacity for work. In evaluating the intensity, persistence, and functionally limiting effects of symptoms, all evidence is considered, including the person’s daily activities; medications or other treatments the person uses, or has used, to alleviate symptoms; the nature and frequency of the person’s attempts to obtain medical treatment for symptoms; and statements by other people about the person’s symptoms.

If you need more information about a Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, VA disability, Railroad Retirement Board disability, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611 or through our website. Our office handles claims throughout Tennessee, Eastern Kentucky, Western North Carolina, Virginia, and Georgia.

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