Social Security’s definition of disability
In order to be found disabled under Social Security's rules, you must have a severe mental or physical impairment, or a combination of impairments, that prevents you from performing your past work or any other type of work. Your impairment or impairments must have lasted for twelve continuous months or be expected to last that long or result in death.
Interstitial Cystitis (IC)
May be associated with other disorders including:
Symptoms are similar to other genitourinary disorders including:
The following symptoms of IC may occur singly or in combination:
For IC, SSA will assess medical records for the following tests:
Cystoscopy with hydrodistention (uses fluid to distend the bladder) is especially helpful in evaluating interstitial cystitis. Cystoscopy can estimate bladder capacity (how much urine the bladder can hold); and to look for bladder wall abnormalities, such as glomerulations (pinpoint bleeding caused by recurrent irritation) and Hunner’s ulcers.
A diagnosis of IC is based on the presence of some or all of the following:
Note: SSA will not purchase a cystoscopy test to help establish a diagnosis of IC because it is an invasive procedure.
In IC, diagnostic tests may yield minimal objective findings, similar to Fibromyalgia & Irritable Bowel Syndrome, but SSA must still consider the reported severity of subjective symptoms and reported impact on function if the diagnosis of IC is established by a treating source.
Your physician and medical records
SSA will rely on the judgment of a physician who has made the diagnosis after a review of the claimant’s medical history, a physical examination of the claimant, and any pertinent testing to establish the existence of IC.
In the absence of evidence to the contrary in the case record, SSA will find a medically determinable impairment is established if the evidence contains the appropriate symptoms, signs, and laboratory findings. However, if there is evidence that shows the diagnosis is questionable, and the evidence is inadequate to decide whether or not the individual is disabled, SSA says it will contact the treating source for clarification.
I don’t recommend you rely on SSA to contact a treating source to clarify any discrepancies. You should make sure all of your doctor’s medical records have been submitted and contain enough detail to confirm the diagnosis of IC. If necessary, have the doctor who treats you for IC write a letter to SSA confirming the diagnosis with supporting tests and/or labs.
Treatment for IC
Note: Studies have shown that antibiotics are not useful for treating IC.
Response to treatment is variable, and some individuals may have intractable (persistent despite treatment) symptoms. Individuals with intractable pain are more likely to win Social Security disability benefits, especially if your file shows you are significantly limited by the pain.
Symptoms and how they limit you
SSA considers reported pain, weakness, fatigue, and other symptoms. Don’t rely on SSA to obtain detailed information about daily activities. You should provide this type of information even without being asked for it. SSA will consider an individual’s statements about how symptoms limit functional abilities, so it is important that applicants describe in vivid detail how they are limited by symptoms of IC.
SSA considers the duration, frequency, and intensity of symptoms; precipitating and aggravating factors; type, dosage, effectiveness and side effects of prescribed medications; and any other factors that result in functional limitations or restrictions.
Chronic pain can limit exertional and non-exertional functions, and make it difficult to focus and sustain attention on the task at hand. Bladder pain can range from mild discomfort to extreme distress. Many individuals also experience vaginal, testicular or penile pain; or low back and thigh pain.
Nocturia (night-time urinary frequency) can disrupt sleeping patterns, leading to drowsiness with lack of mental clarity during the day.
Social functioning may be restricted when urinary frequency, which can necessitate trips to the bathroom as often as every 10 to 15 minutes, makes leaving home difficult.
Limitations in your function depend on many factors, including urinary frequency and pain. Individuals should tell if they have limitations of exertional functions, such as sitting, standing, walking, lifting, carrying, pushing, and pulling. Also report any postural limitations, such as climbing, balancing, stooping, and crouching. And any limited ability to tolerate extreme heat, humidity, or hazards due to symptoms of IC.
SSA also considers reports of persistent weakness, fatigue, and symptoms not controlled by treatment.
Other conditions associated with IC
If other conditions are associated with IC, SSA considers these conditions in combination with IC. For example, medical records may show a possible discrete mental impairment or symptoms, such as anxiety or depression, resulting from IC or the side effects of medication.
IC can increase the severity of coexisting or related impairments, including mental disorders, to the extent that the combination of impairments meets or equals listing requirements. The reverse may also be true. Coexisting or related impairments can increase the severity of IC.
IC and your ability to work
The ability to sustain work activities on a regular and continuing basis may be limited due to symptoms of IC. SSA must consider the effect IC has upon the individual’s ability to perform routine movement and necessary physical activity within the work environment.
Individuals with IC may have problems with the ability to sustain a function over time, but medical records must support this fact.
If an individual’s impairment does not meet or equal a listing, SSA must provide a Residual Functional Capacity (RFC) assessment, which considers an individual’s maximum remaining ability to do sustained work activities in an ordinary work setting on a regular and continuing basis.
A ‘‘regular and continuing basis’’ means 8 hours a day, for 5 days a week, or an equivalent work schedule. In cases involving IC, fatigue may affect the individual’s physical and mental ability to sustain work activity. This may be particularly true in cases involving urinary frequency and chronic uncontrolled pain.
IC as a medically determinable impairment
The Social Security Administration has acknowledged IC as a medically determinable impairment capable of producing signs, symptoms, and laboratory findings that may cause an individual to meet Social Security’s definition of disability. But it has not yet decided IC is a condition that supports its own listing in the “Listing of Impairments.”
This puts a greater onus on the individual applying for disability due to IC to prove they are disabled and unable to work. Don’t let this stop you from applying, because, as you can see from this article, there are steps you can take to improve your chances of winning benefits.
What you should do
With perseverance, you will succeed. Good luck.