The digestive listings cover a variety of impairments with similar and multiple
complications. These complications have varying impact on individuals. Like wise
the effects of treatment have a vast range of effectiveness and side effects.
Much like the claimants who suffer from HIV+ disease, claimants with Hepatitis
and other chronic liver diseases, can experience several moderately severe
manifestations of this illness but lack the necessary requisite findings. They may
experience ascites, bacterial peritonitis and hepatorenal symptoms, none of which
meet the severity of the listing. Yet all of these complications have the potential for
symptoms of severe pain, fatigue, nausea, diarrhea and general malaise. The
claimant may not be limited in their exertional capabilities or have a vocational
profile that would render them disabled by Social Security standards. However, the
inability to know from day to day if they will have their pain, nausea and diarrhea
under control, or have energy and stamina to carry out simple routine tasks would
prevent a sustained capacity for SGA. These factors can be argued at hearing but
claimants with such severe functional restrictions are being unfairly denied and
forced to wait for years for their benefits. A functional listing would give consistent
guidance to those adjudicating Hepatitis and chronic liver disease claims.
It is also reasonable to apply the same type of standard functional standard for
Listing 5.02 and 5.06 in order to take into account the residual fatigue, weakness,
and anemia following hemorrhaging and episodes of stenosis that is not frequent
enough to meet the Listings.
Because of the diversity of the effects of this series of diseases and the chronicity
of most of these impairments, we believe that an addendum to the new Digestive
Impairment Category listings should include a functional component similar to the
one outlined in listing 14.08N for individuals with immunosuppressant disease.
Comment on FR Doc # E7-24061
This is comment on Proposed Rule
Revised Medical Criteria for Evaluating Functional Limitations Due to Digestive Disorders
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