5.06: Inflammatory Bowel Disease

What actually decides a claim under 5.06

Obstruction of stenotic areas requiring hospitalisation, or two or more specified findings within six consecutive months: anaemia, low serum albumin, a tender abdominal mass with pain, perineal disease with fistula, involuntary weight loss, or a need for daily supplemental nutrition. Note what is absent from that list — how often you need a bathroom, which is frequently the symptom that actually prevents work and has to be carried by the functional assessment instead.

Conditions evaluated under 5.06

• Crohn's Disease and IBDHow SSA evaluates it, the evidence that decides it, and why claims are denied

Frequently asked questions

Do you have to meet 5.06 to be approved?

No. Meeting a listing is one route to approval and not the most common one. Most awards are made on residual functional capacity — what SSA concludes you can still do across a full working week, given your age, education and past work. A claim that falls short of 5.06 can still be approved that way, which is why a denial citing this listing is not the end of the matter.

What if my records do not meet 5.06 exactly?

Two things can still happen. SSA can find your condition medically equals the listing — equal in severity and duration without matching every criterion — or it can move on to the functional assessment described above. What sinks these claims is usually a gap in the file rather than a gap in the criteria: a limitation you live with that no doctor wrote down.

Which conditions are evaluated under 5.06?

Crohn's Disease and IBD. The criteria are the same; what differs is the evidence each condition needs to satisfy them.