DI 34225.005 Digestive Listings from 5/24/02 to 12/17/07
105.00 DIGESTIVE SYSTEM
-
A.
Disorders of the digestive system which result in disability usually do so because of interference with nutrition and
growth, multiple recurrent inflammatory lesions, or other complications of the disease.
Such lesions or complications usually respond to treatment. To constitute a listed
impairment, these must be shown to have persisted or be expected to persist despite
prescribed therapy for a continuous period of at least 12 months.
-
B.
Documentation of gastrointestinal impairments should include pertinent operative findings, appropriate medically acceptable imaging
studies, endoscopy, and biopsy reports. Medically acceptable imaging includes, but
is not limited to, x-ray imaging, computerized axial tomography (CAT scan) or magnetic
resonance imaging (MRI), with or without contrast material, myelography, and radionuclear
bone scans. "Appropriate" means that the technique is the proper one to support the
evaluation and diagnosis of the impairment. Where a liver biopsy has been performed
in chronic liver disease, documentation should include the report of the biopsy.
-
C.
Growth retardation and malnutrition. When the primary disorder of the digestive tract has been documented, evaluate resultant
malnutrition under the criteria described in 105.08. Evaluate resultant growth impairment
under the criteria described in 100.03. Intestinal disorders, including surgical diversions
and potentially correctable congenital lesions, do not represent a severe impairment
if the individual is able to maintain adequate nutrition, growth, and development.
-
D.
Multiple congenital anomalies. See related criteria, and consider as a combination of impairments.
105.01 Category of Impairments, Digestive
105.03 Esophageal Obstruction, caused by atresia, stricture, or stenosis, with malnutrition as described under the
criteria in 105.08.
105.05 Chronic liver disease. With one of the following:
-
A.
Inoperable biliary atresia demonstrated by appropriate medically acceptable imaging
or surgery; or
-
B.
Intractable ascites not attributable to other causes, with serum albumin of 3.0 gm./100
ml. or less; or
-
C.
Esophageal varices (demonstrated by endoscopy or other appropriate medically acceptable
imaging); or
-
D.
Hepatic coma, documented by findings from hospital records; or
-
E.
Hepatic encephalopathy. Evaluate under the criteria in 112.02; or
-
F.
Chronic active inflammation or necrosis documented by SGOT persistently more than
100 units or serum bilirubin of 2.5 mg. percent or greater.
105.07 Chronic inflammatory bowel disease (such as ulcerative colitis, regional enteritis), as documented in 105.00. With one
of the following:
-
A.
Intestinal manifestations or complications, such as obstruction, abscess, or fistula
formation which has lasted or is expected to last 12 months; or
-
B.
Malnutrition as described under the criteria in 105.08; or
-
C.
Growth impairment as described under the criteria in 100.03.
105.08 Malnutrition, due to demonstrable gastrointestinal disease causing either a fall of 15 percentiles
of weight which persists or the persistence of weight which is less than the third
percentile (on standard growth charts). And one of the following:
-
A.
Stool fat excretion per 24 hours:
-
1.
More than 15 percent in infants less than 6 months.
-
2.
More than 10 percent in infants 6-18 months.
-
3.
More than 6 percent in children more than 18 months; or
-
B.
Persistent hematocrit of 30 percent or less despite prescribed therapy; or
-
C.
Serum carotene of 40 mg./100 ml. or less; or
-
D.
Serum albumin of 3.0 gm./100 ml. or less.
105.09 Liver transplant. Consider under a disability for 12 months following the date of surgery; thereafter,
evaluate the residual impairment.