Interstitial Cystitis

Interstitial Cystitis

Excerpts from Social Security Ruling 15-1p, policy statement on Interstitial Cystitis.

This ruling rescinds and replaces a previous ruling, SSR 02-2p.

I. What is Interstitial Cystitis?

 

A.    IC is a complex genitourinary disorder resulting in recurring pain or discomfort in the bladder and pelvic region. The AUA and other medical experts characterize IC, in part, as an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes. IC is most common in women and sometimes occurs before age 18. It is not unusual for people to have prodromal (early predictive) symptoms years or decades before they get IC. Prodromal symptoms may include periodic episodes of urinary frequency, bladder pain, or pelvic pain.

B.    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. For example, the AUA guidelines recommend a basic laboratory examination that includes urinalysis and urine culture. NIDDK notes that diagnostic tests physicians may also use to rule out other conditions include cystoscopy, biopsy of the bladder wall and urethra, distention of the bladder under anesthesia, and, in men, culture of prostate secretions.

C.    IC may co-occur with fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, inflammatory bowel disease, vulvodynia, chronic headaches, Sjögren's syndrome, endometriosis, or systemic lupus erythematosus.

D.    Treatments for IC are mostly directed at symptom control. They include, but are not limited to: changes in diet; physical therapy and pelvic floor strengthening exercises; stress management; bladder distention; bladder instillation; oral drugs, such as prescription drugs indicated for IC (for example, Elmiron and dimethyl sulfoxide), antidepressants, antihistamines, antacids, anticoagulants, and narcotic analgesics; transcutaneous electrical nerve stimulation; and surgery, such as substitution cystoplasty or urinary diversion with or without cystectomy. Treatment is not effective for everyone because response varies among patients.

Effective on March 18, 2015.  Federal Register, Vol. 80, No. 52, Page 14215.

Footnotes omitted here.

See full text at:

https://www.ssa.gov/OP_Home/rulings/di/01/SSR2015-01-di-01.html

Genetic Tests & Disability

In Social Security Ruling 16-4p, the Social Security Administration provides basic information about genetic testing and how it evaluates genetic test results found in medical evidence.

Note that non-mosaic Down syndrome and xeroderma pigmentosum (for children and adults) are discussed.

Here is an excerpt from SSR 16-4p:

“Are genetic test results alone sufficient to make a disability determination or decision?

“With the sole exception of non-mosaic Down syndrome, genetic test results alone are not sufficient to make a disability determination or decision. A person may be found disabled based on meeting the criteria for non-mosaic Down syndrome in the Listing of Impairments (listings) under 10.06A and 110.06A, when this condition is documented by a karyotype report signed by a physician.  Genetic test results alone are otherwise not sufficient to make a disability determination; however, in two other medical listings, we use genetic test results as part of the criteria to evaluate whether a person's impairment meets the listing. [These listings are for xeroderma pigmentosum (8.07A and 108.07A), 20 CFR part 404, subpart P, appendix 1.] Additional evidence, including signs and symptoms of a person's impairment, is generally necessary to make a disability determination. As genetic testing continues to advance, we will consider appropriate changes to our program policy.”

Footnotes omitted.

See the full ruling at:
https://www.ssa.gov/OP_Home/rulings/di/01/SSR2016-04-di-01.html

NY Medical Records Fees

Fees in New York state have been eliminated for medical records for people pursuing a claim for Social Security disability or Medicaid benefits.

The governor signed the legislation last week amending New York’s public health and mental hygiene laws to eliminate fees for medical records in either electronic or paper form for residents.

See:  http://www.fiercehealthcare.com/regulatory/new-york-law-prohibits-medical-record-fees-for-those-seeking-government-benefits