Lupus and Social Security Disability, Can You Qualify for Benefits?

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The Social Security Administration provides financial support and medical benefits to individuals suffering from qualifying illnesses, injuries, and emotional problems.  These benefits are provided under two programs; Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  People suffering from chronic medical conditions such as Lupus may be eligible for SSDI or SSI benefits (both commonly referred to as Social Security Disability benefits).

To qualify for either SSDI or SSI, a person must prove that they cannot work, in an occupation for which they are suited, due to a long-term medical condition, must be out of work due to disability for 5 months in order to qualify for benefits, and the medical condition must be expected to last for a minimum of a year or be expected to cause death.   The Social security administration determines which program people qualify for based on work history.  SSDI is available to people have paid into the FICA through their wages.  SSI is for people who meet income guidelines, regardless of work history.

Lupus is a chronic inflammatory disease that occurs when the body’s immune system attacks its own organs and tissues.   There are four types of lupus; systemic lupus erythematosus, discoid lupus erythematosus, drug-induced lupus erythematosus and neonatal lupus. Of these, systematic lupus erythematosus is the most common and serious form of lupus.

The symptoms of lupus vary, making diagnoses difficult.  Physicians sometimes misdiagnosis or dismiss the symptoms.  Initial symptoms include fever, muscle and joint pain, and fatigue.  Other diagnostic factors include dermatological, musculoskeletal, hematological, pulmonary, cardiac, and neurological symptoms, including; skin rashes and lesions, anemia, low white blood cell count, inflammation of organs, pulmonary hypertension and hemorrhage, extreme joint pain, and excess red blood cells and proteins in the urine. Inflammation caused by Lupus can affect many body systems, but it most frequently attacks the skin, joints, blood, heart, lungs, nervous system and kidneys. There is no cure for lupus, but there are treatments for certain symptoms, most commonly immunosuppressants and corticosteroids.

The Social Security Administration has compiled a list of medical conditions so severe that they will most likely cause a person to be declared disabled, called the “Blue Book.”  Systemic lupus erythematosus is included in the Blue Book as a qualifying condition, and lists specific criteria for eligibility.  To see if your lupus is at the listing level, review the Blue Book listing 14.02.

The Social Security Administration denies over 60% of first time disability applicants.  The majority of these applications are denied due to insufficient documentation of their medical condition.   To improve your chances of being approved for Social Security benefits, be sure to submit all available documentation, including; proof of diagnosis, complete medical records, all test results, course of treatment, duration of condition, medications (and any negative side effects), and functional limitations.