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Lupus and Social Security Disability

Lupus - Condition and Symptoms

Lupus is a chronic autoimmune disorder that affects organ systems, skin, joints, and internal organs. Normally the immune system produces proteins called antibodies that protect the body from viruses and bacteria. In Lupus and other autoimmune diseases, the immune system cannot tell the difference between these foreign invaders and the body’s healthy tissues, so it creates auto-antibodies that attack and destroy healthy tissue, causing inflammation, pain, and tissue damage. Lupus symptoms flare and then fade into remission, and the disease itself can be mild to life-threatening. While anyone can have Lupus, it is more common among women.

There are a number of different types of Lupus. The most common form of the disease is Systemic Lupus Erythematosus (also known as SLE), which affects the entire body including skin, joints, and the internal organs and nervous system. Cutaneous Lupus is another type of Lupus which affects the skin only, causing rashes and lesions.

Drug-induced Lupus is not a disease, but rather a condition that has symptoms similar to systemic Lupus which is caused by certain drugs. It only rarely affects major organs and the Lupus-like symptoms usually disappear when use of Lupus-inducing medications is suspended.

Most babies born to mothers with Lupus are healthy at birth. Neonatal Lupus is a rare condition affecting infants of some women who have Lupus, caused when antibodies produced by the mother attack the fetus. While a newborn with neonatal Lupus may have Lupus like symptoms at birth, these symptoms usually disappear completely after several months and do not cause permanent damage. However, some newborns with neonatal Lupus may be born with a heart defect.

Lupus is difficult to diagnose because it can have so many symptoms and those symptoms may commonly have causes other than Lupus. It is possible to test positive on some diagnostic tests for Lupus and not have the disease. Lupus develops over time and symptoms appear and disappear. It is important for your doctor to track your symptoms over time and to rule out other possible causes of your symptoms.

If your doctor suspects you may have Lupus, he or she will order routine blood tests, such as a CBC, which may reveal low levels of red and white blood cells, platelets, and blood serum. Other routine tests are urine tests (to see if the kidneys are filtering properly and to test for protein in the urine), blood tests that indicate inflammation of the body’s tissues, blood clotting time tests, tissue biopsies, and an antinuclear antibody test.

Most people with Lupus have antinuclear antibodies and if you also have other signs of Lupus this antinuclear antibody test can (but does not always) confirm your diagnosis. Your doctor will also look for antibodies to double-stranded DNA, antibodies to histone, antibodies to phospholipids, antibodies to Ro/SS-A and La/SS-B, antibodies to target Sm proteins in the cell nucleus, and antibodies to RNP target ribonucleoproteins. The presence of these other antibodies usually serves to confirm the diagnosis of Lupus.

Symptoms of Lupus include hair loss, changes in hair and skin pigment, various types of rashes, high fevers (over 100 degrees), blood clots, seizures, memory problems, headaches, behavioral changes, confusion, arthritic joints, numb or painful fingers and toes, anemia, sensitivity to light that causes or aggravates a rash, swelling in the legs and ankles, chest pain when breathing deeply, protein in the urine, extreme fatigue and weakness, heart attack, stroke, and miscarriage.

Lupus is treated with anti-inflammatory corticosteroids, anti-malarial immuno-suppressives and anti-coagulant medications, depending on the symptoms that are present. In addition, people with Lupus are generally advised to get adequate rest at night and to take naps during the day, to stay out of the sun and avoid fluorescent and halogen lights, get regular exercise, eat a good diet, and stop smoking.

Filing for Social Security Disability with a Lupus Diagnosis

The Social Security Administration (SSA) lists Systemic Lupus Erythematosus under Section 14.00D1 and Section 14.02 of the Blue Book. SSA requests medical evidence of a Lupus diagnosis that will satisfy the criteria for "Classification of Systemic Lupus Erthematosus” in the most recent edition of the Primer on Rheumatic Diseases published by the Arthritis Foundation. These criteria include constitutional symptoms and major organ or body system involvement. In addition to this medical evidence, SSA requires that you meet the criteria under either Paragraph A or Paragraph B below:

  1. Your medical documentation must show that at least two or more of your major organs or body systems are affected by Lupus AND that at least one of those organs or body symptoms is affected to at least a moderate level AND have at least two symptoms, such as severe fatigue, fever, malaise, or involuntary weight loss.
  2. OR

  3. You have experienced repeated manifestations of Lupus with at least two of the constitutional symptoms (severe fatigue, fever, malaise, or involuntary weight loss) AND marked limitation of at least one of the following:
    1. your activities of daily living,
    2. your ability to function socially, or
    3. completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

Cutaneous Lupus would be classified as a skin disorder under Section 8.00 of the Blue Book if you have no involvement of organs other than the skin.

Your Lupus Disability Case

If your disability due to Lupus is so severe that it prevents you from working, you may be entitled to Social Security Disability (SSDI) benefits. Although total disability based on a diagnosis of Lupus can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified Social Security disability attorney or advocate can improve your chances of winning your disability claim.