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Scleroderma and Social Security Disability

If you have been diagnosed with scleroderma, which is a disorder of the immune system, and it has left you unable to work you may be able to get approval for Social Security disability benefits. The disorder can cause pain and numbness of the hands and feet, pain and swelling of the joints, and digestive and pulmonary issues that result from inflammation of scarring in the tissues of the esophagus and lungs.

It is categorized by the part of the body that it impacts and the severity. It can impact a limited part of the body or multiple systems, which makes it more dangerous and severe.

In order to gain approval for disability benefits, you have to prove that your condition has lasted or will last for a minimum of 12 months or result in death. Scleroderma is a chronic condition that is not curable, so you will have the condition your entire life. Your focus will be on proving the severity of your particular condition and how it limits your ability to work or do daily activities. Advanced scleroderma, which has attacked multiple body systems can lead to death.

The Cost of Treating Scleroderma

According to Cost Helper, autoimmune diseases are some of the more expensive disorders to treat. Autoimmune diseases rank third as the cause of death in the United States. It is estimated that scleroderma has a financial impact of $1.5 billion in the U.S. each year. The direct patient cost exceeds more than $460 million each year. Brand name immunosupressants, such as CellCept, can cost anywhere from $500 to $1,000 each month. Chemotherapy treatments, such as Cytoxan, can be used effectively in scleroderma patients costing as much as $12,000 for a round of treatment.

Medical Approval for Disability Benefits

If you can prove that you have a confirmed diagnosis of scleroderma as outlined in the Social Security Administration's (SSA) medical guide, which is the Blue Book, and have evidence that your condition is disabling you may be approved for monthly disability benefits. In the Blue Book list of qualifying impairments, scleroderma is listed as an immune system disorder filed under adult and childhood impairments where it is specifically noted as an autoimmune disease.

In order to medically qualify for disability benefits with scleroderma, you have to be able to provide adequate documentation that matches the definition listed in Section 14.00 of the Blue Book as well as one of the following impairment combinations:

  • Two areas of your body must be affected with one area severely impacted OR
  • You must have two symptoms of severe illness meeting the SSA definitions.

If you have chronic scleroderma that is not as severe, you must be able to show two symptoms of extreme illness while also providing evidence that your condition also impacts our ability to function in normal daily activities as well as maintain steady employment in your occupation.

If your condition is severe when it comes to mobility, such as in the hands or feet, you must be able to prove that it severely limits or complete prevents you from walking or using hands dexterously, which impacts your ability to do physical work duties. Reynaud’s syndrome, which is condition commonly associated with scleroderma, can often be sufficient in proving your disability because of its gangrenous or numbing impacts on extremities, particularly the hands or feet.

Meeting the Requirements of a Residual Functioning Capacity for Disability Benefits

If you don’t meet the criteria of a Blue Book medical listing to get approved for disability benefits, you may still be eligible for benefits approval with a residual functioning capacity (RFC) through the medical-vocational allowance. Your treating physician will complete the RFC and specifically list any restrictions or limitations that you may encounter during your daily activities and work duties.

As an example, if your scleroderma also involves Reynaud’s syndrome, your doctor may indicate that because of the severity of numbness involving your hands that you cannot grasp or do fingering duties. You may not be able to stand or sit in a position for more than an hour or two without having to reposition, so that can impact your ability to maintain a job. Because of lung problems, you may not be able to stand for long periods or walk long distances. Your lung problems may keep you from working around chemicals or in areas that are too hot or too cold.

Because some treatments for scleroderma involve chemotherapy drugs, you may experience fatigue, severe nausea, and weight loss that also impact your ability to work and that should be clearly indicated in the documentation. If you are taking CellCept and it causes frequent digestive issues such as diarrhea and vomiting that should be noted as that will impact your ability to work because of frequent bathroom trips. If your medication causes dizziness or fainting that should also be noted as that will keep you from working as well.

Your scleroderma may also impact your mobility or your ability to use your hands, so that can also prevent you from doing a light-duty job, such as a sedentary position. The medical-vocational allowance also considers your work history, transferrable skills, age, and educational level. With the proper documentation and a completely detailed RFC, you can prove that your condition does severely limit your ability to do daily activities and prevent you from working to earn a substantial gainful income.

The Social Security Application Process

The Social Security disability process is very detailed and complex. In order to prove your case and be awarded benefits, you have to provide thorough and extensive documentation that contains evidence that clearly shows your disability and limitations. You have to include medical tests that confirm your diagnosis, which includes blood tests, x-rays, and scans for scleroderma. Your doctor’s notes should indicate your symptoms, treatment that you have undergone and your response to that treatment.

The application process can also be started in person with a visit to the local SSA office. Because of the complexity and detail involved with the disability claims process, you can benefit from enlisting the help of a Social Security disability attorney. An attorney can greatly improve your odds of being approved for benefits.