Autoimmune Conditions and Social Security Disability

Submitted by Eric on

If you have a severe autoimmune disorder you should qualify for disability as it is a disabling condition that prevents you from working and carrying out daily activities.

Autoimmune diseases cause the body’s immune system to attack and destroy healthy body tissue, even though the immune system is supposed to help to protect the body by attacking harmful antigens, like bacteria, viruses, and toxins. There are more than 80 different types of autoimmune diseases.

Is an Autoimmune Disease a Disability?

 Yes, an autoimmune disease can be considered a disability by the Social Security Administration (SSA). However, you’ll need to meet one of the SSA listings in section 14.00 of the Blue Book. You are also required to provide enough medical evidence proving your autoimmune diagnosis to qualify for disability benefits. The following autoimmune diseases are listed in the Blue Book under section 14.00:

Systemic lupus erythematosus

This is a chronic inflammatory disease that can affect any organ or body system.

HIV infection

You may be considered disabled if you have been diagnosed with acquired immune deficiency syndrome (AIDS) under the Blue Book listing 14.11 as long as the impairment meets the criteria in that listing.

Systemic vasculitis

This is an inflammation of blood vessels which may become severe when linked to adverse drug reactions, particular chronic infections, and sometimes malignancie.

Systemic sclerosis (scleroderma)

This covers a number of diseases constitutes when thickening of the skin takes place.

Polymyositis and dermatomyositis

This is when inflammation is present in striated muscle which may occur alone or in association with another autoimmune disorder or malignancy.

Inflammatory arthritis

This is when inflammation of any of the major joints occurs which causes difficulties with walking and other types of movement. Joint pain and swelling are symptoms of inflammatory arthritis. Inflammatory arthritis which affects the peripheral joints may be connected with other disorders such as:

  • Sjögren's syndrome;
  • Rheumatoid arthritis;
  • Psoriatic arthritis;
  • Lyme disease;
  • Inflammatory bowel diseases;
  • Crystal deposition disorders (gout and pseudogout).

If you can show you have had stem cell transplantation to treat your immune deficiency disorder, the SSA will consider you to be disabled until at least 12 months from the transplant date.

Disability Benefits for Autoimmune Disorders

You may be eligible to apply for disability benefits from the Social Security Administration (SSA) if you suffer from an autoimmune disorder. The SSA considers several criteria before approving disability benefits. If you cannot work because of your symptoms and your symptoms match the description of one or more of the disorders described in the SSA’s Blue Book, then you have a better chance of obtaining benefits.

Unless you are unable to work for at least the next 12 months, you are unlikely to be eligible for disability benefits. A residual functional capacity (RFC) assessment, which can be completed by your doctor, can help to establish whether your physical impairments caused by the autoimmune disorder would prevent you from gainful employment and whether you are capable of any work at all.

The Blue Book has a whole section on immune disorders. Autoimmune disorders are defined in section 14.00(D). Autoimmune disorders are categorized as immune disorders in which the body’s own immune system attacks some of its own body tissue. 

The degree of impairment depends on the length of time the disorder has lasted, the course of development it has taken and the specific tissues that have been affected. Autoimmune disorders are often chronic and hard to treat. Adult autoimmune disorders are often not the same as the same disorders in children. Typical diseases known to be caused by autoimmune malfunction include:

  • rheumatic diseases;
  • connective tissue disorders;
  • collagen vascular disorders.

Types of Autoimmune Disorders

The top 10 most common autoimmune diseases are the following:

  • Vitiligo;
  • Rheumatoid arthritis;
  • Rheumatic fever;
  • Pernicious anemia/atrophic gastritis;
  • Hashimoto's autoimmune thyroiditis;
  • Graves' disease;
  • Lupus;
  • Diabetes mellitus, type 1;
  • Celiac disease.

 

How to Qualify with an Autoimmune Disease

An autoimmune condition such as lupus may be able to get disability benefits. If you are suffering from lupus, the SSA’s Blue Book may help you decide the type of medical evidence you will need to support a claim for Social Security benefits.

Lupus affects its victims in different ways, but there are some lupus sufferers who are unable to work because of the effects of the disease.

Lupus can be located in the Blue Book list under the Immune System Disorders section. In order to meet the requirements for eligibility for a disability benefit for lupus at least two of your body systems or organs need to be affected by the disease and you need to be able to prove you have symptoms like fever, fatigue or weight loss which are persistent and ongoing.

You also need to prove you cannot undertake daily activities like washing, cooking and cleaning in your home, as well as going to work and shopping.

Most people who suffer from severe lupus are able to meet the Blue Book listing requirements. If you can’t provide adequate evidence proving your disability is caused by lupus you can ask your doctor to conduct a residual functional capacity (RFC) test which will provides the evidence of what you can and cannot do with lupus.

The more evidence you can provide showing the effects of lupus when filing your disability benefit’s application, the greater the chance you will have to be eligible to receive disability benefits. The evidence you will need to provide such as:

  • results of tests used to rule out other medical conditions that may have similar symptoms to lupus;
  • your doctor’s report about the effects of treatment over a period of at least 3 months but preferably 12 months;
  • a list of prescription medications you are taking and their effects on your symptoms;
  • a description of stays in hospital and the treatment provided;
  • test results revealing the onset of kidney or heart disease, seizures, bone loss, anemia, and other serious medical conditions.

If you have a severe autoimmune disease then you may qualify for a disability benefit as long as you provide medical evidence that shows you are unable to work for at least 12 months.

Additional Resources

Add new comment

Find Out If I Qualify for Benefits!