How to Qualify for Disability with Lupus (Updated 2023)

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You are able to get disability with lupus if it impairs your ability to work full time. If you are able to meet the medical and work requirements that the SSA has outlined and you will be out of work for at least 12 months, you may be able to qualify for disability with lupus.

What is Lupus?

Lupus is an autoimmune disease that causes inflammation throughout any part of the body. It occurs when the immune system attacks its own tissue. 

The Lupus Foundation of America estimates that there are about 1.5 million people in the U.S. living with Lupus.

For those with lupus that is more aggressive or unresponsive to treatment however, the disease can quickly limit employability or put an end to working entirely.

For those with lupus, it is one of many conditions that qualify for disability. If your lupus has made work impossible or has significantly limited your ability to maintain full-time, gainful employment, then you may be able to get approved for disability benefits through the Social Security Administration (SSA). By meeting the Blue Book listing for lupus, those with lupus can qualify for disability benefits. 

These benefits can be the financial relief you need to ensure your bills are paid and that your medical care and everyday living expenses are covered.

Is Lupus a Disability?

Yes, lupus is considered a disability by the SSA and is under the list of disabilities that the SSA has of conditions that qualify for disability.

Since lupus is a disease in which the body’s immune system attacks organs and tissue can produce a wide variety of symptoms that include fever, fatigue, and joint pain, people can get disability for lupus by meeting the requirements of the SSA's Blue Book listing for lupus.

 It is important to note that a lupus disability applicant not only has to prove the existence of lupus, but also must prove that the symptoms of the disease make it impossible for them to work their current job.

Can You Get Disability for Lupus?

Yes, you are able to get disability for lupus if you meet both the medical and work requirements outlined for disability by the SSA. 

Meeting the Blue Book (which is the list of disabilities that qualify for Social Security disability benefits) listing for lupus under Section 14.02 is just one requirements that determines whether you qualify for Social Security disability benefits.

 This is because the SSA has other criteria that disability applicants must meet in order to get approved for disability with lupus

For example, the SSA requires applicants to have worked long enough prior to their development of their disabling medical condition. The SSA measures work history based on applicants' accumulation of work credits. This is because, for every year that an individual works, they earn a certain amount of work credits. 

You can earn as many as four work credits each year.

The amount of wages and/or self-employment income you need to earn for a work credit also changes each year. For example, you will earn one work credit for every $1,640 you generate in wages and/or self-employment income throughout 2023.

When you earn $6,560 in wages and/or self-employment income, you reach the maximum number of work credits allowed by the SSA. Regardless of your age, you must earn the minimum number of work credits within a period designated by federal law.

You also have to demonstrate you have missed work for 12 consecutive months in order to get disability for lupus. The timekeeping records maintained by your employer, as well as the copies of bank statements, act as evidence of missed time from work.

How to Medically Qualify For Lupus Using the Blue Book

Figuring out which conditions qualifies for disability comes down to whether or not the condition is listed in their Blue Book. The Blue Book is the SSA’s manual of medical conditions that they see as being severe enough to qualify someone for disability. 

Since there is a Blue Book listing for lupus, people can get disability for lupus. The specific Blue Book listing for lupus is in Section 14.02 – Systemic Lupus Erythematosus.

The Blue Book listing for Lupus is as followed:

 A. Involvement of two or more organs/body systems, with:

  1. One of the organs/body systems involved to at least a moderate level of severity; and

  2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).


B. Repeated manifestations of SLE, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:

  1. Limitation of activities of daily living.

  2. Limitation in maintaining social functioning.

  3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

The SSA’s Blue Books defines the severity of symptom standards applicants have to meet to qualify lupus as a disability.

lupus erythematosus disability If you suffer from lupus, you must show the disease has negatively impacted two or more organs and/or body systems. You also have to suffer from at last two serious symptoms that have forced you out of work.

The SSA also names the limitations that can make a disability claim valid under the guidelines established by the Blue Book.

 If lupus limits your daily activities, social functioning skills, and the ability to complete tasks on time, then you might be eligible for disability benefits.

 The SSA applies rules to every disability, including being unable to work and transition to another occupation, as well as the symptoms of the disease are expected to remain for at least one year.

To prove you suffer from severe lupus symptoms, you must submit convincing medical evidence. Medical evidence of lupus includes:

  • Results of diagnostic tests used to rule out other medical conditions that cause similar symptoms as lupus
  • Longitudinal reports from your doctor, reporting symptoms, complications, treatments, and treatment affects over a period of three or more months (12 months is even better)
  • Prescription medications used and their affects on your specific symptoms and complications
  • Hospitalization and other treatment records, if appropriate
  • Test results or lab work reports, showing diagnosis of common complications, like kidney or heart disease, bone loss, seizures, anemia, etc. 

You should submit copies of every healthcare receipt, including the cost of prescription medications and the use of an assistive device. Ask your healthcare provider to submit a statement that describes your prognosis of making a full or partial recovery. 

Successful completion of these things can be one of, if not, the most important signs your disability claim will be approved.


Qualifying for Disability Without Meeting The Listing For Lupus

Most people with severe or advanced  lupus are able to satisfy the Blue Book listing requirements. If you are not however, then you may still be able to prove your disability through a “residual functional capacity” (RFC) analysis.

This process is standard for the SSA for any applicant that doesn’t meet or closely match a disability listing. You’ll receive notification in the mail that more information is needed to evaluate your claim.

Along with this notification, you’ll receive questionnaires about your physical and/or mental limitations.

When you fill out these questionnaires, be honest and detailed. Tell the SSA about all of the affects that your symptoms, treatment side effects, and lupus complications have on your everyday life.

For example, fatigue, fever, and a general feeling of “illness” may prevent you from getting out of bed or leaving your home and therefore mean frequent absences from work.

Pain, inflammation, and weakness may stop you from doing everyday tasks, like laundry, sweeping the floor, or mowing the lawn.

This kind of information may at first seem silly for the SSA to ask for, but they use these details about your everyday life to better understand how your lupus may limit your ability to perform common job functions. For example, if you can’t mow the lawn or clean your house, then you can’t perform physical job duties, like those required in retail jobs, manufacturing positions, or similar employment situations.

It’s important to understand though that in order to be approved through an RFC with Lupus, you must also show that your lupus would prevent you from working in an office or other primarily sedentary job.

To avoid denied disability, the SSA must see that you experience problems with completing tasks in a timely manner, processing thoughts or other information, or that you have other cognitive or physical symptoms that would keep you from working at all, in any job whatsoever.

Work with a Disability lawyer To See If You Qualify for Disability with Lupus

Disability lawyers are only paid if you win your claim. That means that you do not have to pay unless you win your claim. A disability attorney will help you make sure all of your medical paperwork is in order, get notes and get recommendations from your doctors. Your disability lawyer will also be able to testify on your behalf and help gather witnesses to help prove your lupus disability case. 

According to a study from the U.S. Government Accountability Office (GAO), those who used a disability lawyer when applying for disability were 3x more likely to get approved than those who did not use a disability lawyer.

You’ll need your financial details, work history, and education information before applying for benefits. Gathering contact information for all your medical care providers is recommended too, as the SSA will need these details to request copies of your medical records.

Considering applying for Social Security disability benefits but not sure how much you’ll earn per month? Our SSDI Calculator can help you determine how much you’ll receive from the SSA before you file for disability

When you’re ready to start your application, you can visit the SSA’s website to apply for SSDI, or you can go to the local Social Security office to apply for SSI and/or SSDI benefits.

Take our Free Disability Evaluation to see if you qualify for disability.

Common Questions For People Applying For Disability With Lupus

When applying for disability with lupus, there are a lot of common questions that people ask regarding their claim. 

Common questions include how much someone can get for disability, how long the process takes, the costs associated for having lupus, etc. 

When you work with a disability lawyer, your lawyer will be able to help you answer any questions you have regarding your claim. Below are a list of common questions that people have regarding filing for disability with lupus.

How Much Can You Get For Disability For Lupus?

The maximum amount you get for disability with lupus is $3,627. The amount you will receive in disability benefits after you have been diagnosed with lupus will depend on your situation, including your average lifetime earnings before you became disabled. 

How Long Does it Take to Get Disability for Lupus?

It takes between 3-5 months to receive an initial decision from the SSA regarding your lupus disability claim. However, 2 out every 3 of applicants are denied at the initial stage. 

You have the option of appealing the SSA’s decision regarding your lupus disability claim, which will delay the process of you receiving disability. A disability attorney can help increase your chances of winning your disability claim, which can help speed up the process. 

How Much Can Having Lupus Cost You? 

Lupus is a chronic condition that must be closely monitored to ensure systemic effects are minimized. In other words, you regularly see your doctor in order to have tests performed to find and prevent or limit damage caused by the disease.

Monitoring costs therefore add up quickly, though the exact expenses are different for each patient, due to the varying nature of the disease itself.

The Lupus Foundation of America reports that the average annual direct medical costs are $12,643 per patient. The type and severity of your symptoms significantly affect your direct medical expenses though.

For instance, a person for whom lupus affects multiple body systems (joints, heart, kidneys, and skin) will have higher treatment costs than a patient for whom the disease primarily affects only one body system.

Doctors must often prescribe multiple medications to control symptoms, and frequent prescription adjustments may be necessary, especially while trying to discover the right cocktail of drugs to effectively control your lupus.

Common prescriptions include corticosteroids, antimalarial drugs, and other autoimmune suppression medications, like Acthar and Benlysta.

If you have severe complications from lupus, then you may need additional prescriptions, including high blood pressure drugs, diuretics to reduce fluid retention, anti-seizure medications for seizures, or antibiotics to treat frequent infections.

With all of these medications combined, your monthly prescription costs may run several hundred, or even several thousand dollars, dependent upon your prescription drug insurance coverage.

Lost work time cannot be overlooked when considering the costs of living with lupus, and the Lupus Foundation of America reports the average annual loss of income at $8,659 per person.

This is, of course, when employment is still an option. When lupus prevents work entirely, then you’re faced with the challenge of surviving without employment income.

Whether you work reduced hours or cannot work at all, Social Security disability benefits for lupus can be the answer to your financial concerns.

What Are Functional Limitations of Lupus?

It's possible that your lupus is affecting only one organ or bodily system significantly, such as your kidneys, but not another organ even marginally, so you don't meet the medical requirements.

You might not meet the functional restrictions criterion if you can still take care of yourself (feed yourself, clean your house, shop for your household necessities, etc.) and maintain a social life, and you don't have any mental difficulties that prevent you from accomplishing chores.

However, if you are unable to work full-time (for example, because you need kidney dialysis twice a week), due to lupus work restrictions, you are still entitled to disability benefits. Because of limitations, you may be eligible for benefits in this case.

Next Steps to Take

If you have lupus and you believe you will be out of work for at least 12 months or more, then you should apply for disability. A disability lawyer can help increase your chances of getting approved for disability. To get connected to an attorney who can take a case in your area, fill out our free disability evaluation today.

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