How To Get Social Security Disability & SSI Benefits: Lupus

Winning Your Lupus (Systemic Lupus Erythematosus) Case

How Social Security Views It - Lupus Medical Treatment

Lupus is a somewhat uncommon Social Security and SSI disability case, but it can be a serious one. Lupus is an autoimmune disease (the body's immune system attacks itself) that mainly attacks the joints, kidneys, skin, and blood vessels. Symptoms are many and wide-ranging and usually include the following:

1. Feeling ill,
2. Fever,
3. Joint pain,
4. Muscle weakness,
5. Fatigue,
6. Chest pain,
7. Kidney damage,
8. Shortness of breath,
9. Alopecia, and
10. Rashes.

Disability will be granted by Social Security if your diagnostic testing and resulting treatment show significant findings. Lupus is primarily diagnosed by a blood test. Because lupus can affect so many parts of the body, specific testing may be done for a specifically affected body part such as the kidneys and blood vessels. The cause of lupus is unknown, and there is no cure. Therefore, treatment is limited to addressing the symptoms of lupus. Social Security will be highly concerned with your overall treatment because the extent of your treatment and your medical records will describe to Social Security the severity of your lupus - what symptoms you report to your doctor and what physical signs your doctor finds in clinical examinations. Generally, treatment includes medications - corticosteroids (Prednisone), nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen, antimalarial drugs (Plaquenil), and immunosuppressants (methotrexate).

Tip. Lupus is a medical condition wherein symptom severity ranges very widely. Medical records do not always fully explain the severity of the condition. Hence, it is possible to have severe symptoms and terribly nondescript documentation in your medical records. Therefore, you should do two things. First, check your medical records and see if they accurately describe your condition. If not, talk to your doctor. Second, obtain a doctor statement. It is often the case that doctors will not alter the medical records or change the way they write them, but the doctor will address your disability in a statement - Doctor Statement.

The Lupus Social Security & SSI Listing

Adult Listing 14.02 and Child Listing 114.02. An adult satisfies the listing by meeting points 1 or 2. A child satisfies the listing by meeting point 1.

1. You have at least two body organs affected and
1. One of your body organs is affected to at least a moderate level of severity, and
2. You have at least two of tiredness, fever, illness, or weight loss; or
2. You have severe continuing problems with at least two of tiredness, fever, illness, or weight loss with a markedly severe restriction in one of -
1. Everyday duties,
2. Social abilities, or
3. Focusing and attending to an agenda.

A Lupus Hearing Success

Mrs. Lewis was a hard-charging women. She was determined not to lose her Social Security disability case. She had been diagnosed with Lupus. She was 46. She had a good work record after she raised her kids. She had been denied at the initial and reconsideration levels, and we presented her case at the a hearing in Cleveland, OH.

Because she was under age 50, we had an any-job standard. That is, we had to prove she could not perform any job in America. If she could perform the easiest work in America - essentially sedentary (sit down) unskilled work, she would lose.

The main issue we had in her case was the Lupus diagnosis. Her primary doctor diagnosed Lupus, but he did not specifically note what diagnostic criteria was satisfied. Mrs. Lewis had been treated only once by a rheumatologist who also did diagnose Lupus. Mrs. Lewis had been treated twice by a neurologist who also did diagnose Lupus. Mrs. Lewis's pain management doctor did not diagnose Lupus which was not entirely unexpected. Mrs. Lewis attended a Social Security consultative examination (CE), but the CE doctor did not make specific diagnoses - including no specific diagnosis of Lupus. Mrs. Lewis's primary doctor was unwilling to offer a doctor statement.

She suffered classic Lupus symptoms: feeling ill, joint pain, muscle weakness, and fatigue.

We could not argue she met the Social Security Lupus Listing because she did not have organ invovement (damage).

Mrs. Lewis was asked to keep a diary which she kept fo the last six months prior to the hearing. Each day, she had noted about three or four sentences of her symptoms and limitations. Her diary indicated she lay down for most of each day.

At the hearing, we focused on the two things: 1) the diagnoses of her PCP and the rheumatologist, 2) her symptoms common for Lupus that caused her to lie down throughout the day, and 3) her good work record.

We did not get a decision at the hearing. Mrs. Lewis was a believable and sympathetic witness. About 60 days after the hearing, she received a partially favorable decision as of the date of the rheumatologist diagnosis whcih was about 8 months after Mrs. Lewis's alleged onset date.

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