Can You Get Disability for Lupus? Lupus Disability Benefits From the SSA

Living with lupus makes everyday tasks like chores and work incredibly challenging, because. Lupus is an autoimmune disease where your immune system attacks healthy tissue, causing inflammation and damage. This affects the skin, joints, kidneys and heart, and can cause severe symptoms. If lupus is affecting your life and work, you may wonder if you qualify for disability. So, can you get disability for lupus? Knowing how the SSA views lupus as a disability and how to apply for benefits can give you financial help.

Getting Social Security Disability for Lupus: Key Takeaways

• Lupus can be rated as a disability by the SSA if it seriously limits your ability to work.
• Systemic lupus erythematosus (SLE) is listed in the SSA’s Blue Book, under Section 14.02.
• You need detailed medical records showing lupus’s impact on your organs and daily life.
• Chronic symptoms like severe fatigue and organ damage are key to eligibility.
• It can be complicated and often requires legal help, as most initial claims are denied.
• Knowing the steps to appeal can help you get benefits if denied.

What is Lupus? Symptoms and Side Effects

Lupus is a chronic autoimmune disease where your immune system attacks healthy tissue, causing widespread inflammation and damage. It can affect many parts of the body, including the skin, joints, kidneys and heart. Common symptoms of lupus include:

• Fatigue: Persistent tiredness that can be overwhelming.
• Joint Pain and Stiffness: Discomfort in joints that can limit movement.
• Skin Rashes: A butterfly-shaped rash across the nose and cheeks is characteristic.
• Photosensitivity: Sensitivity to sunlight can worsen skin problems.
• Shortness of Breath and Chest Pain: Inflammation around the lungs or heart causes these symptoms.
• Cognitive Issues: Problems with memory, concentration, and confusion.
• Kidney Problems: Potentially severe impact on kidney function.

Symptoms can vary greatly from person to person and come and go, with flares where they get worse. Managing lupus usually requires medication to control symptoms and prevent organ damage, but medication can also have big side effects.

In addition to these symptoms, lupus can cause cardiovascular problems, infections, and mental health issues like depression and anxiety. These add to the condition, not just physical health but overall well being. Early diagnosis and treatment is key to managing lupus and minimizing its impact on daily life.

Disability Criteria From the SSA

The Social Security Administration (SSA) has specific criteria to determine if a condition qualifies for disability benefits. To be considered disabled by the SSA and qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), an individual’s condition must meet these guidelines. Here’s what generally applies:

• Severe Impairment: The condition must be severe enough to prevent the person from doing basic work activities. This includes physical, sensory or mental functions that are needed for most jobs, like standing, walking, lifting or concentrating.
• Duration Requirement: The impairment must last or be expected to last at least 12 months or result in death. Temporary conditions do not meet the SSA’s disability requirements.
• Unable to Work: The individual must not be able to do their previous work and must not be able to adjust to other work due to the medical condition. This includes considering age, education and work experience in determining the ability to adjust to other jobs.

In addition to the above, you must not be able to do Substantial Gainful Activity, meaning you can not earn a living wage from your job. As of 2024, the income limit is $1,550 per month for sighted individuals and $2,590 for blind individuals.

Is Lupus a Disability According to the SSA?

The Social Security Administration (SSA) has specific criteria to determine if a condition like lupus is a disability. For lupus, the SSA’s Blue Book has specific requirements under Section 14.02 for systemic lupus erythematosus (SLE). The lupus disability criteria requires you to experience the following symptoms to be considered:

• Involvement of Two or More Organs: Lupus must damage at least two organs or body systems, like kidneys, heart or brain. At least one of these organs must have moderate to severe symptoms.
• Severe Symptoms: You must have at least two severe systemic symptoms like extreme fatigue, fever, malaise or unintended weight loss. These symptoms must be persistent and affect your overall well being.

Or if the above is not met, you can qualify if lupus causes:

• Significant Functional Limitations: The disease must severely limit your ability to do daily activities, interact socially or complete tasks on time. This can include difficulty with basic activities like bathing or dressing, challenges in social situations or inability to focus and complete work tasks on time.

To qualify for SSA disability benefits you must provide detailed medical evidence that supports your diagnosis and documents how lupus affects your daily life and ability to work. This evidence can include medical records, doctor’s reports and test results. Thorough documentation is key to proving the severity and duration of your condition.

Meeting these SSA criteria requires detailed and specific medical documentation. Your doctor’s notes, lab results and treatment records are key. They must show how lupus affects your body and limits your daily activities. This information helps the SSA determine how lupus impacts your ability to work and live your daily life.

Which Lupus Symptoms Might Limit Your Ability to Work?

Lupus can severely impact your ability to work because of its many symptoms. Chronic fatigue makes it hard to have energy throughout the workday. Joint pain and stiffness limits mobility and dexterity making tasks in physical and desk jobs challenging. Lupus can also cause skin rashes and photosensitivity, making it hard to work in bright or outdoor environments. Cognitive issues like memory problems and difficulty concentrating can impact job performance especially in jobs that require sharp mental focus.

Damage to organs like kidneys or heart means frequent medical appointments and severe health issues that disrupt your work schedule. Mental health issues like anxiety and depression related to lupus can also impact your attendance and performance at work.

Other Medical Conditions & Comorbidites That May Help You Get Disability for Lupus

When applying for disability benefits due to lupus, detailed and accurate medical evidence is key. This evidence should document your diagnosis, symptoms and how they affect your daily life and work abilities. Here’s what you need to gather:

• Medical Records: Provide doctor’s notes on your lupus symptoms, treatments and how the condition affects your daily activities and ability to work. Records should show the severity and duration of your symptoms.
• Diagnostic Tests: Include blood test results, imaging test results and other diagnostic tests that confirm your lupus diagnosis and organ involvement. These tests are important to show how lupus affects your body.
• Treatment Plans: Submit documentation of your treatment plans, medications and their effect on your symptoms. This will show ongoing management and how it impacts your condition.
• Specialist Reports: Reports from rheumatologists or other specialists who have treated your lupus will provide in-depth information on the severity and prognosis of your condition. These reports are often crucial in proving the severity of your lupus.
• Evidence of Work Impact: Provide records that show how lupus symptoms limit your work ability. This can include letters from your employer about missed work or reduced performance due to your condition.

Having all the medical evidence will help you get approved for disability benefits, as it will show how lupus affects your ability to function and work.

How to Apply for Lupus Disability Benefits

Applying for disability due to lupus involves several steps. Knowing these steps will help you navigate the process better. Here’s how to apply for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI):

Applying for Social Security Disability Insurance (SSDI) With Lupus

SSDI benefits are provided for people who have a work history and have paid Social Security taxes. To be eligible for SSDI you must:

• Work Credits: Have enough work credits based on your age and the years you have worked. Generally you need to have worked at least 5 out of the last 10 years.
• Disability Severity: Have a medical condition that meets the SSA’s definition of disability which means you cannot work due to your condition and it will last at least 12 months or result in death.
• Income Limits: SSDI is not income or resource limited but substantial gainful activity (SGA) limits apply. In 2024 if you earn more than $1,550 per month you will be disqualified from SSDI.

You can apply for SSDI in several ways. You can apply online through the SSA website where you can fill out the application and upload all required documents. This is the most convenient way and you can do it at your own pace. Or you can apply by phone by calling 800-772-1213 and a representative will guide you through the application process. Or you can visit your local Social Security office. It’s recommended to schedule an appointment so you can get one on one help and avoid long wait times.

Applying for Supplemental Security Income (SSI) With Lupus

SSI is designed for individuals with limited income and resources. It does not require a work history. To be eligible for SSI, you must:

• Financial Criteria: Have limited income and resources. In 2024, individuals must have resources under $2,000, and couples under $3,000.
• Disability or Age: Be disabled, blind, or aged 65 or older. For disability, the condition must meet the SSA’s definition and prevent substantial work.
• Citizenship: Be a U.S. citizen or meet specific non-citizen requirements.

To apply for SSI you can start the process online on the SSA website if you meet the financial eligibility criteria. This way you can start your application from the comfort of your own home. You can also apply by phone by calling the SSA directly. Talking to a representative will help clarify any questions you may have about the application process. If you prefer face to face assistance you can apply in person at your local Social Security office. Scheduling an appointment is recommended as staff can give you one on one help and make sure you have all the required documents.

Work With a Disability Lawyer to Improve Your Odds of Approval

Applying for disability benefits for lupus is complicated and frustrating. A disability lawyer can increase your chances of approval. They specialize in Social Security claims and will guide you through the whole process, from gathering all medical evidence to filling out the application. If your initial claim is denied, a lawyer can represent you during the appeals process, present additional evidence and advocate for you. Their expertise will make sure your application shows how lupus affects your ability to work so you get approved and get the benefits you need to manage your condition.