Disability Benefits for Lupus

About Lupus

Lupus is a group of chronic inflammatory, autoimmune diseases where the immune system attacks its own tissues. There are many different types of lupus and the most common type is systemic lupus erythematosus (SLE). SLE is regarded as more severe than the other types and not only affects the skin but can affect vital organs and body systems as well. Vital organs and body systems that may become affected include but are not limited to:

SLE has periods of increased severity (also known as flare-ups) where the symptoms become worse for a period of time. The flare-ups are unpredictable and what triggers them is currently unknown but is believed to be an environmental trigger.

Diagnosing SLE can be difficult because it mimics other disabling conditions, there is no single test to diagnose the condition, and the symptoms can differ significantly from person to person. Due to these factors, SLE is known as one of “the great imitators”; conditions that have nonspecific symptoms and can be easily confused with other medical conditions.

Symptoms of Lupus

SLE has no cure but the symptoms can be managed with the proper treatment and medication. The symptoms of lupus include but are not limited to:

• Skin rashes and legions
• Distinct butterfly shaped rash on the face
• Fatigue
• Fever
• Sun sensitivity
• Raynaud’s phenomenon (extremities turn blue or white from stress or cold air)
• Joint pain
• Muscle pain
• Chest pain
• Headaches
• Confusion
• Memory loss
• Weight loss

Qualifying for Disability with Lupus

The SSA developed a guide known as the Blue Book in which lists the most common disabling conditions and the requirements needed for these conditions to qualify an individual for disability benefits. The only type of lupus included in the Blue Book is systemic lupus erythematosus. SLE is included in section 14 Immune System Disorders of the Blue Book under listing 14.02 Systemic Lupus Erythematosus. Other types of lupus will be evaluated under this listing as well. If you have a type of lupus that doesn't meet listing 14.02, you will be evaluated based on the medical vocational allowance.

14.02 Systemic Lupus Erythematosus

You must have SLE as described in listing 14.00D1 as well as:

Requirement A

Involvement of at least two organs or body systems with:

1.) Moderate level of severity for at least one of the organs or body systems

2.) Two or more of the constitutional signs or symptoms (this includes fever, serious fatigue, malaise and weight loss)

OR

Requirement B

Recurring manifestations of lupus with two or more constitutional signs or symptoms with at least one of the following:

• Marked limitation in activities of daily living
• Marked limitation in sustaining social functioning
• Marked limitation in finishing tasks in a timely fashion because of deficiencies in concentration, perseverance, or tempo

Medical Vocational Allowance

As stated above, if you have a type of lupus that does not meet the requirements listed in 14.02, your condition will be evaluated under the medical vocational allowance. You can become approved for disability benefits under the medical vocational allowance if your condition is severe enough to prevent you from performing any job in the workforce, given your education and skills.

This involves evaluating how your condition (lupus) restricts your abilities to engage physical or mental activities. For example, if you are unable to concentrate or focus because of severe “lupus fog” (mental confusion) and your fatigue is severe enough to stop you from standing for long periods of time, you potentially would be unable to perform unskilled physical or sedentary work and would qualify under the medical vocational allowance.