Social Security Disability and Lupus

Lupus, or “SLE” (Systemic lupus erythematosus), is a chronic inflammatory disease that can affect any organ or system of the body. According to the American College of Rheumatology, Lupus is sometimes called “The Great Imitator” because its wide range of symptoms often causes it to be confused with other health problems. Lupus mainly affects the joints, kidneys, and skin, although it can also affect the lungs, nervous system, and other parts of the body.

Lupus is an immune system disorder. In healthy individuals, the immune system protects the body by manufacturing antibodies that fight hostile germs. In individuals stricken by Lupus, however, the immune system backfires, instead attacking the victim’s own tissues and organs. The disease most often afflicts victims in their 20s and 30s, and it occurs in 10 times more women than it does in men. It also tends to occur more frequently, and with greater severity, in African-Americans and Asians. All people with Lupus will experience “flares” during which time the disease is active, and “remissions,” when the disease is mostly quiet.

The Social Security Administration, when considering claims for disability benefits based on a diagnosis of Lupus, will review a claimant’s medical history for several key indicators of a severe SLE condition. Usually, SSA will look to see that more than one organ or body system is afflicted – two or more organs or body systems afflicted with Lupus to a moderate degree of severity is an indicator of a disabling form of Lupus. Additionally, SSA will look to see if any of the “constitutional symptoms or signs” of Lupus, as identified by the American College of Rheumatology, are present. These “constitutional symptoms or signs” are severe fatigue, fever, malaise, and involuntary weight loss. Finally, SSA will look to see whether these symptoms cause repeated manifestations of Lupus in the claimant’s life, such as in their activities of daily living (dressing, cooking, cleaning, driving, etc.), their social interactions (attending social functions, interacting appropriately with family, neighbors, and the public), and their ability to concentrate and remain on pace for extended periods of time (reading books, working on the computer, going to school). According to Social Security regulations, “repeated” manifestations refers to manifestations occurring either three times per year on average (each lasting two weeks or more), or those occurring substantially more frequently, even if they do not last as long as two weeks.

In summary, individuals applying for Social Security disability benefits based on Lupus will need to show that they experience repeated flares of Lupus in more than one organ or body system, and that these flare ups interfere substantially with their daily life, their social interactions, and their ability to maintain concentration and attention for extended periods of time. Consistent treatment with a specialist, such as a rheumatologist, is especially important in constructing a longitudinal history of a claimant’s condition and in persuading a Social Security judge of the severity of the impairment.