Social Security disability rules for Lupus

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lupus_diagnosisHow to win my disability case for a lupus diagnosis?

Systemic lupus erythematosus, or simply lupus, is evaluated in the immune system section of the Disability Evaluation Under Social Security disability handbook, more commonly known as the Social Security Blue Book. Although there is a specific listing for lupus in the Social Security disability handbook listing 14.02, the reality is that due to the complicated nature of the disorder, the disability criteria for lupus is somewhat lacking in specificity as other impairment listings are often involved.

According to the NIH, lupus is an autoimmune disorder that attacks different body systems or multiple body systems simultaneously with each exacerbation. Lupus can cause a wide range of limitations that are dependent upon the body system or organs that have been affected. Consequently, Social Security evaluates the limitations imposed by lupus under a variety of other impairments depending upon which body system (or systems) has been affected.

Limitations caused by lupus are evaluated under other impairment listing sections that address impairments of the following body systems: joints, muscles, ocular, respiratory, cardiovascular, digestive, renal, hematological, skin, neurological, or brain. This just means that to be approved for Social Security disability benefits for lupus an individual must meet the criteria established for the body system affected by lupus. For example, an individual with neurological problems must meet the criteria contained within the neurological listing.

If an individual does not meet the criteria established for their particular manifestation of lupus symptoms, they still may be able to receive Social Security disability if the following is true:

Their lupus condition involves two body systems or organs to a lesser extent, and at least one of the body systems or organs is affected by an impairment that is at least moderately severe.

The individual is experiencing severe documented constitutional symptoms and signs such as weight loss, joint pain and stiffness, fever, extreme tiredness, or malaise.

The SSA will use medical history, lab studies, medical imaging (x-ray, blood test, scans, MRI, CT scans, etc.), and even biopsies to establish the existence, duration, and severity of a claimant’s lupus. In addition to this type of medical documentation, the SSA requires a treatment record of at least three months in order to establish that an active impairment exists in spite of treatment and that the condition is expected to last twelve months or more.

If you think you may be entitled to Social Security Disability benefits and have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.

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