Getting Social Security Disability Benefits for Lupus

Lupus may qualify you for disability benefits from Social SecurityWhen people talk about lupus, they are generally referring to Systemic Lupus Erythematosus, an autoimmune disorder which can affect various body systems, including (but not limited to) the musculoskeletal, respiratory, and neurologic systems. It may be diagnosed after an individual seeks treatment for symptoms such as severe fatigue, recurrent fevers, general malaise, oral sores, or involuntary weight loss. There is another condition called Discoid Lupus Erythematosus which affects the skin, causing a severe rash with sores and inflammation. Systemic lupus can present with or without skin symptoms. I have had clients with systemic lupus who have had severe skin problems and others without any. While discoid lupus can be disabling by itself or in combination with other impairments, this article will focus on systemic lupus, which we will just call “lupus.”

If a primary care doctor suspects a patient has lupus, the doctor will usually send the patient to a rheumatologist, a specialist who treats autoimmune and inflammatory diseases. The rheumatologist will ask about the patient’s symptoms and medical history, perform a clinical examination, and run various tests to check for inflammatory indicators. Before making a lupus diagnosis, the physician will rule out similar disorders which could cause the symptoms.

The question mark has come to be a symbol for lupus because it can be mysterious. Doctors and scientists are still seeking a better understanding of what causes the immune system to attack the body, often with catastrophic consequences. Some treatments work well for some lupus sufferers, but not for others. Often, the lupus can wax and wane, leaving a sufferer with unpredictable “good days” and “bad days.”

Medical Treatment is Essential to Getting Disability Benefits for Lupus

For these reasons, lupus can affect different people’s ability to work in different ways. After a lupus diagnosis, someone with a mild case may be able to continue to work if that person has developed vocational skills which allow for work with flexibility and/or the opportunity to work from home. Unfortunately, most people are not in this position and employers will expect them to regularly work on schedule, with little tolerance for absences or unpredictable breaks. Lupus leaves people like this in a nightmare scenario&endash;they cannot sustain work, which creates financial stress, and stress can only worsen the condition. This creates a vicious cycle of emotional distress and increased inflammatory response, with both mental health and the lupus getting worse and worse.

If you find yourself in this position, the most important thing to do is to aggressively pursue medical treatment. If a client told me about being frustrated with their rheumatologist due to a lack of medical improvement, I would encourage them to seek a second opinion. Even if the original rheumatologist is highly qualified, new ideas and perspectives could be helpful. I’ve had numerous clients with lupus or lupus-like symptoms travel great distances to the Mayo Clinic or Cleveland Clinic for evaluations. Hopefully, doctors can find treatments which can help you manage your disease, minimize your symptoms, and put you in position to continue working.

If not, the medical records generated during your treatment will be important evidence in your disability case. Working with a Social Security attorney is also very helpful during this process. They can help point you in the right direction if you experience problems with your health insurance or getting in to see a medical provider. If these kinds of problems have prevented you from getting appropriate care in the past, an attorney can help explain this to a judge so the judge doesn’t view this as an indication that your symptoms are not as severe as you claim.

Lupus Sufferers Often Have Trouble Getting Social Security on Their Own

While lupus can be severely debilitating, disability cases involving lupus can still be challenging. Generally, Social Security’s rules are much more conducive to someone in their 50s being awarded disability than someone younger than this. However, lupus is most often diagnosed between the ages of 15 and 45.

This statistic is consistent with my experience as a practitioner. The vast majority of the lupus cases I have had involved clients younger than 50. Anecdotally, I would say most have been in their late 30s to early 40s, but I can recall a few cases of very severe lupus in individuals much younger than this. If you are younger than 50 and seeking disability for lupus, you absolutely need a skilled attorney to represent you.

Unfortunately, many organizations who provide disability representation employ non-attorney representatives or inexperienced attorneys who add little value, especially when cases are medically complex. Also, judges are more reluctant to approve younger individuals because of the applicable rules (and because, consciously or unconsciously, judges know a younger person will receive many more years of benefits). Therefore, a younger claimant must make an extra-special showing in order to be approved. A non-attorney or unskilled lawyer may not be capable of this.

Our Social Security Attorneys Are Here to Help With Your Disability Claim

Here at Keller & Keller, we will work to build your case by making sure busy doctors and hospitals provide all of the relevant medical documentation. We can seek opinions from your doctors. This is very important because—if you have been denied—Social Security’s own doctors have indicated you are not disabled, and your doctor’s opinion can help us counter this.

Social Security has a "listing" (medical criteria) for disabling lupus. We understand this listing and, if your lupus meets it, we can make a strong argument about how your affected body systems and symptoms satisfy these criteria. If your lupus equals this listing, we can request a medical expert who could provide testimony supporting this conclusion – this is the only way the judge can make such a finding. We can also show why your lupus makes you unable to sustain regular work, which is Social Security’s “bottom line” and what every judge is thinking about when the judge conducts your hearing.

Our disability practice group focuses exclusively on disability and participates in local and national disability representative organizations. This way, we stay on the cutting edge and can make the best arguments possible with evolving laws, health threats, and economic conditions, all of which may impact your case. For example, a lupus sufferer may take immunosuppressive medication which puts them at great risk during periods of significant viral threats. If the person cannot be around others in the workplace, this factor in itself could be disabling. The evolving economy has obviated certain occupations which used to be necessary, but without an attorney who will fight for you, a judge may find you capable of performing these obsolete jobs. (Social Security uses a vocational reference that was last updated at a time when most people did not have cell phones, DVD players, or internet at home. They routinely deny claimants by saying they could do a job called “Document Preparer – Microfilming.”) These are complex issues and if they come up in your case, you need the right attorney by your side. Feel free to contact us for a consultation.

James R. Keller
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