Autoimmune diseases, or diseases in which the body attacks its own healthy tissues, are challenging to diagnose and even harder to effectively treat. It is a complicated area of medicine that is still in developing stages. Autoimmune ailments often have no scientifically proven root causative agent and yet can cause various chronic symptoms that make daily life a struggle.
If you are unable to work, you may be eligible for Social Security Disability (SSD) benefits for your autoimmune disease. For more information on the available benefits or for help with the application process, call our disability attorney in Pittsburgh at Berger and Green for a free, no-obligation consultation: 412-661-1400.
What types of autoimmune diseases can qualify someone as disabled?
There are over 60 types of known autoimmune diseases, such as rheumatic diseases, connective tissue disorders, or collagen vascular disorders. An estimated 50 million Americans—most of them women—are currently living with an autoimmune disease.
Many serious cases can qualify someone for SSD benefits. If your autoimmune condition is included on the Social Security Administration’s (SSA’s) listing of impairments and you meet the criteria for that listing, the SSA will automatically consider you as disabled. Immune diseases are listed in the SSA’s Blue Book under Section 14.00. There are six specific types of autoimmune diseases in this section that the Administration considers disabling:
- Systemic vasculitis;
- Systemic sclerosis (scleroderma);
- Polymyositis and dermatomyositis;
- Inflammatory arthritis; and
- Sjögren’s syndrome.
The SSA also has a listing referred to as “undifferentiated and mixed connective tissue disease,” which includes syndromes that have the same immunologic features of autoimmune disorders, but that do not exactly satisfy the criteria for any of the above disorders.
Note, not all diseases that affect the immune system are listed in under this section. For example, multiple sclerosis and type I diabetes are often considered autoimmune conditions, but are listed under other body systems. To determine if your condition qualifies as a disability for the purposes of Social Security disability benefits, contact a qualified disability attorney.
How does the SSA evaluate autoimmune diseases?
Merely having a diagnosis of one the listed conditions is not enough for the SSA to deem you as disabled. The Administration will also check to ensure you meet the severity criteria for that listing and have adequate medical evidence to back up your claim. The criteria are specific to the condition. If you have lupus, for example, the claims examiner will start by verifying that your condition satisfies the criteria established by the American College of Rheumatology.
Then, he or she will see if you meet one of the following necessary requirements:
- Two or more of your organs/body systems are involved, at least one of which is at least a moderate level of severity, and you have at least two of the telltale symptoms or signs of lupus, such as severe fatigue, fever, malaise, or involuntary weight loss.
- You have had repeated manifestations of lupus, with at least two of the aforementioned symptoms or signs and at least one of the following at the marked level: a) limitation of activities of daily living, b) limitation in maintaining social functioning, or c) limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
Can I still qualify as disabled for my autoimmune disease if I don’t meet the listing criteria?
Even if your condition does not meet the specific criteria, the SSA may still deem you disabled if you prove that you have a condition so severe it prevents you from working.
The claims examiner will review your medical records and your residual functional capacity (RFC) form, completed by your doctor, to evaluate your physical and mental functional limitations. If the Administration decides that given your autoimmune disease, signs, symptoms, limitations, age, and work history, you cannot work or adjust to new work, they may still award you benefits based on what is called a medical vocational allowance.
What other criteria must I meet to collect disability benefits?
The first step to getting approved for disability benefits is to prove that you have an autoimmune disease that meets that SSA’s definition of disabled, that has lasted or is expected to last a year or more or result in death, and that prevents you from working.
The next step is to show that you meet the financial or work history requirements, depending on which benefit you are applying for.
- Supplemental Security Income (SSI) applicants will need to show that they have assets or resources valued at under $2,000 and that their monthly income does not exceed $735.
- Social Security Disability Insurance (SSDI) applicants will need to have a certain number of work credits on their record, the number of which depends on their age.
What if my disability claim based on an autoimmune disease was denied?
Getting approved for disability benefits is far from easy. Oftentimes, people are denied benefits simply because of lack of sufficient medical evidence or a failure to submit the right paperwork to the SSA.
This is why it is a good idea to have a disability lawyer assist you with the process. The attorneys at Berger and Green have been helping people in Pittsburgh living with disabilities for over 40 years. We know all about the claims process from start to finish. We know which types of medical documents to submit to prove an autoimmune disease, how to follow the SSA’s protocols, and how to appeal a wrongly denied claim.
We offer free consultations and do not charge for legal services unless and until we help you win your case. There are never any upfront, out-of-pocket expenses for you to worry about. Call our office today at 412-661-1400 to learn more about our services and how we can help you pursue the disability benefits for autoimmune disease you and your family need.