Sjögren’s syndrome is an immune-mediated disorder of the exocrine glands. Involvement of the lacrimal and salivary glands is the hallmark feature, resulting in symptoms of dry eyes and dry mouth, and possible complications, such as corneal damage, blepharitis (eyelid inflammation), dysphagia (difficulty in swallowing), dental caries, and the inability to speak for extended periods of time. Involvement of the exocrine glands of the upper airways may result in persistent dry cough.
Many other organ systems may be involved, including musculoskeletal (arthritis, myositis), respiratory (interstitial fibrosis), gastrointestinal (dysmotility, dysphagia, involuntary weight loss), genitourinary (interstitial cystitis, renal tubular acidosis), skin (purpura, vasculitis), neurologic (central nervous system disorders, cranial and peripheral neuropathies), mental (cognitive dysfunction, poor memory), and neoplastic (lymphoma).
Severe fatigue and malaise are frequently reported. Sjögren’s syndrome may be associated with other autoimmune disorders (for example, rheumatoid arthritis or SLE); usually the clinical features of the associated disorder predominate.
The Social Security requirements are:
A. Involvement of two or more organs/body systems, with:
1. One of the organs/body systems involved to at least a moderate level of severity; and
2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
B. Repeated manifestations of Sjögren’s syndrome, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:
1. Limitation of activities of daily living.
2. Limitation in maintaining social functioning.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
A variety of tests are used for Sjogren’s syndrome. Doctors use blood tests to look for hints of Sjogren’s syndrome in the levels of blood cells, antibodies and blood glucose, as well as looking for indicators of inflammation and liver or kidney problems.
Eye tests are used to measure tear production and look for damage. Saliva production is measured through a simple spit test (spitting into a tube every minute for 15 minutes), or by injection of a radioactive isotope that allows doctors to monitor the amount of saliva produced by the salivary gland.
The important thing to keep in mind is that the Social Security Administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition either meets the listing above or causes functional limitations. Functional limitations can be great enough to make work activity not possible.