ASK THE ADVOCATE: I am a 60-year-old female with Lupus. I was a bookkeeper for many years and was forced to retire. Primarily, I found that I could not work due to muscle and joint pain, sometimes with swelling, a constant low-grade fever of 99 degrees or more and sensitivity to light, especially office lighting. Can I qualify for benefits? I am too young to collect early retirement benefits and I only get a small retirement from my employer.
ANSWER: Systemic Lupus Erythematosus (SLE) or lupus is an inflammatory auto-immune disorder that can affect any body part or only one or a combination of body parts. For example, SLE may harm joints, heart, kidneys, lungs, skin, blood vessels or even the nervous system. While lupus is incurable and can be fatal, it can most often be treatable. Unfortunately, the disease course is often unpredictable because of alternating periods of exacerbation and remission. Some of the symptoms of lupus are severe fatigue, joint pain, fever, myalgias, involuntary weight loss, skin rashes, anemia, headaches, and multitude of other potential symptoms dependent upon the body system or organ affected.
Significant organ or body system involvement might include the following conditions: cardiovascular (pericarditis, vasculitis, endocarditis, myocarditis), respiratory (pneumonitis, pleuritis), neurological (seizures), renal (glomerulonephritis) hematologic (leukopenia, thrombocytopenia, anemia), mental (mood disorders, anxiety, fluctuating cognition or lupus brain fog, psychosis, organic brain syndrome), skin (ulcers, rashes, photo sensitivity), or even other immune disorders (inflammatory arthritis).
Social Security has a specific impairment listing in their disability Blue Book, as it is more commonly known. Impairment listing 14.02 lists the criteria needed to meet or medically equal the severity requirements of the Social Security disability program if a person has SLE or lupus.
The disability applicant must have a diagnosis of SLE or lupus with:
A. involvement of two or more body systems or organs. Additionally, one of the organs or body systems must involve at least a moderate level of severity; and two or more constitutional signs or symptoms (i.e. fever, severe fatigue, malaise, or involuntary weight loss). OR
B. Recurring manifestations of SLE,
with two or more of the constitutional symptoms or signs and one of
the following at a severe or marked level:
1. Limitation in maintaining social functioning.
2. Limitation in completing tasks timely because of deficiencies in persistence, pace, or concentration.
3. Limitation of activities of daily living.
Social Security considers the effects of lupus as it does any other medical or mental impairment. Lupus is a severe impairment if it prevents a person from working for twelve continuous months or more or will result in death.
If a person does not specifically meet or equal the listing criteria and severity of the lupus impairment listing, they may still be approved for disability benefits. Social Security has another method of approving individuals for disability. If a person is unable to work because of the limitations of lupus, they may be approved for disability through a medical vocational allowance.
Social Security disability examiners are able to consider a person’s residual functional capacity (what they are able to do in spite of limitations), age, education, past work activity and their ability to perform other types of work when their limitations are considered. If the disability examiner finds that their residual functional capacity is so restrictive it precludes their past work or jobs or any other work, they may be approved for disability benefits.
A rheumatologist is always the best avenue and I also recommend that a person with lupus keep a diary documenting periods of exacerbation. The diary should be given to the doctor at each visit to insure proper treatment.