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SSDI and Lupus

By September 30, 2021November 8th, 20232 min read

According to the Lupus Foundation of America, lupus, or systemic lupus erythematosus, is a chronic autoimmune disease. It can damage any part of the body, and approximately 5 million people around the world suffer from it. If you have been diagnosed with lupus and meet additional criteria, you may be eligible for disability benefits through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

There are two ways to qualify for disability benefits if you suffer from lupus. You can either meet medical criteria or functional limitations criteria. Either way, your medical records must document that you have been diagnosed with lupus by your treating physician and that you suffer from at least two of the four following conditions: 1) severe fatigue; 2) malaise; 3) fever not caused by any other condition; and/or 4) involuntary weight loss.

To meet the medical criteria, your lupus symptoms must involve two or more body systems or organs, which include renal, neurologic, cardiovascular, respiratory, mental, or hematologic systems and/or inflammatory arthritis. Common physical symptoms include anemia, headaches, painful or swollen joints, fever, extreme fatigue, hair loss, swelling, abnormal blood clotting, sensitivity to light, and chest pain when breathing deeply.

To be considered chronic, these symptoms have to last longer than six weeks, and severe cases of lupus can quickly become disabling. You can meet the functional limitations criteria if your symptoms severely limit your daily activities, social functioning, and/or your ability to complete tasks in a timely manner because of problems with pace, persistence, or concentration.

Unfortunately, lupus symptoms can change over time in type and severity. They are also hard to observe, so it is important that your medical records are as detailed and descriptive as possible. They should include your physician’s observations and test results.

SSA will examine whether you have been diagnosed with lupus correctly, and they will look for the presence of at least four of the eleven following criteria established by the American College of Rheumatology: photosensitivity; oral ulcers; arthritis; discoid rash; malar rash; immunologic disorder; neurologic disorder; hematologic disorder; renal disorder; sersitis; and antinuclear antibody.