Social Security Disability Insurance and Lupus 

Lupus is an autoimmune disease, meaning that it causes the immune system to attack otherwise healthy organs and tissue. It is estimated that more than 1.5 million Americans have the condition, and live with the chronic fatigue, pain, and inflammation that it causes. Because it is autoimmune in nature, it is also a disease that makes it more likely for individuals to experience other health concerns like serious infection.  

Is lupus considered a disability? While lupus (for some) can respond very well to treatment, and their symptoms are minimized, others are not as lucky. When lupus is more aggressive or untreatable, it can make it impossible for the individual to continue working full-time, or at all. After all, it causes extreme weakness and fatigue, and it can bring about permanent organ damage. These are conditions that can make working both dangerous and extremely challenging. 

SSDI exists for those who suffer physical or mental disabilities that leave them unable to work, and if lupus is causing someone to miss work, it may be time to consider SSDI. Approval for a claim is possible as the Social Security Administration, or SSA, does identify lupus as a qualifying disability. 

The Blue Book 

Lupus, like other conditions recognized by the SSA, has to be disabling enough to qualify the individual for benefits. Because it is chronic and has no cure, it demands ongoing monitoring. That is a costly part of treatment because it involves testing and time off work. There are medications that may be required, and if the condition is already harming organs or bodily systems, those too are qualifying expenses. 

Between loss of income and ongoing medical care (including medications), there are many with lupus who qualify for SSDI. The SSA has a Blue Book that is used to determine whether a claimant’s medical condition has worsened to the degree they can no longer work.  

Though it uses official jargon, the listing requirements for lupus to qualify as a disability include that it must have affected two or more body systems or organs. The claimant must also experience ongoing symptoms such as fever, fatigue or weight lost. Their daily functioning has to be compromised by the condition. 

The SSA requires formal medical evidence before a claim for SSDI benefits will be approved. A treating physician will have all that is needed to demonstrate the ways in which the condition has degraded a claimant’s health. If these are not available, however, a residual functional capacity, or RFC, analysis is done. 

This requires answering in-depth questionnaires about the condition, and the physical or mental limitations it causes. The goal is to determine that a claimant is experiencing problems in completing tasks that make it impossible for them to work. The SSA may demand diagnostic tests, reports from physicians, records from laboratory work or hospital visits and more.