DOES SOCIAL SECURITY CONSIDER LUPUS A DISABILITY?



How does Social Security consider lupus as a disability?



 
Social Security considers lupus as it would consider any other medical or mental impairment. By this we mean that both Social Security Disability and SSI disability are based on an individual's ability, or inability, to perform substantial gainful activity, or SGA. This is essentially work activity that earns a certain minimal amount of earnings which SSA considers to be self-supporting.

Eligiblity for disability benefits is not simply, as is often believed to be the case, based upon an individual's diagnosed physical or mental conditions. In other words, being diagnosed with a specific condition will not, in and of itself, result in a disability award. An allowance, or approval for disability, will depend upon the severity of the claimant's symptoms, which can only be proven through information obtained from a claimant's medical records.

These records, of course, may include a medical source statement--also known as a residual functional capacity statement--from a claimant's treating physician. Note: Treating physicians are defined as physicians with whom a claimant has a history of receiving treatment, to the extent that the physician would be qualified to comment as to the claimant's prognosis and physical or mental limitations.

Many conditions, including lupus, are given consideration in the disability evaluation handbook (usually referred to by judges, attorneys, and disablity examiners as the "blue blook" since the published paper version has a blue cover, and occasionally also referred to as the Social Security Disability list of impairments).



Currently, Social Security evaluates lupus by establishing if there is a diagnosis of lupus with one of the following joint: muscle, respiratory, or ocular (eye) involvement. Not surprisingly, only a small majority of cases are aproved on the basis of meeting, or equaling, the requirements of the listing for lupus.

Due to the nature of lupus (exacerbations and healthier periods), it is difficult to gain an allowance at the initial or reconsideration levels of Social Security Disability SSI and Filing based on Lupus


About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.







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