Behcet's disease and Filing for Disability
Behcets disease would qualify as a severe medical condition to list on a SSD or SSI disability application. This condition is evaluated under the classification of autoimmune impairments. If it were listed in the SSA Blue Book listings it would be evaluated using the adult listing section 14.00, Immune System - Adult.
Immune system impairments are defined as disorders caused by dysfunctional immune responses that are directed against the body's own tissues, resulting in chronic, multisystem impairments that differ in clinical manifestations, course, and outcome. They are often referred to as connective tissue disorders, collagen vascular disorders, or rheumatic disorders.
The disability listing that usually applies to Behects's
Behcets disease is a rare disorder that causes blood vessel inflammation throughout your body. This condition may affect the mouth, skin, genitals, eyes, joints, blood vessels, digestive system, or brain. Behcets disease symptoms sometimes come and go, which makes it more difficult to diagnose and treat. Generally, it is evaluated under impairment listing 14.03, Systemic Vasculitis; however it could be evaluated under any affected body system inmpairment listing. If the person meets or equals a listing they may be approved for disability without further evaluation.
Because Behcets disease does not have it own listing in the SSA impairment listings, an individual considering an application for disability on the basis of this condition must prove that the condition causes them to be unable to work at a level that earns what the Social Security Administration considers to be substantial and gainful income.
This can be proven through A) information contained in treating physcian's medical records, and through B) information provided in the vocational work history; specificially the kinds of jobs they have done, the functional requirments of each job, along with their job skills that could enable them to perform some other type of work.
The Social Security Disability sequential evaluation requires that past work and the potential for other work be evaluated if a person's condition does not meet an impairment listing. Those who do not meet a SSA listing may be found disabled through a medical vocational allowance, if their condition prevents them from performing their past jobs or other kinds of work when their limitations are considered.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
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 causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will the disability attorney for the case have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1) Behcet's syndrome is also known as silk road disease, Morbus Beh'et, and Beh'et's disease.
2) Behcet's syndrome is caused by a disturbance in the immune system, leading to inflammation in the body that affects blood vessels. Symptoms may include skin rashes and lesions, mouth sores, eye inflammation, abdominal pain, headaches, poor balance, diarrhea, and genital sores. The symptoms usually seem unrelated, and can come and go without notice.
3) Although more males are affected by the disease worldwide, more females are affected by Behcet's syndrome in the United States. About 20,000 Americans have been diagnosed with Behcet's syndrome.
4) Risk factors for Behcet's include being male, being in your 20s, 30s and 40s, having certain genes, and living in the Middle East and Asia. Although the cause is unknown, it is thought that it is caused by a combination of environmental factors (including environmental toxins) and genetics.
5) There is no cure for Behcet's syndrome, although medications can treat symptoms individually. Left untreated, Behcet's syndrome may cause blindness.
6) The condition of Behcet's syndrome is determined by a diagnosis of exclusion; it is not a condition with a well defined cause or origin, much like sarcoidosis, Tolosa-Hunt syndrome, irritable bowel syndrome, and Bell's Palsy. Behcet's cannot be diagnosed by examination or testing. Diagnosis is only determined by elimination of other possible causes for symptoms.
7) Many times treatment will include mouth rinses for mouth sores, creams and ointments for skin disturbances, and eye drops that relieve eye pain and inflammation. Severe cases of Behcet's include treatments such as corticosteroids, immunosuppressive drugs, and immune system regulators.
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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