Facts about Pemphigus and Filing for Disability

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.

  • How to apply for disability and the information that Social Security needs

  • Who will qualify for disability and what qualifying is based on

  • Requirements for disability - Qualifications Criteria for SSD and SSI

  • How to Prove you are disabled and win your disability benefits

  • Facts about the condition

    1. Pemphigus vulgaris is a rare autoimmune skin disorder that causes blisters first in the mouth, then on the skin. It is the most common form of pemphigus, a group of similar skin disorders. The blisters that appear with pemphigus vulgaris are usually painful but not itchy.

    2. Usually pemphigus vulgaris develops among those in middle age or later.

    3. Those of Mediterranean and Jewish background are more likely to develop the condition.

    4. Other autoimmune conditions and thymus tumors are two factors that increase the risk of developing pemphigus.

    5. Pemphigus vulgaris can lead to infection of the skin, and infection that spreads to the blood stream. Infection in the blood stream, called sepsis, can be fatal. Otherwise, complications of pemphigus vulgaris are typically limited to the side effects of medications used to treat the condition, particularly corticosteroids.

    6. Treatment of pemphigus vulgaris is most effective when the condition is caught early and treatment begins as soon as possible. Treatment is focused on reducing symptoms and preventing complications.

    7. Pemphigus vulgaris may be easier to keep under control with treatment if symptoms are located in a small area of the body, rather than being widespread. Mild pemphigus that is not widespread can usually be treated at home.

    8. . Corticosteroids, immunosuppressants, antibiotics and anti-fungal medications are commonly prescribed. Complications of corticosteroids, especially when used over an extended period of time, include mood swings, high blood sugar levels, bone density loss, body fat changes, and increased risk of infection.

    9. Severe pemphigus will usually need to be treated in a hospital setting. Treatment may be similar to that of severe burns, because large open sores that are widespread over the body are more likely to become infected. Additional treatments include intravenous fluids and feeding, anesthetic lozenges for mouth sores, and therapeutic plasmapheresis (plasma transfusion).

    10. At home, manage the condition and the complications of treatment by protecting the skin, taking good care of sores as recommended by a doctor, using talcum powder on sheets to prevent sores from sticking, and using lotions and dressings to sooth and treat sores.

    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 their attorney or representative 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.

    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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