Facts about Sjogren's Syndrome 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.
Facts about the condition
1. Sjogren's syndrome is an autoimmune disorder that hinders the body's production of tears and saliva, causing dry eye and dry mouth. Autoimmune disorders occur when the immune system attacks healthy tissue and cells by mistake. With Sjogren's syndrome, the body attacks the exocrine glands.
2. Sjogren's syndrome often develops in individuals who already have another autoimmune disorder, such as lupus.
3. Women develop Sjogren's syndrome much more often than men do; about nine times more often. Those over 40 are also more likely to have the condition. However, people of all ages and either gender do develop Sjogren's.
4. Of all rheumatic (affecting joints and soft tissues) autoimmune disorders, this is thought to be the second most common.
5. Dry eye causes discomfort in the eyes, including itching and burning as well as feeling like there is something in them. Dry mouth can make it difficult to swallow or speak and causes bad breath. Dry eye and dry mouth lead to the most common complications, which are tooth cavities, yeast infections, and vision problems.
6. Sjogren's syndrome may also cause the salivary glands located between the jaw and the ear to swell. Swollen and stiff joints, skin problems including rash or dry skin, vaginal dryness, persistent cough (dry, not productive), and fatigue may also occur with Sjogren's syndrome.
7. A variety of tests are used for Sjogren's syndrome. Doctors use blood tests to look for hints of Sjogren's syndrome in the levels of blood cells, antibodies and blood glucose, as well as looking for indicators of inflammation and liver or kidney problems.
8. Eye tests are used to measure tear production and look for damage. Saliva production is measured through a simple spit test (spitting into a tube every minute for 15 minutes), or by injection of a radioactive isotope that allows doctors to monitor the amount of saliva produced by the salivary gland.
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.
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