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Obtaining Social Security Disability & SSI Benefits For Persons With Lupus (SLE)
Law Offices of Stuart Pastor - Dallas, Austin and Plano, Texas
Social Security recently revised its listing for Lupus (SLE). Revised Listing 14.02, effective June 16, 2008, can be found at Federal Register Vol. 73 No. 53, page 14607 (page 39 of the online PDF). A listing contains criteria for a particular disease or medical condition, and if the medical condition of an applicant for SSDI or SSI benefits matches the criteria in the listing the claim should be approved. Social Security uses the listings only to decide that an applicant is disabled. Under SSA regulations failure to meet the criteria of a listing does not result in denial of the claim. The claim may be approved under other rules.
The listing for lupus can be met by showing involvement of two or more organ/ body systems, with at least one system involved to at least a moderate level of severity, and at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss). Numerous body systems may be affected by Lupus including: the skin, the musculoskeletal system, the nervous system, the respiratory system, the cardiovascular system, the renal system, the hematologic system. The two body systems most commonly affected by Lupus are the skin, and musculoskeletal systems. Lupus patients typically experience skin rashes, and swollen, and achy joints. Sensitivity to the sun or light is common.
Alternatively the listing for lupus can be met by showing repeated manifestations of the disease (flares) with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise or involuntary weight loss), and one of the following at the marked level:
- Limitation of activities of daily living,
- Limitation in maintaining social functioning,
- Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
If the medical evidence is not sufficient to show that the claimant's medical condition meets social security's listing for lupus, a claim can be won by proving that the claimant's symptoms and limitations prevent the claimant from performing any occupation on a full-time basis, eight hours per day, or an equivalent schedule on a sustained basis.
In many cases the constitutional symptoms cause the greatest limitation on the claimant's activity especially fatigue and malaise. These symptoms cannot be objectively measured, and claims in which these symptoms are prominent are especially challenging. Social Security has issued regulations and rulings concerning the evaluation of subjective symptoms such as fatigue, malaise, and pain. These rulings and regulations describe the factors that must be considered in the process of judging the severity of such symptoms, and in the assessment of the statements of the claimant concerning such symptoms.
Some of the symptoms of Lupus may be readily observable. For instance joint swelling, skin rashes, and weight loss. Other symptoms will only be known to the physician if the patient informs the doctor that he is experiencing the symptoms: fatigue, malaise, mental impairment. Thus it is important that the patient advise his or her doctor of all of the symptoms that he or she experiences, and continues to report the symptoms to the doctor as long as they persist. Similarly the medical records will not reflect the impact of the disease on the patient's daily activity, and social functioning unless the patient tells the doctor about these matters on a regular basis.
The foregoing is not intended to be a comprehensive review of the law applicable to social security disability claims arising from Lupus or to provide specific advise for any particular social security disability claim, but rather to provide some general information relevant to such claims so that the reader will be in a better position to obtain legal assistance.
Additional information may be obtained by contacting the Law Office of Stuart Pastor. There is no charge for an initial consultation, and no fee is due unless the claim is won.
Mr. Pastor may reached toll free at 1-888-616-6162 or by e-mail.
