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Do you qualify for SSD benefits if you have lupus?

On Behalf of | Jun 9, 2024 | Social Security Disability

Lupus is a chronic autoimmune disease that often results in severe symptoms that may significantly impact a person’s ability to work. If you are living with lupus and finding it challenging to maintain employment, you may wonder if you are potentially eligible for Social Security Disability (SSD) benefits.

The good news is that people with lupus can qualify for SSD benefits, provided that their condition meets certain eligibility criteria outlined by the Social Security Administration (SSA). However, because lupus manifests differently in every patient, the diagnosis itself is not an automatic right of eligibility for these benefits.

The basics

Lupus causes the immune system to attack healthy tissues, leading to chronic inflammation and damage in various parts of the body, often simultaneously. Symptoms can be unpredictable, with periods of flare-ups and remissions, making consistent work difficult for many people. This unpredictability can make applying for benefits tough with a lupus diagnosis, especially if you are well enough to work sometimes, but not others.

The SSA’s Blue Book lists the medical criteria for various impairments, including lupus, under section 14.02, which covers systemic lupus erythematosus (SLE). To qualify for SSD benefits, you must meet one of the following conditions:

  • Involvement of two or more organs/systems: You must have lupus that involves at least two major organs or body systems, with at least one organ or system demonstrating a moderate level of severity. Additionally, you must have at least two of the following symptoms: severe fatigue, fever, malaise or involuntary weight loss.
  • Recurrent manifestations: You must have repeated challenges/flares caused by lupus with at least two of the primary symptoms mentioned above and a certain degree of limitations as a result of those symptoms.

If your lupus does not meet the Blue Book criteria, you can still potentially qualify for SSD benefits based on something called residual functional capacity (RFC). Seeking legal guidance can help you to better understand this “catch all” option and can help you to evaluate your overall eligibility for benefits based on the unique manifestations of your condition.