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SSD appeals when autoimmune conditions require more evidence

On Behalf of | Jul 10, 2024 | SSD Denied Claims/Appeals

Applying for Social Security Disability (SSD) benefits due to an autoimmune condition can be a complex and challenging process. These conditions, including lupus, rheumatoid arthritis and multiple sclerosis, often require substantial evidence to demonstrate the severity of an individual’s impairment and its impact on their ability to work. 

When an initial SSD application for an autoimmune condition is denied, an appeal may be necessary.  Oftentimes, the Social Security Administration (SSA) needs additional evidence about applicants’ conditions before it can approve requests for benefits. This is often especially true in autoimmune cases, as they can manifest so differently both in unique patients and under a variety of circumstances. 

Navigating the process

If your SSD application is denied, you have the right to appeal that decision. The appeals process typically involves several stages:

  • Reconsideration: A complete review of an applicant’s claim by a different examiner within the SSA
  • Hearing: An opportunity to present an applicant’s case before an administrative law judge (ALJ)
  • Appeals Council review: A review by the SSA’s Appeals Council if an applicant disagrees with the ALJ’s decision
  • Federal Court review: As a final resort, an applicant may need to a lawsuit in federal court

For autoimmune conditions, the burden of proof in the context of an appeal lies in demonstrating the extent to which the condition at issue limits an applicant’s ability to perform substantial gainful activity. This often requires comprehensive and up-to-date medical evidence.

If you need to appeal an SSD denial, ensure that your medical records are thorough and current. Documentation of your diagnosis, treatment history and ongoing symptoms should all be clear and current. Additionally, regular visits to your healthcare provider can help establish a continuous record of your condition. You may also need to obtain statements or reports from specialists who treat your autoimmune condition, and clearly document your physical and mental limitations. 

Navigating the SSD appeals process can be daunting, especially because you are already dealing with the complexities of an autoimmune condition. Know that seeking personalized guidance and assistance is always an option.