Section 14 of the Social Security Disability listings describe diseases of the immune system. The SSA organizes Immune System Disorders into three categories: autoimmune disorders, immune deficiency disorders that are not HIV, and HIV. An autoimmune disorder occurs when the body literally starts attacking itself. The immune system mistakes healthy tissues for hostile, rendering multiple body systems impaired. One of the most common autoimmune disorders is systemic lupus erythematosus (SLE), also known as “lupus.”
SLE primarily strikes people between the ages of ten and fifty. Women are ten times more likely to be affected than men. African Americans and Asians are afflicted more often than those of other races.
SLE can affect any organ or body system. It is a chronic inflammatory disease that’s accompanied by constitutional symptoms such as severe fatigue, fever, malaise, and involuntary weight loss. Some sufferers of lupus develop severe chronic arthritis and extreme photosensitivity. Other complications resulting from SLE potentially include blood clots, anemia, fluid around the heart or lungs, and fluctuating cognition a.k.a. the “lupus fog.” The American College of Rheumatology lists eleven criteria—symptoms that commonly manifest in those with SLE. Having at least four of the eleven problems with no other explanation will often lead to a diagnosis of SLE. The SSA specifically cites the College’s criteria as a guide to proper diagnosis and documentation of SLE.
Systemic lupus erythematous can be demonstrated in the following ways:
A. Involvement of two or more organs/body systems, with:
1. One of the organs/body systems involved to at least a moderate level of severity; and
2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
B. Repeated manifestations of SLE, 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:
1. Limitation of activities of daily living.
2. Limitation in maintaining social functioning.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
While SLE is probably the most well known of the autoimmune disorders, several others are listed under Section 14 as potential qualifiers for SSD. They are:
• Systemic Vasculitis (14.03)—inflammation of the blood vessels
• Systemic Sclerosis (Scleroderma) (14.04)—thickening of the skin, often a manifestation of abnormalities in the heart, lungs, or kidneys
• Polymyositis and Dermatomyositis (14.05)—inflammation of the striated muscles
• Undifferentiated and Mixed Connective Tissue Disease(14.06)—a catchall for afflictions that have the features of several autoimmune disorders, but not enough to satisfy the criteria for any specific one.
To qualify for SSD with an autoimmune disorder, you will need to provide your medical history, a report of a physical examination, and reports of relevant laboratory findings. For lupus, blood tests, specifically the antinuclear antibody (ANA) test is considered the most important. Other autoimmune disorders may require medical imaging (MRIs, CAT scans, radionuclear bone scans, etc.) or tissue biopsies.
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