Lupus is a chronic autoimmune disease affecting organs and tissues of the body. If you are one of millions of people with lupus, you may be eligible for disability benefits through the Social Security Disability Insurance or Supplemental Security Income programs.
Lupus tricks a person’s immune system that fights infections into attacking the heart, lungs, kidneys, and other parts of the body. Social Security rules and procedures make it challenging to qualify for a disability check with lupus. The following information explains lupus disease and the SSI and SSDI programs to help you understand what is needed to qualify for disability benefits.
What Is Lupus?
Lupus is a long-term illness affecting the immune system. Instead of fighting infections, the immune system of a person with lupus attacks healthy tissue, including the skin, joints, and internal organs, causing swelling that results in pain and swelling.
Medical professionals do not know what causes lupus. Common symptoms include the following:
- Joint pain and swelling
- Extreme fatigue
- Sensitivity to light
- Difficulty breathing
- Skin rash
It can be difficult to accurately diagnose the disease because the symptoms may mimic those of other diseases, such as diabetes and arthritis. Doctors rely on medical and family histories and lab tests to gather enough information to arrive at a diagnosis.
If you have lupus, a cure does not currently exist for it. Your doctor will propose a treatment plan to manage the symptoms. Medications prescribed for you may include steroids and anti-inflammatories to reduce inflammation and pain, anti-coagulants, and medicines to minimize organ damage.
How Do SSI And SSDI Work?
If the symptoms of lupus prevent you from working, you may qualify for disability benefits through SSI and SSDI, which are different programs administered by the Social Security Administration. The disability definition used to determine eligibility is similar for both programs, but each has its own non-medical requirements.
To qualify for SSDI benefits, you must have worked long enough and contributed to the Social Security system through payroll taxes on the money you earned. The SSI program is a need-based program for people with low income and resources or assets valued at $2,000 or less for individuals and $3,000 or less for eligible couples.
To meet the medical requirements to qualify for SSI and SSDI, you must have a medically determinable physical or mental impairment that prevents you from doing substantial gainful activity. The physical or mental impairment must last or be expected to last for at least 12 continuous months or expected to cause death.
Process To Determine If You Are Disabled
When you apply for disability benefits, the Social Security Administration reviews it to determine if it meets the non-medical requirements for SSI or SSDI. If it does, the claim goes to the Disability Determination Services, a state agency that reviews your medical records to decide whether you meet the federal definition of “disabled.”
The Social Security Administration created a list of impairments severe enough to satisfy the disability definition. The list, called the Blue Book, includes lupus in section 14.02 as a listed impairment and the criteria required for a person to be disabled.
For a person to meet the Blue Book requirements to qualify for a disability check for lupus, medical evidence must prove the following:
- Involvement of two or more organs or body systems to a moderate or more significant level of severity; and
- At least two of the following constitutional symptoms: severe fatigue, malaise, fever, or involuntary loss of weight.
Alternatively, a person can qualify as disabled with at least two of the constitutional symptoms: severe fatigue, malaise, fever, or involuntary loss of weight, and exhibit a marked level of at least one of the following:
- Limitations maintaining social functioning.
- Limitations of activities of daily living.
- Limitations in completing tasks on time because of concentration, persistence, or pace deficiencies.
The fact that your medical condition does not meet the requirements of the listing does not disqualify you from being approved for SSI or SSDI. You can qualify with evidence showing your condition as equaling the severity of a listed impairment.
If you cannot match or equal the listed criteria, the review process continues to determine whether you qualify based on assessing whether lupus affects your capacity to do the work you did before. If you do past types of work and cannot adjust to other available jobs, your claim may be approved.
How Much Is A Disability Check For Lupus?
A monthly SSI disability check for lupus for an individual in 2024 is $943, and $1,415 for a person with an eligible spouse. Many states supplement the monthly federal benefit.
SSDI benefits for lupus are calculated based on the person’s lifetime earnings record. The more you earn before being disabled, the more you receive in SSDI or retirement benefits. The maximum SSDI check a person could receive each month in 2024 is $3,822.
Get The Benefits You Deserve With Assistance From A Disability Lawyer
If you live with lupus disease, the disability lawyers at Liner Legal can ensure you get the disability benefits you deserve. Contact them today for a free consultation and assistance with an application for benefits or to appeal a denial of a lupus disability claim.