Is Lupus a Disability?

Is Lupus a Disability?
What are the Symptoms of Lupus?
Can You Get Disability for Lupus?
Can You Work With Lupus?
Lupus Disability Criteria - Blue Book
Qualifying for Disability Without Meeting The Listing For Lupus
Applying for Disability with Lupus - FAQs
Working with a Disability Lawyer to Qualify for Disability with Lupus
Next Steps to Take
Additional Resources

Lupus is an autoimmune disease that causes inflammation throughout any part of the body. It occurs when the immune system attacks its own tissue.

The Lupus Foundation of America estimates that there are about 1.5 million people in the U.S. living with Lupus.

For those with lupus that is more aggressive or unresponsive to treatment however, the disease can quickly limit employability or put an end to working entirely.

Yes, lupus is considered a disability by the SSA and is under the list of disabilities that the SSA has of conditions that qualify for disability.

Since lupus is a disease in which the body’s immune system attacks organs and tissue can produce a wide variety of symptoms that include fever, fatigue, and joint pain, people can get approved for disability for lupus by meeting the requirements of the SSA's Blue Book listing for lupus.

It is important to note that a lupus disability applicant not only has to prove the existence of lupus, but also must prove that the symptoms of the disease make it impossible for them to work their current job.

What are the Symptoms of Lupus?

Lupus can manifest in a number of ways, each unique to the individual affected. Understanding the symptoms of lupus is crucial for recognizing its potential impact on one's daily functioning.

Some common symptoms of lupus include:

Fever
Joint pain or stiffness
Rash
Fatigue
Chest pain
Increased sensitivity to sunlight

The experience of lupus can significantly differ from person to person. For some, the symptoms may be mild and manageable, yet for others, they can be severe and debilitating. This variation adds a layer of complexity when considering lupus as a disability.

Lupus symptoms can:

Lupus affects the skin, joints, and organs, needing varied management methods and impacting daily life.
Symptoms flare up and ease, making it hard to keep regular routines, like work or social activities.
Lead to unpredictable bouts of illness, making it difficult for individuals to maintain consistent work or social schedules.

While lupus affects each person differently, the common thread is its potential to affect daily living and functioning significantly. Recognizing the fluctuating nature of lupus symptoms is vital for both those affected by the disease and for professionals evaluating lupus in the context of disability.

Can You Get Disability for Lupus?

Yes, you are able to get disability for lupus if you meet both the medical and work requirements outlined for disability by the SSA.

Meeting the Blue Book (which is the list of disabilities that qualify for Social Security disability benefits) listing for lupus under Section 14.02 is just one requirement that determines whether you qualify for Social Security disability benefits.

This is because the SSA has other criteria that disability applicants must meet in order to get approved for disability with lupus.

Can You Work With Lupus?

Some individuals with lupus can work, but the ability to work depends on the severity of your symptoms and the type of job you have. Some people with lupus may experience periods of remission where symptoms are minimal and may be able to work full-time or part-time without significant difficulty. However, others may find it challenging to maintain employment due to frequent flare-ups, fatigue, pain, and other symptoms that can affect their ability to function at work.

If you feel you are unable to work, you can receive work credits for having lupus. The SSA requires applicants to have worked long enough prior to their development of their disabling medical condition. The SSA measures work history based on applicants' accumulation of work credits. This is because, for every year that an individual works, they earn a certain amount of work credits. You can earn as many as four work credits each year.

The amount of wages and/or self-employment income you need to earn for a work credit also changes each year. For example, you will earn one work credit for every $1,640 you generate in wages and/or self-employment income throughout 2023.

When you earn $6,560 in wages and/or self-employment income, you reach the maximum number of work credits allowed by the SSA. Regardless of your age, you must earn the minimum number of work credits within a period designated by federal law.

You also have to demonstrate you have missed work for 12 consecutive months in order to get disability for lupus. The timekeeping records maintained by your employer, as well as the copies of bank statements, act as evidence of missed time from work.

Lupus Disability Criteria - Blue Book

Figuring out which medical conditions qualifies for disability comes down to whether or not the condition is listed in their Blue Book. The Blue Book is the SSA’s manual of medical conditions that they see as being severe enough to qualify someone for disability.

Since there is a Blue Book listing for lupus, people can get disability for lupus. The specific Blue Book listing for lupus is in Section 14.02 – Systemic Lupus Erythematosus.

The Blue Book listing for Lupus is as followed:

A. Involvement of two or more organs/body systems, with:

One of the organs/body systems 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).

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:

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.

The SSA’s Blue Books defines the severity of symptom standards applicants have to meet to qualify lupus as a disability.

If you suffer from lupus, you must show the disease has negatively impacted two or more organs and/or body systems. You also have to suffer from at last two serious symptoms that have forced you out of work.

The SSA also names the limitations that can make a disability claim valid under the guidelines established by the Blue Book.

If lupus limits your daily activities, social functioning skills, and the ability to complete tasks on time, then you might be eligible for disability benefits.

The SSA applies rules to every disability, including being unable to work and transition to another occupation, as well as the symptoms of the disease are expected to remain for at least one year.

To prove you suffer from severe lupus symptoms, you must submit convincing medical evidence. Medical evidence of lupus includes:

Results of diagnostic tests used to rule out other medical conditions that cause similar symptoms as lupus
Longitudinal reports from your doctor, reporting symptoms, complications, treatments, and treatment affects over a period of three or more months (12 months is even better)
Prescription medications used and their effects on your specific symptoms and complications
Hospitalization and other treatment records, if appropriate
Test results or lab work reports, showing diagnosis of common complications, like kidney or heart disease, bone loss, seizures, anemia, etc.

You should submit copies of every healthcare receipt, including the cost of prescription medications and the use of an assistive device. Ask your healthcare provider to submit a statement that describes your prognosis of making a full or partial recovery.

Successful completion of these things can be one of, if not, the most important signs your disability claim will be approved.

Qualifying for Disability Without Meeting The Listing For Lupus

Most people with severe or advanced lupus are able to satisfy the Blue Book listing requirements. If you are not however, then you may still be able to prove your disability through a “residual functional capacity” (RFC) analysis.

This process is standard for the SSA for any applicant that doesn’t meet or closely match a disability listing. You’ll receive notification in the mail that more information is needed to evaluate your claim.

Along with this notification, you’ll receive questionnaires about your physical and/or mental limitations.

When you fill out these questionnaires, be honest and detailed. Tell the SSA about all of the effects that your symptoms, treatment side effects, and lupus complications have on your everyday life.

For example, fatigue, fever, and a general feeling of “illness” may prevent you from getting out of bed or leaving your home and therefore mean frequent absences from work.

Pain, inflammation, and weakness may stop you from doing everyday tasks, like laundry, sweeping the floor, or mowing the lawn.

This kind of information may at first seem silly for the SSA to ask for, but they use these details about your everyday life to better understand how your lupus may limit your ability to perform common job functions. For example, if you can’t mow the lawn or clean your house, then you can’t perform physical job duties, like those required in retail jobs, manufacturing positions, or similar employment situations.

It’s important to understand though that in order to be approved through an RFC with Lupus, you must also show that your lupus would prevent you from working in an office or other primarily sedentary job.

To avoid denied disability the SSA must see that you experience problems with completing tasks in a timely manner, processing thoughts or other information, or that you have other cognitive or physical symptoms that would keep you from working at all, in any job whatsoever.

Applying for Disability with Lupus - FAQs

When applying for disability with lupus, there are a lot of common questions that people ask regarding their claim.

Common questions include how much someone can get for disability, how long the process takes, the costs associated for having lupus, etc.

When you work with a disability lawyer, your lawyer will be able to help you answer any questions you have regarding your claim. Below are a list of common questions that people have regarding filing for disability with lupus.

How Much Can Having Lupus Cost You?

Lupus is a chronic condition that must be closely monitored to ensure systemic effects are minimized. In other words, you regularly see your doctor in order to have tests performed to find and prevent or limit damage caused by the disease.

Monitoring costs therefore add up quickly, though the exact expenses are different for each patient, due to the varying nature of the disease itself.

The Lupus Foundation of America reports that the average annual direct medical costs are $12,643 per patient. The type and severity of your symptoms significantly affect your direct medical expenses though.

For instance, a person for whom lupus affects multiple body systems (joints, heart, kidneys, and skin) will have higher treatment costs than a patient for whom the disease primarily affects only one body system.

Doctors must often prescribe multiple medications to control symptoms, and frequent prescription adjustments may be necessary, especially while trying to discover the right cocktail of drugs to effectively control your lupus.

Common prescriptions include corticosteroids, antimalarial drugs, and other autoimmune suppression medications, like Acthar and Benlysta.

If you have severe complications from lupus, then you may need additional prescriptions, including high blood pressure drugs, diuretics to reduce fluid retention, anti-seizure medications for seizures, or antibiotics to treat frequent infections.

With all of these medications combined, your monthly prescription costs may run several hundred, or even several thousand dollars, dependent upon your prescription drug insurance coverage.

Lost work time cannot be overlooked when considering the costs of living with lupus, and the Lupus Foundation of America reports the average annual loss of income at $8,659 per person.

This is, of course, when employment is still an option. When lupus prevents work entirely, then you’re faced with the challenge of surviving without employment income.

Whether you work reduced hours or cannot work at all, Social Security disability benefits for lupus can be the answer to your financial concerns.

How Much Can You Get For Disability For Lupus?

The maximum amount you get for disability with lupus is $3,882 per month. The amount you will receive in disability benefits after you have been diagnosed with lupus will depend on your situation, including your average lifetime earnings before you became disabled.

How Long Does it Take to Get Disability for Lupus?

It takes between 3-5 months to receive an initial decision from the SSA regarding your lupus disability claim. However, 2 out every 3 of applicants are denied at the initial stage.

You have the option of appealing the SSA’s decision regarding your lupus disability claim, which will delay the process of you receiving disability. A disability attorney can help increase your chances of winning your disability claim, which can help speed up the process.

Working with a Disability Lawyer to Qualify for Disability with Lupus

Disability lawyers are only paid if you win your claim. That means that you do not have to pay unless you win your claim. A disability attorney will help you make sure all of your medical paperwork is in order, get notes and get recommendations from your doctors.

Your disability lawyer will also be able to testify on your behalf and help gather witnesses to help prove your lupus disability case. A disability lawyer will be able to tell you how much disability you can get.

According to a study from the U.S. Government Accountability Office (GAO), those who used a disability lawyer when applying for disability were 3x more likely to get approved than those who did not use a disability lawyer.

You’ll need your financial details, work history, and education information before applying for benefits. Gathering contact information for all your medical care providers is recommended too, as the SSA will need these details to request copies of your medical records.

Considering applying for Social Security disability benefits but not sure how much you’ll earn per month? Our Social Security benefits calculator can help you determine how much you’ll receive from the SSA before you file for disability.

When you’re ready to start your application, you can visit the SSA’s website to apply for SSDI, or you can go to the local Social Security office to apply for SSI and/or SSDI benefits.

Take our Free Disability Evaluation to see if you qualify for disability.

Next Steps to Take

If you have lupus and you believe you will be out of work for at least 12 months or more, then you should apply for disability. A disability lawyer for lupus can help increase your chances of getting approved for disability. To get connected to an attorney who can take a case in your area, fill out our free disability evaluation today.

You could be entitled to $3,882 per month!
Free Disability Evaluation:

How to Qualify for Disability with Lupus (Updated 2024)

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