Does Lupus Qualify Me for Social Security Disability Benefits?

 Posted on September 08, 2017 in Social Security Disability

According to the National Institutes for Health, there are about 240,000 Americans who suffer from lupus, a “serious and potentially fatal diseases” that affects a person's autoimmune system. Lupus can lead to the inflammation of multiple organs and bodily systems, including the skin, kidneys, heart, lungs, and brain.

While lupus is often difficult to diagnose—as its symptoms can be mistaken for other ailments—the most “distinctive sign” of the disease is a “facial rash that resembles the wings of a butterfly unfolding across both cheeks,” according to the Mayo Clinic.

In certain cases, “systemic lupus” may qualify a person for Social Security Disability Insurance benefits. Social Security's own listing of impairments states that a person is considered legally disabled if his or her lupus affects at least two organs or body systems and causes at least two of the following symptoms: severe fatigue, fever, malaise, or involuntary weight loss.

Social Security Improperly Ignored Doctor's Lupus Diagnosis

Of course, even if you have lupus and can provide medical evidence that your symptoms qualify you for disability benefits under the listing, Social Security may still give you a hard time. As discussed many times before, the agency's administrative law judges (ALJs) frequently try to ignore or minimize medical evidence of a disability. And while ALJs have a certain amount of discretion in weighing the credibility of medical evidence, they cannot simply disregard the findings of your treating physician.

Yet here is another recent Illinois case where an ALJ did precisely that. The applicant here suffers from “chronic discoid lupus.” The applicant's treating physician found that her symptoms “met or equaled” the requirements of the disability listing for lupus. Not only did the applicant have at least two of the required symptoms, the physician said she also had “limitations in maintaining social functioning and completing tasks in a timely manner” and “would have difficulty lifting” items and walking in a workplace setting.

The ALJ ultimately found the applicant was not disabled. More to the point, the ALJ disregarded the treating physician's diagnosis. Among other reasons, the ALJ claimed there was “bias on the doctor's part” and he was a specialist in internal medicine and not lupus.

On appeal, a federal magistrate said the ALJ's reasoning was “legally insufficient and not supported by substantial evidence.” To begin, the ALJ “offered no support” for his baseless allegations of bias on the part of the treating physician. The ALJ appeared to conflate the doctor helping the applicant fill out some of her disability paperwork with intentionally exaggerating her lupus symptoms.

As for the doctor's specialty, the magistrate said she was “puzzled” by this criticism given that the ALJ largely relied on the contrary opinions of outside agency consultants—doctors who reviewed the applicant's medical records but did not personally examine her—who were also not experts in lupus.

More disturbingly, these outside doctors did not even bother to review the treating physician's records before arriving at their conclusions. For this and other reasons, the magistrate said the applicant was entitled to a new disability hearing.

Do You Need Help Dealing With Social Security?

If you suffer from any kind of autoimmune disorder, including lupus, that prevents you from working full time, you should speak with a qualified Chicago disability benefits lawyer before attempting to deal with Social Security. Contact Pearson Disability Law, LLC, at 312-999-0999 today if you need to speak with an attorney right away.

Sources:

https://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=47

http://www.mayoclinic.org/diseases-conditions/lupus/basics/definition/CON-20019676

https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm#14_02

https://scholar.google.com/scholar_case?case=1901377185956440255