Social Security has specific "Listings,"
which are criteria for many body systems and diseases. As an example, Listing 14.02 sets
out the criteria for Systemic Lupus Erythematosus (revised June 2008). Failure
to meet the criteria of a Listing does not result in denial of the claim. The claim may be approved under other rules.
The "Listing":
The listing for lupus can be met by showing involvement
of two or more organ/ body systems, with at least one system 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).. Major organ or
body system involvement can include: respiratory (pleuritis, pneumonitis), cardiovascular (endocarditis, myocarditis, pericarditis,
vasculitis), renal (glomerulonephritis), hematologic (anemia, leukopenia, thrombocytopenia), skin (photosensitivity), neurologic
(seizures), mental (anxiety, fluctuating cognition ("lupus fog"), mood disorders, organic brain syndrome, psychosis),
or immune system disorders (inflammatory arthritis). Immunologically, there is an array of circulating serum auto-antibodies
and pro-anti-coagulant proteins that may occur in a highly variable pattern."
Alternatively, the listing
for Lupus can be met by showing repeated manifestations of the disease (flares) 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.
If the medical evidence is not sufficient to show that the claimant's medical condition
meets social security's Listing for Lupus, a claim can be won by proving that the claimant's symptoms and limitations prevent
the claimant from performing any occupation on a full-time basis, eight hours per day, or an equivalent schedule on a sustained
basis.
In many cases the constitutional symptoms cause the greatest limitation on the claimant's activity
especially fatigue and malaise. These symptoms cannot be objectively measured, and claims in which these symptoms are prominent
are especially challenging. Social Security has issued regulations and rulings concerning the evaluation of subjective symptoms
such as fatigue, malaise, and pain. These rulings and regulations describe the factors that must be considered in the process
of judging the severity of such symptoms, and in the assessment of the statements of the claimant concerning such symptoms.
Some
of the symptoms of Lupus may be readily observable. For instance joint swelling, skin rashes, and weight loss. Other symptoms
will only be known to the physician if the patient informs the doctor that he is experiencing the symptoms: fatigue, malaise,
mental impairment. Thus it is important that the patient advise his or her doctor of all of the symptoms that he or she experiences,
and continues to report the symptoms to the doctor as long as they persist. Similarly the medical records will not reflect
the impact of the disease on the patient's daily activity, and social functioning unless the patient tells the doctor about
these matters on a regular basis.
It is important that a claimant
work with an attorney with enough experience in SSA disability law and knowledge of Lupus to
be effective. Our office has successfully represented Lupus clients for over 25 years, and can provide the experience you
need to win your claim.
For a free initial consultation
and evaluation of your claim,contact our office at 770-438-2394.
(We can discuss your case with you in our office, or over the telephone.)