SSDI Eligibility Guidelines: Lupus
Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,170 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
Conclude the lupus disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
Ask if the lupus disability meets or equals a medical listing. Lupus is considered under the Immune System Disorders and has several specific medical listings or categories. To satisfy the listing criteria, a person with lupus must have:
- 14.02 Systemic lupus erythematosus.As described in 14.00D1. With: 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; and2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).ORB. 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.
Explore the ability of an individual to perform work they have done in the past despite their lupus. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine lupus disability, the SSA enlists medical-vocational rules, which vary according to age.
For example, if a person is:
Under age 50 and, as a result of the symptoms of lupus, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
Age 50 or older and, due to the disability, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.
Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.
Over age 60 and, due to the disability, unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.
Any age and, because of lupus, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.
SSDI & Lupus: A Personal Story
Read how one person’s journey to approval was made easier with True Help.
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