Lupus can be a debilitating condition that qualifies for disability benefits. Here's what you need to know about applying for SSI or SSDI with systemic lupus erythematosus (SLE).
In this article, we'll cover:
- When lupus qualifies
- SSA's autoimmune listings
- Evidence needed
- Tips for approval
1. When Lupus Qualifies
Lupus can qualify when:
- Symptoms are severe
- Affect multiple organ systems
- Despite treatment
- Prevent substantial work
Disabling symptoms:
- Severe fatigue
- Joint pain and swelling
- Skin manifestations
- Kidney involvement
- Neurological symptoms
- Cardiovascular issues
- Frequent flares
When it typically qualifies:
- Multiple organ involvement
- Frequent severe flares
- Poor response to treatment
- Significant functional limitations
2. SSA's Autoimmune Listings
Listing 14.02 - Systemic Lupus Erythematosus: Requires involvement of two or more body systems with:
- One system at least moderately severe, AND
- Constitutional symptoms (fatigue, malaise, weight loss, fever)
OR
- Repeated manifestations with at least two of:
- Constitutional symptoms
- Severe fatigue
- Fever
- Malaise
- Weight loss
AND one of:
- Marked limitation in daily activities
- Marked limitation in social functioning
- Marked limitation in completing tasks
Body systems:
- Musculoskeletal
- Skin
- Kidneys
- Lungs
- Heart
- Blood
- Nervous system
Important: Lupus affects many body systems. Document involvement in all affected areas.
3. Evidence Needed
Diagnosis:
- Rheumatologist diagnosis
- Positive lab markers (ANA, anti-dsDNA, etc.)
- Clinical criteria met
- Documented symptoms
Lab work:
- ANA (antinuclear antibodies)
- Anti-dsDNA antibodies
- Complement levels (C3, C4)
- CBC (for anemia, low counts)
- Kidney function tests
- Inflammatory markers
Medical records:
- Rheumatology visits
- All specialists
- Hospital records
- ER visits
Treatment history:
- Medications (especially immunosuppressants)
- Response to treatment
- Side effects
- Failed treatments
Organ involvement:
- Documentation of each system affected
- Severity of involvement
- Test results for organs
- Specialist evaluations
Functional limitations:
- Daily activity limitations
- Fatigue levels
- Pain severity
- Good days vs. bad days
4. Tips for Approval
Document all affected systems:
- Not just the main one
- Every organ system matters
- Combined impact
- Severity of each
Track flares:
- Frequency
- Severity
- Duration
- Triggers
- Recovery time
Show treatment failure:
- Medications tried
- Why they didn't work
- Side effects limiting use
- Ongoing symptoms
Describe fatigue:
- Lupus fatigue is profound
- Affects everything
- Not relieved by rest
- Different from normal tiredness
Include all symptoms:
- Skin issues
- Joint problems
- Cognitive issues ("lupus fog")
- Sensitivity to sun
- Headaches
Document unpredictability:
- Can't predict flares
- Unreliable for work
- Need flexibility
- Impossible to maintain schedule
Common Challenges
"You don't look sick":
- Lupus is often invisible
- Internal symptoms not visible
- Document thoroughly
- Doctor statements critical
Variable symptoms:
- Good days and bad days
- Doesn't mean you can work
- Can't be consistent
- Explain the pattern
Young patients:
- Lupus often affects younger women
- May have limited work history
- SSI doesn't require work credits
- SSDI needs sufficient credits
Related Conditions
May also have:
- Fibromyalgia (common with lupus)
- Depression
- Anxiety
- Sjögren's syndrome
- Raynaud's phenomenon
Document all:
- Combined impact matters
- Even if lupus alone doesn't qualify
- Total functional limitation
- All conditions count
How Purple Helps
Purple supports those with lupus:
- Simple banking
- Track benefit deposits
- Manage finances easily
- Less stress
- Banking from home