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|Announce Date: Monday, December 15, 2008|
Social Security Disability Blog Provides Information for Claimants with Lupus
My Social Security Disability Blog, a blog that publishes information on the disability programs conducted by the social security administration (social security disability and SSI disability), has recently posted information for disability claimants who are filing a claim on the basis of Lupus.
Lupus, or Systemic lupus erythematosus, is a chronic autoimmune disorder, a type of disease in which the immune system attacks the body's own cells. As such, and is the case with many autoimmune disorders, Lupus typically involves inflammation and damage to a number of body organ systems. There is no cure for lupus. And for those who suffer from the effects of lupus (to skin, joints, heart, lung, liver, and other areas), treatment focuses on managing the symtomology of lupus.
But in addition to its physical manifestions, Lupus, according to Tim Moore, the publisher of My Social Security Disability Blog, presents several other problems from a disability adjudication standpoint.
First of all, lupus, as a disease, is an "imitator". Imitators are diseases for which the symptoms vary so widely that they can easily be mistaken for other disorders and disease processes. This, of course, tends to lead to misdiagnosis and/or very late proper diagnosis.
How does the imitator aspect of Lupus potentially affect an individual who is filing for disability benefits with the social security administration? By muddying the waters, so to speak. Disability examiners, who render decisions on social security disability and SSI disability claims and appeals, review medical records to look for evidence of diagnosed conditions. Mental and physical conditions for which a clear diagnosis has been made by a treating physician may then be checked against the social security disability blue book, a manual that lists the approval criteria for a number of physical and mental impairments. In the case of lupus, if a proper diagnosis has not been made, a claimant may possibly fail to receive consideration under the social security administration's listing for lupus.
Secondly, lupus is a disease that has the characteristic of exacerbation and remission. In other words, its apparent severity, as documented in a claimant's medical records, may change over time.
For a disability claim, this presents a potential hurdle, much in the same way that certain mental impairments (such as bipolar disorder) and other autoimmune illnesses also demonstrate an exacerbating, remissing quality: though a lupus patient may find that their condition significantly hampers their ability to maintain employment which provides a substantial and gainful income, a disability adjudicator, in reviewing the claim, may focus on the fact that the current evidence available indicates a lesser degree of severity.
This is most likely to occur, of course, at the lower levels of the disability adjudication system (initial claim and reconsideration) where the decision process does not allow the claimant or the claimant's representative to directly engage the decision-maker (a disability examiner) and debate the merits of the evidence.
Not surprisingly, a claimant who files for disability on the basis of lupus may find, as a great many claimants also find, that their chance of eventually winning disability benefits rises significantly at a disability hearing where both the claimant and their chosen representative, who may be an attorney or a non-attorney representative, may engage the decision-maker (in this case, a federal administrative law judge) in a discussion of the medical evidence. Additionally, preparation for the hearing event--gathering medical records and medical source statements, otherwise known as RFC forms--falls entirely to the claimant and, if the claimant is represented, ideally, to a representative who has a substantial amount of experience in handling social security disability and SSI claims.
The recent posting on Mr. Moore's Social Security Disability Blog regarding Lupus and Social Security Disability may be found at the following address: http://disabilityblogger.blogspot.com/2008/11/lupus-and-social-security-disability.html
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