Autoimmune Diseases: Which Conditions Qualify as a Disability?

Autoimmune disorders are conditions where the immune system mistakenly attacks the body’s own cells, viewing them as foreign invaders. This misdirected immune response can cause a variety of health issues, ranging from mild discomfort to severe, life-altering symptoms.

These disorders, which include conditions like rheumatoid arthritis, lupus, and multiple sclerosis, can drastically impact one’s health and lifestyle. Symptoms often vary widely but may include fatigue, pain, swelling, and even organ damage. These symptoms can interfere with daily activities, making tasks that were once routine, such as working or even getting out of bed, increasingly difficult.

Moreover, autoimmune disorders often bring about significant social and financial difficulties. The chronic nature of these conditions can lead to prolonged periods of illness, affecting personal relationships and employment status. Financially, the costs associated with ongoing treatments and care can be substantial, placing an additional burden on those affected.

According to the National Institutes of Health (NIH), an estimated 23.5 million Americans are diagnosed with an autoimmune disorder. This prevalence underlines the importance of understanding these conditions and the support available to those affected, such as disability benefits.

The Role of Social Security Disability Benefits in Autoimmune Disorders

Social Security Disability (SSD) is a federally funded program aimed at providing financial assistance to individuals who are unable to work due to a significant illness or disability. For those living with autoimmune disorders, these benefits can be a lifeline, helping to offset the costs of medical treatments and basic daily needs.

The primary goal of SSD benefits is to ensure that individuals with severe, long-term, or terminal illnesses have a means of support when they are unable to earn an income due to their condition. These benefits are designed to replace some of the income lost due to the inability to work, thereby reducing financial stress and allowing the individual to focus on managing their health.

The Social Security Administration (SSA) recognizes a range of autoimmune disorders as qualifying for disability benefits. These include conditions like:

• Lupus
• Undifferentiated and mixed connective tissue disease
• Systemic Vasculitis
• Neurologic system disorders
• Inflammatory Bowel Disease (IBS)
• Cardiovascular system disorders such as endocarditis and myocarditis
• Respiratory system disorders such as pleuritis and pneumonitis
• Blood disorders such as anemia and leukopenia
• Renal system disorders (glomerulonephritis)
• Skin disorders (photosensitivity)
• Scleroderma (thickening of the skin)
• Inflammatory arthritis such as Rheumatoid Arthritis and Ankylosing Spondylitis
• Septic arthritis
• Pneumonia
• Meningitis
• Sinusitis
• Endocarditis
• Sepsis
• Human immunodeficiency virus (HIV) infection

However, it’s important to note that eligibility isn’t solely based on a diagnosis. The SSA requires comprehensive medical evidence demonstrating how the disorder significantly impairs your ability to work. This evidence, combined with an assessment of your work history and age, is used to determine whether you qualify for benefits.

Qualifying for Social Security Disability Benefits with an Autoimmune Disorder

If you’re suffering from an autoimmune disorder, it’s possible to qualify for Social Security Disability benefits. However, merely having a diagnosis is not enough. There are specific requirements and factors that the Social Security Administration (SSA) takes into consideration to determine eligibility.

Medical Eligibility

Firstly, your autoimmune disorder must be medically recognized. The SSA maintains a list of impairments, known as the “Blue Book,” which contains medical criteria that must be met for each condition.

For example, if you have rheumatoid arthritis, you will need to provide medical evidence demonstrating that you have inflammation or deformity in one or more peripheral weight-bearing joints, resulting in difficulty walking, or in one or more peripheral joints in each upper extremity, resulting in difficulty performing fine and gross movements.

Severity and Duration of Condition

Secondly, the severity and duration of your condition matter significantly. Your disorder must be severe enough to prevent you from performing substantial gainful activity (SGA), which is any work that earns a certain amount of income per month. In 2024, this is $1,550 for non-blind individuals. Additionally, your condition should be expected to last at least 12 months or result in death.

Work History

One more element that may impact your eligibility is your employment history. The Social Security Administration (SSA) will take into account your age, education, and work experience when determining whether your condition keeps you from performing the work you used to do or makes it difficult for you to adapt to new duties. This is often assessed through a process called a Residual Functional Capacity (RFC) assessment.

Documentation

Lastly, you must provide comprehensive documentation supporting your claim. This includes medical records, lab results, treatment histories, and statements from healthcare providers detailing how your condition limits your ability to function.

Social Security Disability Benefits: What Are They?

Once your Social Security Disability (SSD) benefits are approved for an autoimmune disorder, you become entitled to a range of benefits that can significantly ease the financial and medical burdens associated with your condition.

Monthly Financial Assistance

The most immediate benefit is monthly financial assistance. The amount you receive is determined not by the severity of your medical condition or your current income, but rather by your average lifetime earnings prior to the onset of your disability. The average monthly SSD benefit in 2024 is approximately $1,537.

Medical Coverage

Regardless of age, you can apply for Medicare after receiving SSD benefits for two years. This can help cover hospital visits, outpatient care, and prescription drugs. Some states also provide Medicaid coverage to SSD recipients immediately upon approval.

Dependent Benefits

If you have dependents under 18, they may be eligible for auxiliary benefits. These are typically up to 50% of your disability rate.

Work Incentives

The SSA provides work incentives, allowing you to explore work while still receiving benefits. Programs like “Ticket to Work” provide free employment services to help SSD recipients progress toward financial independence.

Protection from Discrimination

The Americans with Disabilities Act (ADA) protects SSD recipients from discrimination. This means employers cannot discriminate against you based on your disability.

Moving Forward with Social Security Disability Benefits

Living with an autoimmune disorder that disrupts your normal life can indeed be challenging. The diagnosis and the severity of the condition that hinders your daily activities, work, and overall quality of life can sometimes feel overwhelming. However, it’s essential to remember that this is not the end.

With the help of Social Security Disability benefits, you can gain access to the financial and medical support you need to endure these challenging times. These benefits are designed to ease your burden and provide a safety net as you navigate through your health journey.

These benefits could also potentially cover the cost of treatments, therapies, and medications that might otherwise be financially out of reach. This could open up possibilities for managing your symptoms better, improving your quality of life, and potentially even recovering from your disorder.