woman with lupus
By Michelle Shvarts
Principal Attorney

Systemic Lupus Erythematosus (SLE), commonly referred to as lupus, is a complex autoimmune disease that affects millions of people worldwide. In Florida, individuals battling lupus often face not only the physical and emotional challenges of their condition but also the financial strain of medical bills and lost income. Fortunately, Social Security Disability Insurance (SSDI) can provide financial assistance to those who qualify. This article explores the medical criteria for lupus in Florida SSDI claims and how Disability Advocates Group can help you secure the benefits you need.

Understanding Lupus (SLE)

Lupus is a chronic autoimmune disease where the immune system mistakenly attacks healthy tissues and organs. This can lead to a wide range of symptoms, including joint pain, fatigue, skin rashes, and organ damage. Lupus is known for its unpredictability, with symptoms that can range from mild to severe, and periods of remission interspersed with flare-ups.

Medical Criteria for SSDI Eligibility Due to Lupus

To qualify for SSDI benefits due to lupus in Florida, applicants must meet the Social Security Administration’s (SSA) medical criteria. These criteria include:

  1. Evidence of Diagnosis: You must provide medical evidence that confirms a diagnosis of lupus by a qualified healthcare professional, typically a rheumatologist or immunologist. This evidence should include clinical observations, laboratory tests, and imaging studies.
  2. Severity of Symptoms: The symptoms of lupus must be severe enough to significantly limit your ability to perform substantial gainful activity (SGA). This includes documentation of fatigue, joint pain, skin rashes, organ involvement, and any other symptoms that impact your daily life.
  3. Duration of Impairment: Lupus must have lasted or be expected to last for at least 12 months or result in death.
  4. Medical Documentation: Detailed medical records are essential. These records should include the results of blood tests, imaging studies, and other relevant diagnostic tools. A complete record of prescribed medications and their side effects is also crucial.
  5. Functional Limitations: You must provide evidence of how lupus limits your ability to perform work-related tasks. This may include difficulty with physical exertion, concentration, and handling stress.
  6. Frequency and Duration of Flare-Ups: Documenting the frequency and duration of lupus flare-ups is vital. The SSA considers whether your symptoms and limitations persist despite prescribed treatments.

Common Challenges in Lupus SSDI Claims

Despite meeting the medical criteria, individuals applying for SSDI benefits due to lupus often encounter challenges, resulting in initial denials. Some common issues include:

  1. Lack of Comprehensive Documentation: Incomplete medical records or a lack of specific lupus-related diagnostic tests can lead to denials.
  2. Failure to Demonstrate Severity: It can be challenging to convey the severity of lupus symptoms, especially when they fluctuate over time.
  3. Credibility Issues: The SSA may question the credibility of an applicant’s symptoms or limitations if they are not consistently documented.

How Disability Advocates Group Can Assist

Disability Advocates Group is committed to helping individuals in Florida with lupus navigate the SSDI application process successfully. Here’s how we can assist:

  1. Gathering Comprehensive Medical Evidence: We work closely with your healthcare providers to compile a comprehensive case file that includes all necessary medical records, diagnostic tests, and specialist opinions.
  2. Documenting Functional Limitations: We assist you in detailing how lupus affects your ability to perform work-related tasks and daily activities.
  3. Preparing Appeals: In the event of an initial denial, we guide you through the appeals process, ensuring your case is well-prepared for presentation before an administrative law judge. We emphasize the severity of your lupus and its impact on your daily life.
  4. Addressing Credibility Concerns: Our team works with you to ensure that all evidence and statements are consistent and credible, increasing your chances of success.

Conclusion

Living with lupus in Florida can be physically, emotionally, and financially challenging. SSDI benefits are designed to provide crucial financial support to individuals facing these difficulties. However, the SSDI application process can be daunting, especially when dealing with the unpredictable nature of lupus.

Disability Advocates Group is here to support you throughout this journey. Our experienced team understands the unique challenges posed by lupus and is dedicated to helping you secure the SSDI benefits you need and deserve.

If you’re dealing with lupus and believe you meet the medical criteria for SSDI benefits, don’t let an initial denial discourage you. Contact Disability Advocates Group today, and let us work together to ensure that your SSDI case for lupus in Florida is successful, providing you with the financial support and peace of mind you deserve.

About the Author
Ms. Shvarts and the rest of the team at Disability Advocates Group are dedicated to assisting individuals in Florida obtain Social Security Disability Benefits (SSDI) and Supplemental Security Income (SSI) benefits.