Suffering an Unfair Job Loss is Tough, our california employment attorneys can help.

Autoimmune Diseases & Pain Disorders

How Do I Get Social Security Disability Benefits for an Immune System Disorder?Immune System Disorders and Disability

Do you have an immune system disorder that prevents you from being able to work? You may be entitled to Social Security Disability benefits. The experienced Fullerton social security disability attorneys here at Howard Law can help you get the Social Security Disability benefits you are entitled to. We represent people with immune system disorders who are unable to work and have been denied social security disability benefits.

Listed below are the immune system disorders and the guidelines the Social Security Administration uses to determine if you qualify as disabled. If you are living with an immune system disorder, are unable to work, and have been denied Social Security Disability benefits, call the experienced Fountain Valley attorneys at Howard Law and let us fight to help you obtain the benefits you deserve.

Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. SLE can affect almost any part of the body including, skin, kidneys, intestine, muscles, joints, eyes, lungs, or heart.

To qualify for Social Security disability benefits due to systemic lupus erythematosus, you must meet either A or B, below.

  1. 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; and
    2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
  2. OR

  3. 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.

For more information on Systemic Lupus Erythematosus and the Social Security Administration guidelines, visit the Social Security Administration website.

Systemic Vasculitis

Systemic vasculitis means generalized inflammation of the arterial system.

For your condition to be severe enough to meet the listing, you must have systemic vasculitis with either A or B, below.

  1. 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; and
    2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
  2. OR

  3. Repeated manifestations of systemic vasculitis, 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.

For more information on systemic vasculitis and the Social Security Administration guidelines, visit the Social Security Administration website.

Systemic Sclerosis (Scleroderma)

Scleroderma is a connective tissue disease that involves changes in the skin, blood vessels, muscles, and internal organs. It is a type of autoimmune disorder, a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.

For your condition to be severe enough to meet the listing, you must have systemic sclerosis (scleroderma) with either A, B, C, or D, below.

  1. 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; and
    2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
  2. OR

  3. With one of the following:
    1. Toe contractures or fixed deformity of one or both feet, resulting in the inability to ambulate effectively or
    2. Finger contractures or fixed deformity in both hands, resulting in the inability to perform fine and gross movements effectively, or
    3. Atrophy with irreversible damage in one or both lower extremities, resulting in the inability to ambulate effectively; or
    4. Atrophy with irreversible damage in both upper extremities, resulting in the inability to perform fine and gross movements effectively.
  4. OR

  5. Raynaud's phenomenon, characterized by:
    1. Gangrene involving at least two extremities; or
    2. Ischemia with ulcerations of toes or fingers, resulting in the inability to ambulate effectively or to perform fine and gross movements effectively;
  6. OR

  7. Repeated manifestations of systemic sclerosis (scleroderma), 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.

For more information on systemic sclerosis (scleroderma) and the Social Security Administration guidelines, visit the Social Security Administration website.

Polymyositis and Dermatomyositis

Polymyositis is a persistent inflammatory muscle disease that causes weakness of the skeletal muscles, which control movement. Dermatomyositis is an uncommon inflammatory disease marked by muscle weakness and a distinctive skin rash. Both are autoimmune disease that can occur alone or in association with other connective tissue disorders or malignancy.

To qualify for Social Security Disability benefits due to Polymyositis or dermatomyositis, you must satisfy either A, B, C, D, or E, below.

  1. Proximal limb-girdle (pelvic or shoulder) muscle weakness, resulting in inability to ambulate effectively or inability to perform fine and gross movements.
  2. OR

  3. Impaired swallowing (dysphagia) with aspiration due to muscle weakness.
  4. OR

  5. Impaired respiration due to intercostal and diaphragmatic muscle weakness.
  6. OR

  7. Diffuse calcinosis with limitation of joint mobility or intestinal motility.
  8. OR

  9. Repeated manifestations of polymyositis or dermatomyositis, 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.

For more information on polymyositis and dermatomyositis and the Social Security Administration guidelines, visit the Social Security Administration website.

Immune Deficiency Disorders

This listing refers disorders associated with decreased immunity other than those caused by HIV.

For your condition to be severe enough to meet the listing, you must suffer from an immune deficiency disorder, excluding HIV infection, with either A, B, or C, below.

  1. One or more of the following infections. The infection(s) must either be resistant to treatment or require hospitalization or intravenous treatment three or more times in a 12-month period.
    1. Sepsis; or
    2. Meningitis; or
    3. Pneumonia; or
    4. Septic arthritis; or
    5. Endocarditis; or
    6. Sinusitis documented by appropriate medically acceptable imaging.
  2. OR

  3. Stem cell transplantation. Consider under a disability until at least 12 months from the date of transplantation. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system.
  4. OR

  5. Repeated manifestations of an immune deficiency disorder, 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 function.
    3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

To learn more about immune deficiency disorders and the Social Security Administration guidelines, visit the Social Security Administration website.

Human Immunodeficiency Virus (HIV) Infection

HIV infection is a condition caused by the human immunodeficiency virus (HIV). The condition gradually destroys the immune system, which makes it harder for the body to fight infections.

For you to qualify for Social Security Disability benefits due to human immunodeficiency virus (HIV) infection, you must have documentation of HIV and one of the following:

  1. Bacterial infections:
    1. Mycobacterial infection (for example, caused by M. avium-intracellulare, M. kansasii, or M. tuberculosis) at a site other than the lungs, skin, or cervical or hilar lymph nodes, or pulmonary tuberculosis resistant to treatment; or
    2. Nocardiosis; or
    3. Salmonella bacteremia, recurrent non-typhoid; or
    4. Multiple or recurrent bacterial infections, including pelvic inflammatory disease, requiring hospitalization or intravenous antibiotic treatment three or more times in a 12-month period.
  2. OR

  3. Fungal infections:
    1. Aspergillosis; or
    2. Candidiasis involving the esophagus, trachea, bronchi, or lungs, or at a site other than the skin, urinary tract, intestinal tract, or oral or vulvovaginal mucous membranes; or
    3. Coccidioidomycosis, at a site other than the lungs or lymph nodes; or
    4. Cryptococcosis, at a site other than the lungs (for example, cryptococcal meningitis); or
    5. Histoplasmosis, at a site other than the lungs or lymph nodes; or
    6. Mucormycosis; or
    7. Pneumocystis pneumonia or extrapulmonary Pneumocystis infection.
  4. OR

  5. Protozoan or helminthic infections:
    1. Cryptosporidiosis, isosporiasis, or microsporidiosis, with diarrhea lasting for 1 month or longer; or
    2. Strongyloidiasis, extra-intestinal; or
    3. Toxoplasmosis of an organ other than the liver, spleen, or lymph nodes.
  6. OR

  7. Viral infections:
    1. Cytomegalovirus disease at a site other than the liver, spleen or lymph nodes; or
    2. Herpes simplex virus causing:
      1. Mucocutaneous infection lasting for 1 month or longer; or
      2. Infection at a site other than the skin or mucous membranes (for example, bronchitis, pneumonitis, esophagitis, or encephalitis); or
      3. Disseminated infection; or
    3. Herpes zoster:
      1. Disseminated; or
      2. With multidermatomal eruptions that are resistant to treatment; or
    4. Progressive multifocal leukoencephalopathy.

  8. OR

  9. Malignant neoplasms:
    1. Carcinoma of the cervix, invasive, FIGO stage II and beyond; or
    2. Kaposi's sarcoma with:
      1. Extensive oral lesions; or
      2. Involvement of the gastrointestinal tract, lungs, or other visceral organs; or
    3. Lymphoma (for example, primary lymphoma of the brain, Burkitt's lymphoma, immunoblastic sarcoma, other non-Hodgkin's lymphoma, Hodgkin's disease); or
    4. Squamous cell carcinoma of the anal canal or anal margin.
  10. OR

  11. Conditions of the skin or mucous membranes (other than described in B2, D2, or D3, above), with extensive fungating or ulcerating lesions not responding to treatment (for example, dermatological conditions such as eczema or psoriasis, vulvovaginal or other mucosal Candida, condyloma caused by human Papillomavirus, genital ulcerative disease).
  12. OR

  13. HIV encephalopathy, characterized by cognitive or motor dysfunction that limits function and progresses.
  14. OR

  15. HIV wasting syndrome, characterized by involuntary weight loss of 10 percent or more of baseline (computed based on pounds, kilograms, or body mass index (BMI)) or other significant involuntary weight loss, and in the absence of a concurrent illness that could explain the findings. With either:
    1. Chronic diarrhea with two or more loose stools daily lasting for 1 month or longer; or
    2. Chronic weakness and documented fever greater than 38* C (100.4* F) for the majority of 1 month or longer.
  16. OR

  17. Diarrhea, lasting for 1 month or longer, resistant to treatment, and requiring intravenous hydration, intravenous alimentation, or tube feeding.
  18. OR

  19. One or more of the following infections (other than described in A-I, above). The infection(s) must either be resistant to treatment or require hospitalization or intravenous treatment three or more times in a 12-month period.
    1. Sepsis; or
    2. Meningitis; or
    3. Pneumonia; or
    4. Septic arthritis; or
    5. Endocarditis; or
    6. Sinusitis documented by appropriate medically acceptable imaging.
  20. OR

  21. Repeated manifestations of HIV infection, but without the requisite findings for those listings (for example, carcinoma of the cervix not meeting the criteria or diarrhea not meeting the criteria), or other manifestations (for example, oral hairy leukoplakia, myositis, pancreatitis, hepatitis, peripheral neuropathy, glucose intolerance, muscle weakness, cognitive or other mental limitation) resulting in significant, documented symptoms or signs (for example, severe fatigue, fever, malaise, involuntary weight loss, pain, night sweats, nausea, vomiting, headaches, or insomnia) 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.

For more information on HIV and the Social Security Administration guidelines, visit the Social Security Administration website.

Inflammatory Arthritis

Rheumatoid or inflammatory arthritis is a disease of the immune system that causes inflammation: tenderness, swelling, and pain in the tissues surrounding the joints.

To qualify for Social Security Disability benefits due to inflammatory arthritis, you must satisfy either A, B, C, or D, below.

  1. Persistent inflammation or persistent deformity of:
    1. One or more major peripheral weight-bearing joints resulting in the inability to ambulate effectively or
    2. One or more major peripheral joints in each upper extremity resulting in the inability to perform fine and gross movements effectively
  2. OR

  3. Inflammation or deformity in one or more major peripheral joints with:
    1. Involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity; and
    2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
  4. OR

  5. Ankylosing spondylitis or other spondyloarthropathies, with:
    1. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 45o or more of flexion from the vertical position (zero degrees); or
    2. Ankylosis (fixation) of the dorsolumbar or cervical spine as shown by appropriate medically acceptable imaging and measured on physical examination at 30* or more of flexion (but less than 45*) measured from the vertical position (zero degrees), and involvement of two or more organs/body systems with one of the organs/body systems involved to at least a moderate level of severity.
  6. OR

  7. Repeated manifestations of inflammatory arthritis, 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.

For more information on inflammatory arthritis and the Social Security Administration guidelines, visit the Social Security Administration website.

Sjogren's Syndrome

Sjoegren's syndrome is an autoimmune disease that affects the salivary and tear glands, which supply moisture to the eyes and mouth.

To qualify for Social Security Disability benefits due to Sjoegren's syndrome, you must satisfy either A or B, below.

  1. 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; and
    2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).
  2. OR

  3. Repeated manifestations of Sjoegren's syndrome, 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.

For more information on Sjoegren's syndrome and the Social Security Administration guidelines, visit the Social Security Administration website.

[Back to Top]

Listing vs. Residual Functional Capacity (RFC): How Does the Social Security Administration Determine Whether I Qualify for Disability Benefits for an Immune System Disorder?

Social Security disability benefits may be available for people who suffer from an Immune System Disorder. The Social Security Administration must first determine whether your Immune System Disorder is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. The Social Security Administration will conclude that you are disabled and eligible for disability benefits if it determines that you meet or equal a listing because of your Immune System Disorder.

If the Social Security Administration decides that your Immune System Disorder is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

[Back to Top]

How Can I Meet a Listing and Win Social Security Disability Benefits for an Immune System Disorder?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your Immune System Disorder is severe enough to equal a listing.

The term "listing" refers to a compiled list of common impairments. The Social Security Administration created a set of guidelines called the Listing of Impairments that contains the most common impairments. For each listing of a particular impairment, there is an explanation regarding the degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work.

The Social Security Administration will consider you disabled if your Immune System Disorder is severe enough to meet or equal a listing.

[Back to Top]

What is Your Residual Functional Capacity Assessment for Your Immune System Disorder?

If the Social Security Administration decides that your Immune System Disorder is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

The Social Security Administration expresses an RFC for physical impairments in terms of whether the Social Security Administration believes you are able to do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

[Back to Top]

Can Your Doctor's Medical Opinion Help You Qualify for Social Security Disability Benefits for an Immune System Disorder?

The role of the Social Security Administration is to conclusively establish whether you are disabled based on your education, work experience, medical evidence, and your age.

The role of your doctor is to provide the Social Security Administration with information concerning the degree of your medical impairment by providing the Social Security Administration medical source statement that describes your capacity for work which is part of your residual functional capacity assessment. Your residual functional capacity is what you can still do despite your limitations.

The Social Security Administration must consider your treating physician's opinion because the Social Security Administration considers it to be controlling when making its decision.

[Back to Top]

What is the 5 Step Sequential Evaluation Process?

The Social Security Administration has created a five (5) step sequential process to determine whether an adult claimant is entitled to receive disability benefits. Children have a different test to determine eligibility.

Step 1: Substantial Gainful Activity

The Social Security Administration presumes that if you are working and that you make a certain amount of money that you are engaging in what it determines to be a substantial gainful activity (SGA). The Social Security Administration considers a person to be engaged in a SGA if that person is earning more than a certain amount of money each month (i.e. net of impairment - related work related expenses).

In 2013, the Social Security Administration has determined that a statutorily blind individual is engaged in a SGA if they earn more than $1740.00 per month while a non-blind individual must earn more than $1040.00 per month. Changes in the national average wage index usually affect the aforementioned SGA amounts.

Step 2: Severe Impairment

The Social Security Administration has determined that each claimant must either have a severe impairment or a combination of impairments. The impairment or combination of impairments must drastically limit the claimant's physical or mental ability to do basic work activities without regard to age, work history, or education. For many claimants, the level of proof at this level is minimal; therefore, they usually satisfy the Step 2 requirements and proceed to Step 3.

Step 3: Listing of Impairments

The Listing of Impairments details specific impairments that the Social Security Administration considers severe enough to prevent an adult claimant from engaging in a substantial gainful activity and in the case of a minor, the impairment has to be severe enough to cause functional limitations. There is also a durational requirement. The Social Security Administration has determined that the impairment must last for 12 months or long or result in the death of the claimant. If the claimant fails Step 3 because they do not meet or equal a listing then the case will proceed to Step 4.

Step 4: Past Relevant Work

At Step 4, if your condition is severe enough to meet the requirements of Step 2 (Severe Impairment); however, your severe impairment does not meet or equal a listed impairment that is the subject of Step 3 (Listing of Impairments), then the Social Security Administration must decide whether your severe impairment interferes with your ability to do any of the work you previously performed. The Social Security Administration likes to look at the work you performed over the past 15 years prior to the onset of your disability. If the Social Security Administration determines that your impairment does not interfere with work you previously did then you must proceed to Step 5.

Step 5: Ability to Perform Other Work

A majority of disability claims are decided at this level. If you cannot perform work you did in your past, then a determination must be made as to whether you can adjust to different types of work. The determination at this level takes into consideration your education, age, and prior work and is better known as your residual functional capacity.

[Back to Top]