Living with an autoimmune disorder can be a daily battle, even if those around you can’t see the struggle. These chronic conditions are often invisible, but their impact can be significant, affecting a person’s physical, emotional, and social well-being. If you or a loved one is facing the challenges of an autoimmune disorder and struggling to maintain employment, you may be wondering about your eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). In this blog post, we will explore the hidden challenges of autoimmune disorders and how SSDI/SSI benefits may help by providing the support needed to navigate these often unseen battles.
The Impact of Autoimmune Disorders
Autoimmune disorders encompass a broad range of conditions, including rheumatoid arthritis, lupus, multiple sclerosis, and Crohn’s disease, to name a few. These disorders share a common trait: the immune system mistakenly attacks healthy cells and tissues, leading to a wide array of symptoms and complications. Many autoimmune disorder sufferers find themselves unable to work due to chronic pain, fatigue, joint inflammation, and other related symptoms.
Qualifying for SSDI/SSI with an Autoimmune Disorder
The Social Security Administration (SSA) recognizes the significant impact of autoimmune disorders and provides assistance through the SSDI and SSI programs. These benefits offer a financial safety net for individuals who are unable to engage in substantial gainful activity (SGA) due to a medical condition, including autoimmune disorders. There are, however, non-medical criteria to meet in addition to the medical criteria:
1. Work History (for SSDI): SSDI is available to individuals with a substantial work history who have paid into the Social Security system and relatively recently. Sometimes a person can qualify under a family member’s work history.
2. Income and Resources (for SSI): SSI is a need-based program. To qualify for SSI benefits, you must have income and resources under very low thresholds.
3. Medical Criteria. Social Security’s definition of disability is: the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. The same definition applies to both the SSDI and SSI programs.
Applying for SSDI/SSI with an Autoimmune Disorder
The application process for SSDI/SSI can be complex and time-consuming, but the following steps are important to secure the support you need.
1. Gather Comprehensive Medical Evidence: Collect detailed medical records, test results, and documentation of your symptoms and limitations. (At a minimum, keep a record of all of your treatment, so that Social Security can obtain a complete medical record.) Maintain a consistent treatment plan with a qualified healthcare provider.
2. Consistently Report Your Symptoms: At your medical appointments, always tell your providers about your symptoms, even if you feel like they should already know because you told them at the last appointment. Be specific and accurate without exaggeration. SSA rules give a premium to consistency. SSA is more likely to be persuaded that your hard-to-measure symptoms like pain and fatigue are disabling when your statements are consistent and your medical providers’ records consistently document them.
3. Consult with Specialists: If your autoimmune disorder is a listed impairment in the SSA’s Blue Book (a set of rules about various conditions), consult with specialists familiar with your condition to see if your condition meets the medical criteria in the listing or to determine if there is additional testing needed to satisfy all the criteria. If your condition meets the criteria in the listing, you are presumed “disabled.”
4. Residual Functional Capacity (RFC): If your condition doesn’t meet a specific listing, the SSA will assess your residual functional capacity (RFC) to determine your ability to do work you have done in the past or other work. Your RFC evaluation considers both physical and mental limitations and their impact on your capacity to engage in substantial gainful activity. Social Security will ask you how your conditions affect your daily activities. Be sure to explain the ways in which your activities are limited. Your answers will be used to help SSA decide on your RFC.
5. Submit Your Application: You can submit your application online, by phone, or in person at your local Social Security office.
6. Consider Legal Assistance: Consulting with an attorney that is experienced in Social Security disability law may help improve your chances of a successful claim. An attorney can assist you in navigating the application process, gathering evidence, and presenting your case effectively.
7. Be Prepared for Appeals (if necessary): In the event your claim is denied, you have the right to appeal. The appeals process may involve a reconsideration, a hearing, and further appeals.
Living with an autoimmune disease presents unique challenges, but with the right approach, you can secure the financial support you need through SSDI or SSI. It’s essential to understand the eligibility criteria, provide thorough medical documentation, and be prepared for a potentially lengthy appeal process. Consulting with a knowledgeable attorney can help increase your chances of a successful claim. If you or a loved one is struggling with an autoimmune disorder and would like to seek further support, Roose & Ressler is here to help. Remember, you don’t have to navigate this journey alone.
The Roose & Ressler Team is located in Lorain, Toledo, and Wooster, Ohio. You can count on us as your local disability specialist to analyze your case thoroughly to determine what is necessary for you to receive benefits. We assess the best methods on how to prove the crucial facts of your case and gather the necessary evidence. Having 40+ years of experience serving Northern Ohioans, we know the ins and outs of the local disability process.