Thursday, May 29, 2008

Sjogren's Syndrome Social Security Disability SSI - Applying for Disability

Autoimmune disorders are frequently found on applications for social security disability and SSI disability. The ones that tend to stand out in terms of their prominence in the social security list of impairments (the blue book) are multiple sclerosis and lupus.

Many people, however, would be surprised to learn how many autoimmune disorders are not given a separate listing in the book or are only given scant consideration. Sjogren's is a condition that, currently, does not have a specific listing of its own. In other words, the manual does not contain a separate and distinct section that details the disability criteria an individual would need to satisfy (rather, their medical record documentation would need to satisfy such criteria) in order to win disability benefits under either the SSD or SSI program.

This fact may change at some point, of course. The listing of impairments is not etched in stone and on a continuing basis they undergo revision. Unfortunately, most revisions tend to be fairly unsubstantial changes that involve adding a few words here or there to an existing listing or body system section (sections of the manual include 14.00, Immune system).

In the meantime, of course, a claimant who decides to file for disability on the basis of sjogren's syndrome or any other condition may still be approved on the basis of receiving a medical vocational allowance. Additional information regarding approval standards can be found here: Social Security Disability Criteria.

Some brief information on Sjogren's Syndrome

Sjogren’s Syndrome is an autoimmune disease that causes the immune system to attack and destroy the exocrine glands (saliva/tears). Although the usual sites for Sjogren’s syndrome are the mouth and eyes, this autoimmune disorder can cause dryness of the nose, skin, and vagina. Additionally, Sjogrens’s syndrome may also cause damage to vital organs such as the kidneys, liver, lungs, brain, and pancreas.

Sjogren’s Syndrome affects as many as four million individuals in the United States alone, and the majority of these individuals are women. In fact, ninety percent of individuals diagnosed with Sjogren’s syndrome are women who are between the ages of forty and sixty. Unlike other autoimmune conditions Sjogren’s syndrome does not go into remission and there is no known cure for the disorder.

Since there is no cure or treatment that will restore exocrine gland function, most treatment is geared toward relieving symptoms of Sjogren’s syndrome. Generally, treatment consists of moisture replacement for eyes, nose, and vagina, as well as medication to stimulate the production of saliva. More severe cases may require corticosteroids, immunosuppressive drugs, pain relievers (joint pain is often associated with this disorder), and anti-rheumatoid medications such as methotrexate.

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Anonymous Michelle said...

First I want to thank you for including me in your blogroll! I have been down for the count for the last couple of months, and my blog shows it, but I'm coming back.
I was looking up some info for a friend in a support group on Sjogrens, and came upon some exciting news. The SS Disability Guidelines include Sjogrens for the first time. Good news for all the people who suffer from this disease. It's usually a secondary disease, but the woman I was talking to had Sjogrens only and it was pretty severe.
Here's a link if you'd like to check it out.
Thanks for putting out all the great information in your blog. I really enjoy reading it and would like to put it on my blogroll.
Take care

6:06 AM  
Blogger Disability Blogger said...

Hi Michelle. Thanks for adding this site to your blogroll. Regarding the Sjogren's listing, I saw the federal register information a while back. However, while listing 14.10 has been designated for Sjogren's, it's not presently part of the adult listings. When it will appear on or in an updated version of the blue book (something I used to use on a daily basis as an examiner), I don't know. It raises the question: how can a disability examiner use listing 14.10 on a case involving Sjogren's if it isn't in the listing book that's sitting on their desk, or on the adult listings sections of the SSA site. What I found interesting about 14.10, however, is that the federal register indicates it will be a two part listing and will largely be a rehash of listing 14.03, which is the listing for Systemic vasculitis.

8:28 PM  
Anonymous Michelle said...

It sure is complicated for the lay(sp) person to understand. And what a misleading article then if it's not part of the adult listings. It's very easy to see though, that if someone is applying for SS benefits they need some type of advocate that understands all of this. I was turned down the first time in 2 months. I got an attorney and am appealing my case but I won't see an appeal date until late 2009. We started the appeal in the middle of 2007. Talk about a backlog... But that's a whole other topic :)
Take care,

8:16 AM  
Anonymous Anonymous said...

Hi, I read your blog regularly and it is one of the most informative available for social security disability information. I am diagnosed with Sjogren's and I have been trying to get SSDI for a few years. The Sjogren's foundation website discusses the new guidelines on the following webpage with a link to the 3/18/08 Federal register.

If you view the 3/18/08 Federal Register you can see the actual guidelines that were recently added for Sjogren's on page 14585 or page 17 of the 48 page document that is linked on this webpage.

Thank you again for all of your wonderful information. Ann

5:34 PM  
Blogger Disability Blogger said...

"And what a misleading article then if it's not part of the adult listings"

Michelle, according to the federal register, it's been approved. However, it's not currently available in the adult listings presented on or in the blue book used by examiners. I spoke to my wife about this (she's a former examiner as well) and she sees it the way I do. Even if a listing has been approved, what good is that if examiners do not have the information available to them, either in the handbook or online. In that sense, it might as well not even exist. At some point, this new listing will be in print. But it doesn't seem to be yet.

Hi Ann, thanks for reading the blog. I read that page you mentioned. The Sjogren's listing is just a rehash of existing information, apparently of listing 14.03 for systemic vasculitis. My take is that the new Sjogren's listing (which until examiners see it in hard print on their desks or online--which it isn't--won't play a role in decision making) doesn't really change anything.

Why do I say this? Because, prior to the construction of 14.10, a claimant could be approved by "equaling" 14.03. Once 14.10 makes it into hard print, examiners may approve a claimant with Sjogren's on the basis of "meeting" 14.10. However, since the language of 14.10 will apparently be identical to the language of 14.03, it doesn't really seem to make for a practical difference in how these cases are decided.

9:01 PM  

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