Sjogren’s Syndrome and Qualifying for Disability Benefits

Even though Sjögren’s syndrome is listed as a disabling impairment in the Social Security Administration’s Blue Book under Section 14.10, everyone who has Sjögren’s syndrome and applies for SSDI will not be approved for benefits. There are three ways to qualify for SSDI under Sjögren’s syndrome.

---

There are three ways to qualify for SSDI under Sjögren’s syndrome. Call 512-454-4000 for a free consultation.

Sjögren’s syndrome (pronounced “show-grins”) is an autoimmune disorder that attacks moisture-secreting glands throughout the body.

Approximately one to four million people have Sjögren’s Syndrome. Though women are 10 times more likely than men to develop the condition, Sjögren’s Syndrome affects people of all ages and races.

During Sjögren’s syndrome, the immune system attacks healthy cells instead of bacteria and viruses.

White blood cells which normally protect a person from germs attack the glands that produce moisture. Unable to produce tears and saliva, the eyes, mouth, and other parts of the body dry out. There are many treatments to provide relief from these symptoms, and most people who have Sjögren’s syndrome are able to remain healthy and live active lives.

Symptoms vary from person to person; one person may have only one or two symptoms, while others may experience several. The most common symptoms include:

•   dry eyes that burn, itch or feel gritty
•   dry mouth
•   swollen glands in neck and face
•    swelling, pain and stiffness in joints
•   dry cough
•   sensitivity to UV light
•   fatigue
•   numbness or tingling in some parts of the body
•   skin rashes or dry skin

These symptoms can cause you to miss work and jeopardize your ability to maintain employment.

Like many other conditions, treatment for Sjögren’s syndrome focuses on relieving symptoms and continues throughout life.

Eye drops like artificial tears can keep eyes from drying out. Other medications can relieve a dry mouth and treat joint pain.
Demonstrating that you are following your doctor’s treatment plan is an important part of qualifying for disability benefits.

Qualifying for disability with Sjögren’s syndrome

Though Sjögren’s syndrome targets glands that make tears and saliva, it can also damage joints, the thyroid, kidneys, liver, lungs, skin, and nerves.

The symptoms of Sjögren’s syndrome are relatively mild for some people, but others may experience blurred vision, difficulty swallowing, eating and speaking, or may have debilitating joint pain or fatigue. Holding a full-time job may become impossible, but even though Sjögren’s syndrome is listed as a disabling impairment in Social Security’s Blue Book under Section 14.10, everyone who has Sjögren’s syndrome and applies for Social Security Disability Income will not be approved for benefits. Basically, there are three ways to qualify for SSDI under Sjögren’s syndrome. An applicant can 1) meet the criteria stated in the Blue Book listing; 2) qualify under a related listing such as lupus or rheumatoid arthritis; or 3) prove that the limitations caused by Sjögren’s syndrome are so limiting they are unable to work.

In order to qualify under 14.10 Sjögren’s syndrome, the applicant must be able to prove the following:

•    Sjögren’s syndrome affects at least two body organs or systems, such as the eyes and joints; and
•   Sjögren’s syndrome causes at least two of the following symptoms: severe fatigue, fever, malaise, or involuntary weight loss.

OR

•   Sjögren’s syndrome evidenced by at least two of the above symptoms and severe limitations in one of the following:

1.   Limitation of daily living activities such as eating, cooking, bathing or grocery shopping.
2.   Maintaining social functioning.
3.   Ability to complete tasks in a timely manner because of lack of focus, pace or persistence.

Only those applicants who provide compelling medical evidence will be approved for Social Security Disability benefits.

In addition to a confirmed diagnosis, you should be prepared to provide to Social Security your complete, up-to-date medical records, including:

•    Results of blood tests
•   Antibody blood test results
•   Ophthalmologic tests including a Schirmer test
•   Dental imaging
•   Lip or salivary gland biopsy. This is very important. A positive lip biopsy is considered a determining factor for Sjögren’s syndrome.
•   Records of treatments you have received and your responses to treatment, including medications, side effects and lifestyle modifications.

In addition, your doctor should document any other ailments you may have.

Many people with Sjögren’s syndrome have another immune system disorder, or they develop liver or kidney problems. Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical vocational assessment), taking into account whether or not you are able to drive, your age, and level of education.

Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable.

Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.

If you have Sjögren’s syndrome, you may be eligible for Social Security Disability Income, but getting approval may not be easy.

Your symptoms must be severe enough to prevent you from working and you must have worked long enough and recently enough to be covered under SSDI. Applying for Social Security benefits can be a long and confusing process. An experienced Social Security Disability lawyer with a thorough knowledge of Social Security’s requirements and procedures can evaluate your case and improve your chances for success.

In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

1.   Are you working?   Your disability must be “total”.
2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.

More details can be found on our Qualifying for Disability page.

Author: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court – all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.