Lupus is a disabling and chronic inflammatory disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs. The disabling effects of lupus include chronic fatigue, swollen joints, fever, sensitivity to light, and many other symptoms, depending upon the severity of a flare up of the disease.
Social Security considers Lupus to be a severe impairment. In fact, a person can be found presumptively entitled to Social Security Disability (“SSD”) benefits by meeting the criteria of listing 14.02. However, even you cannot show that you meet the listing, you can still be entitled to SSD benefits if it decreases your functional capacity.
I represent a pharmacist whose SSD application was approved today. While I was able to get the treating rheumatologist to say the pharmacist met listing 14.02, the Administrative Law Judge (“ALJ”) approved the application on the grounds that the Lupus reduced the pharmacist’s functional capacity to the point where sustained work was not possible. Explaining to the ALJ how the Lupus symptoms precluding the claimant from being able to perform her job duties as a pharmacist was essential.
Interestingly, the State agency analyst thought the medical evidence showed the pharmacist met listing 14.02A. However, the State agency doctor, who never examined the claimant, rather than explaining why the listing was or was not met, lazily told the analyst to send the claimant for a consultative examination (“CE”). I advised the claimant that a CE was contrary to the Social Security rules and regulations, and was not needed, which was confirmed by the ALJ.