If you suffer from mixed connective tissue disease that is so severe you are unable to work, you may be approved for Social Security disability benefits. The Social Security Disability Insurance (SSDI) program is administered by the Social Security Administration (SSA). It is a program that enables workers who become disabled to receive monthly benefits to provide the necessities of life.
In order to be eligible to receive SSDI, you have to have worked enough to earn sufficient credits and to have paid in enough in taxes to the SSA. Providing plenty of documentation is essential in proving your SSDI case because evidence is extremely important. If you approved for benefits, you may also have some dependents who are eligible to receive benefits as well.
Mixed connective tissue disease combines the symptoms of polymyositis, lupus, and scleroderma, and on occasion rheumatoid arthritis, causing an overlapping disease that can be debilitating. The disease can typically present itself much like lupus, but the diagnosis is later updated with the presentation of additional symptoms. With that being said, you may have a wide spectrum of serious symptoms that impact your daily living as well as your ability to work.
Connective tissue disease affects your body’s connective tissues, which are the substances that connect and hold the cells together. Fat and cartilage are examples of connective tissues. Connective tissues are found throughout the body, being vital to the body’s shape and functioning. There are many kinds of connective tissue disease, but they are most often grouped into two different kinds based on the cause.
Some connective tissue diseases are genetic mutations that are inherited at birth, such as Marfan syndrome, which impacts the bones, eyes, lungs, and heart, or Ehlers-Danlos syndrome, which causes loose joints and skin. There is a much larger group of connective tissue diseases that have no known cause. Many connective tissue disorders care called autoimmune disorders. Systemic lupus, scleroderma, rheumatoid arthritis, dermatomyositis, and polymyositis are among those.
- Dermatomyositis has raised skin rashes on the trunk, the face, and knuckles while causing muscle weakness.
- Scleroderma causes thick, hardened skin patches that are painful and restrictive of movement.
- Rheumatoid arthritis has fever, inflammation, aches and pains, redness, and joint pain during flare-ups.
- Systemic lupus has rashes on the face, fever, mouth ulcers, swelling in the heart and lung linings, poor circulation, and many other complications.
All of these conditions do present hallmark symptoms, but sometimes blood tests are more definitive showing the particular antibodies and abnormalities. The process of developing into the full-blown problems that they can cause can take years. Milder or beginning cases can take years to diagnose as they progress because of the similarities.
The Cost of Treating Mixed Connective Tissue Disease
According to the National Center for Biotechnology Information, treating connective tissue diseases can be costly. The global burden of treating these disorders has seen an increase of 25% during the last decade alone. An individual suffering from connective tissue disease can expect regular physician visits, including visits to a specialist such as a rheumatologist. There are also prescriptions, such as steroids, pain medications, and anti-inflammatory drugs used to help reduce the severity of the symptoms. Some of the newer, more effective medications are very expensive, such as Humira injections.
On average, an individual with connective tissue disease can expect to pay out about $3,000 per year in copays and coinsurance to treat their disorder and the symptoms that it presents. As the disease advances, the costs may increase because additional medical interventions may be required to lessen the severity of the symptoms and the pain. With the help of Social Security Disability, you may be able to receive money to offset these financial challenges.
Medical Qualifications and the SSA Evaluation
The SSA using very specific criteria set forth for different medical conditions in their medical guide, which is called the Blue Book. In order for a medical condition to be approved for SSDI, it must meet the strict guidelines that are set forth for that particular condition. If you suffer from an undifferentiated or mixed connective tissue disease, there is a listing in the Blue Book.
These diseases are listed by the SSA as qualifying impairments using the category “Immune Disorders”, which is found in Section 14.00 of the medical guide. In order to be approved for disability benefits for the disorder, you have to be able to provide medical proof that either:
- Undifferentiated connective tissue disease – you have symptoms associated with connective tissue disease but not meeting the criteria for and therefore are unable to be narrowed down to one specific disease
- Mixed connective tissue disease – symptoms and blood tests that solidly indicate more than one kind of connective tissue disease is present.
The SSA also requires one of the following scenarios and combinations of symptoms:
- You must have frequent disease symptoms with at least two signs of severe illness, with the ability to prove that your condition prevents you from doing daily tasks as well as interacting with others while functioning physically and mentally to perform job tasks
- Two or more areas of your body must by impacted by the disease. At least one of these areas must show symptoms, and you have to show symptoms of severe illness, such as fever, weight loss, weakness, etc.
If your condition is debilitating but does not meet these criteria, you may still be approved for disability by using a residual functioning capacity (RFC) and the medical-vocational allowance.
Qualifying for Disability with a Residual Functioning Capacity and a Medical-Vocational Allowance
The RFC sets forth your limitations very clearly. If you are unable to stand for more than two hours without having to readjust your position because of joint pain and swelling, it is clearly stated. If you are unable to grasp objects or lift because of joint pain and muscle weakness in the hands and fingers, that is also indicated.
Your physician’s restrictions and your limitations are clearly indicated when the RFC is used, showing that you are not able to do what a normal, healthy individual can or is expected to day in a given day. Just because your connective tissue disease cannot yet be diagnosed or it is complicated by the signs and symptoms of multiple diseases does not mean you are not eligible for benefits. You just have to provide the documentation to show that you are indeed disabled.
Applying Specific Medical Tests to Your Disability Case
There are several medical tests used to prove or diagnose connective tissue disorders, with the majority focusing on blood draws. Your blood work should show your inflammation levels, any muscle damage is evident by muscle enzymes, vitamin deficiencies, and other problems that occur in conjunction with your particular disorder. You need to provide as much documentation as possible to build a strong case.
The SSA may order at their expense a medical evaluation with a third-party physician to confirm your condition and the severity of symptoms. Sometimes a mental evaluation is ordered to determine if depression and/or anxiety are also impacting you after your chronic illness diagnosis. These evaluations are for informational purposes only.