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. Those with mixed connective tissue disease or undifferentiated connective tissue disease may qualify for Social Security disability benefits if your condition meets the SSA's Blue Book listing.
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. Undifferentiated or mixed connective tissue disease is a unique condition because it is the presence of symptoms for multiple other conditions. If you are able to qualify based on one of the other conditions that might make your case easier. However if you cannot meet the criteria for those other conditions, 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. For example, if a blood test demonstrated findings of rheumatoid arthritis, but you are unable to meet the specific listing.
- 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
The most important piece of your application is the evidence that you are able to provide. For something like a musculoskeletal disorder, an X-ray would be a great piece of evidence to provide. With MCTD, the testing can be a little more complicated.
One test that can be used as evidence in your Mixed Connective Tissue Disease disability benefits case is a test for ANA antibodies. The presence of Antinuclear Antibodies (ANA) could mean that you have an autoimmune disorder. Autoimmune disorders are unique because it means that your immune system can attack your own healthy cells. Since Mixed Connective Tissue Disease Is An autoimmune disorder, this would be a good place to start your specific medical testing.
After testing positive for ANA, you can also take a test for RNP antibodies. RNP antibodies are commonly found in those that have lupus or other connective tissue disorders. It is important to note that RNP antibodies are not present for all that have Mixed Connective Tissue Disease which is why it is important to gather multiple pieces of evidence for your case.
In Addition to the RNP antibody test, there are other tests that you should consider. Blood work will be important in demonstrating the presence of MCTD. By having blood work done, you will be able to look at:
- Inflammation levels
- Muscle damage as evidence by muscle enzymes
- Vitamin deficiencies
- Other markers that can occur in conjunction with MCTD
Be sure to meticulously track and record any and all tests that you have undergone. The evidence that you are able to provide to the SSA is the basis for the decision on your case.
In addition to your own medical documentation, the SSA might have their own evaluation done. This might require an additional medical evaluation from a third-party physician. This is to make sure that you are not getting unfair treatment from the SSA or preferential treatment from a physician that you have a relationship with.
In addition to medical tests and blood work, mental evaluations can help your case. Dealing with a chronic illness can be stressful. Often this can lead to the manifestation of depression and/or anxiety. No matter the circumstances, every time that you visit the doctors office, be sure to keep it for your records.
Is Undifferentiated Connective Tissue Disease a Disability?
Connective tissue is found all over the interior of the body. It binds various other types of tissue and individual organs together with each other and to the skin. Undifferentiated connective tissue disease, together with mixed connective tissue disease, has various causes. In some people it is due to genetic factors and can occur at birth. In many other cases, it is one of several types of auto-immune diseases, like lupus or rheumatoid arthritis in which the body’s immune system attacks its own tissue.
Anyone who has undifferentiated connective tissue disease may experience symptoms which are severe enough to be disabling and may prevent the sufferer from continuing employment.
The Social Security Administration recognizes undifferentiated connective tissue disease and mixed connective tissue disease as potential disabilities depending on their severity as matched to the criteria for these conditions listed in the relevant section of the Blue Book.
To be eligible for a disability benefit, you would need to show that your symptoms match the criteria listed in the Blue Book and have sufficient medical evidence available to prove that your symptoms have become severe.
The SSA will also need to be given evidence that you are unable to work for at least the next 12 months because of your condition.
In some cases, where the symptoms of undifferentiated or mixed connective tissue disease do not quite match the Blue Book listing criteria, you may still qualify for a medical-vocational allowance by having a residual functional capacity (RFC) assessment completed by your doctor.
Getting Help With Your Case
Medical testing and building a social security disability claim on your own may seem difficult on your own, however there are resources available to you. It is important that you have a doctor on your side. A doctor can help you go through the SSA blue book listing to ensure that you are able to meet the specific criteria to qualify for disability benefits. In addition, you will need to a doctor to help with your residual functional capacity evaluation. This is something that you cannot do on your own.
It can be overwhelming to build a case while you are also dealing with mixed connective tissue disease. An attorney or advocate can help streamline that process. You will have to prove that you meet both medical and technical standards to qualify for disability benefits. You will also be faced with deadlines regarding disability benefits. Having someone who is familiar with the process can increase your chances of success.
Not only can an attorney or advocate help with the initial application, but they can also help if you are denied. Being denied initially is common when applying for SSDI. Fortunately, there are steps that you can take that don’t require you to restart your case. With a denial, the SSA will give you the reason that your MCTD case was denied. An attorney can help interpret that information and gather the evidence you need to bolster your case.
Get started today by filling out your free evaluation. Most attorneys or advocates will work on a contingency basis which means that there is no upfront cost to you.