Disability and Sjogren's Syndrome - Filing for SSDI and SSI

Sjogren's syndrome is an autoimmune disorder that causes your body's immune system to attack healthy tissue. Specifically, Sjogren's syndrome causes your white blood cells to attack the glands that produce moisture—disrupting your body's ability to make tears and saliva—which is why the disease is characterized by dry eyes and a dry mouth.

But Sjogren's syndrome can be slowly progressive, affecting secretory glands in other parts of your body. People with Sjogren's also often develop other immune system disorders, such as lupus or rheumatoid arthritis.

If you can't work because of Sjogren's syndrome, you might be able to get disability benefits through the Social Security Administration (SSA). There are three ways to qualify for disability:

• by meeting the requirements of Social Security's disability listing for Sjogren's syndrome
• by meeting the requirements of a related disability listing, such as the listing for lupus or rheumatoid arthritis, or
• by showing that your limitations are so severe that you can no longer work.

Here's what you need to know about getting Social Security disability benefits for Sjogren's syndrome, including how to apply for benefits.

What Are the Symptoms of Sjogren's Syndrome?

While some people with Sjogren's disorder have only mild symptoms of dry eyes and mouth that they're able to treat, others have disabling symptoms such as:

• difficulty eating and swallowing
• swollen salivary glands
• prolonged fatigue
• debilitating joint pain or stiffness
• skin rashes
• persistent cough
• blurred vision
• involuntary weight loss, and
• malaise (feelings of physical discomfort resulting in low activity).

Sjogren's syndrome can progress from just causing dry eyes and mouth to damaging other parts of the body, such as your kidneys, liver, lungs, and nerves.

How Do Doctors Diagnose Sjogren's?

The most recent classification criteria for Sjögren's Syndrome, which were approved by the American College of Rheumatology in 2016, include having symptoms of dry eyes and dry mouth and positive test results from:

• a serologic test (showing that you have anti-SSA/Ro antibodies)
• an ocular staining test
• Schirmer's tear production test
• a saliva flow rate test, and/or
• a labial salivary gland (LSG) biopsy.

If you have enough positive results from the above tests, you'll be diagnosed with Sjogren's.

How Do You Qualify for Disability Under the Listing for Sjogren's Syndrome?

Social Security has a list of medical conditions called the Blue Book. The list includes impairments the SSA considers serious enough to keep someone from working. If you meet the criteria of a listing, you'll automatically qualify for disability benefits.

To meet Social Security's disability listing for Sjogren's syndrome (listing 14.10), your condition must fall into one of the following two scenarios:

• Your Sjogren's syndrome affects at least two body organs or systems, such as the eyes and the digestive system, at least moderately, and causes at least two of the following constitutional symptoms:
  • frequent fatigue resulting in low activity
  • frequent fever
  • malaise (feelings of discomfort or lack of well-being), or
  • significant weight loss.

OR

• You've had repeated manifestations of Sjogren's syndrome with at least two of the above constitutional symptoms and a severe limitation in one of the following:
• your activities of daily living (everyday activities like eating and caring for yourself)
• your ability to maintain social functioning, or
• your ability to finish tasks quickly due to difficulty with concentration or persistence.

Can You Qualify for Disability Under Other Listings?

If you have Sjogren's syndrome and suffer from another impairment that causes limitations in your ability to function—like lupus or rheumatoid arthritis—you might qualify for disability under the listing for that impairment. Social Security has specific listings for inflammatory (rheumatoid) arthritis and systemic lupus erythematosus.

Some people with Sjogren's syndrome also develop kidney or liver problems (including cirrhosis). Others develop peripheral neuropathy (tingling and numbness in your hands and feet). If you have complications from Sjogren's syndrome, you should be evaluated under the listing for the affected body part or organ.

How Do You Qualify for Disability Based on Functional Limitations?

If you're diagnosed with Sjogren's syndrome but don't meet the listing criteria because of a lack of documentation, Social Security will look at your residual functional capacity (RFC). Your RFC represents the kind of work you can still do despite the limitations caused by your medical condition.

If you have Sjogren's syndrome, your RFC might include limitations based on symptoms directly caused by the disorder. It might also be based on the limitations caused by other related impairments.

For example, because Sjogren's syndrome can cause blurred vision and light sensitivity, you might have limitations on things like:

• doing work that involves unimpaired vision, or
• exposure to a bright environment.

You might also have limitations on how long you can stand and walk, due to frequent fatigue or malaise. And if you need to constantly use eye drops and drink fluids due to excessive thirst and dry mouth, you may need frequent bathroom breaks, which can rule out many types of jobs.

If you also have rheumatoid arthritis, depending on where in your body the arthritis is located, you could have limitations on:

• pushing
• pulling
• lifting, or
• grasping.

If Social Security finds that the limitations in your RFC aren't so severe that they should keep you from working, your claim will be denied. But if the SSA determines that your Sjogren's symptoms are so limiting that there's no job you can be expected to do full-time, you'll be awarded benefits under a "medical-vocational allowance."

How Do You Apply for SSDI or SSI for Sjogren's Syndrome?

Social Security has two types of disability benefits you might qualify for with Sjogren's syndrome:

• Social Security disability insurance benefits (SSDI), and
• Supplemental Security Income (SSI) disability benefits.

SSDI is for people who've worked recently and paid enough Social Security taxes. SSI is a needs-based program for those with low incomes and few resources. The programs have different non-medical requirements, and the application processes for SSDI and SSI also differ somewhat.

For example, there are three ways you can apply for SSDI:

• complete Social Security's online application
• apply by phone by calling the SSA's national office at 800-772-1213 (TTY 800-325-0778), or
• contact your local Social Security office to apply in person.

But while you can start your application for SSI online (using the above link), you'll need to speak with a Social Security representative to complete the application process.

(Learn more about the differences between SSDI and SSI.)