Sarcoidosis and Social Security Disability Claims
By Pitt Dickey

This column will examine how the Social Security Administration evaluates Disability Insurance Claims for people who are diagnosed with Sarcoidosis. Sarcoidosis is an inflammatory disease in which the person’s immune system becomes confused and attacks organs or systems in the patient’s body. The disease can produce small growths or nodules called granulomas which are small bumps. These granulomas can appear in a wide variety of organs including the patient’s lungs, eyes, lymph nodes, skin and spleen. The granulomas may heal on their own and disappear. They may also remain and inflict permanent damage on the effected organ.

The Social Security Administration (SSA) has a set of criteria that it uses called Listings to determine whether a person is eligible for monthly disability insurance payments. To obtain disability insurance benefit payments from the SSA a person must in general have a health problem that can be expected to last at least one year or to result in death and be unable to perform any type of substantial gainful employment. The person generally also must have worked at least ten years and paid taxes into the Social Security System.

To see how the SSA reviews claims that involve persons who have sarcoidosis it is helpful to briefly look at what sarcoidosis is. The cause of sarcoidosis is unknown. It is not contagious. The disease can attack different organs of the body. Frequently the person’s lungs are attacked causing breathing problems such as shortness of breath or coughing attacks. If the patient’s lymph nodes are involved the nodes can become enlarged. The disease can also effect the patient’s eyes causing inflammation, redness and increased light sensitivity. If the skin is affected, visible bumps can appear which can be quite painful.

If the sarcoidosis appears in the patient’s bones this can cause pain and frequently attacks hands and feet leading to arthritis. In more rare cases the sarcoidosis can also effect the brain and central nervous system. If the brain or nervous system is involved, a patient may have problems with lessened sensation, muscle weakness, dizziness and head aches.

As sarcoidosis is an inflammatory disease, the main treatment for it is by use of anti-inflammatory medications based on steroids such as prednisone or steroid inhalants.

To receive SSA Disability Insurance Benefits for sarcoidosis a person must meet the following requirements. In the interest of space it is not possible to list all of the standards but these ones below are representative of the listings.

As discussed above, Sarcoidosis is a disease of the immune system which can result in a variety of organ involvements. The SSA has a category of diseases called systemic vasculitis which covers sarcoidosis. Because sarcoidosis can impact such a variety of body organs and systems the SSA has to evaluate each affected system based upon criteria established for that particular system. In English, this means that if a patient has sarcoidosis in his lungs, the SSA will use the tests for lung disease to determine if the person meetings the listings; if the patient has sarcoidosis in his central nervous system, the SSA will use the tests for nerve damage to determine if he meets the listings.

The SSA has identified the following body systems to be considered in determining if the patient with sarcoidosis is disabled: involvement of joints, muscles, eyes, respiratory system, heart, digestive system, kidneys, skin, neurological or mental functioning. The SSA will award Disability Insurance Benefits for sarcoidosis if there is severe loss of function in any single body organ or body system listed above. The patient also meets the disability test if he has lesser degrees of loss of functional loss in two or more body systems listed above and also has symptoms of severe fatigue, fever, malaise, and weight loss. At least one of the lesser involved body systems must have at least “moderately severe” involvement resulting from the sarcoidosis.

It should be kept in mind that a person can still be found to be disabled by sarcoidosis after a hearing before an Administrative Law Judge even if he does not meet a particular listing if he has health problems that in combination are the equivalent of a listing. The Judge has the discretion to decide if a person’s health problems are serious enough to warrant an award of disability benefits despite not meeting the specific technical requirements of one of the SSA listings for disability.

Pitt Dickey has practiced law in Fayetteville since 1978. He has handled SSA disability claims for over nineteen years. He practices with the firm of Smith Dickey Dempster & Carpenter, P.A. at 555 Executive Place, Fayetteville, N.C. He can be reached at 485-8020 or at pitt@smithdickey.com.