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Pemphigus and pemphigoid are a group of rare autoimmune diseases that affect the skin and mucous membranes causing painful blistering and scarring. For some patients, the noticeable and sometimes life-threatening, symptoms are too much to work with. The Social Security Administration’s (SSA) disability benefit programs are for patients like those who can’t support themselves because of their disability.

Social Security Disability

If you cannot work enough to earn the SSA’s monthly Substantial Gainful Activity (SGA) limit of $1,130, then you may be eligible for Social Security Disability Insurance (SSDI). Generally, you need to have worked five of the last ten years in a job that pays into Social Security, and additional years depending on your age. Benefits average $1,000-$1,500 each month, but the SSA calculates your payment by averaging your previously reported income, so it may be higher or lower.

After you are approved, you will not receive your first check until five months after the date your pemphigus or pemphigoid started, or your reported onset date. Be aware the SSA may take up to two years to approve the claim; however, you will be given any back pay in a lump sum check. Two years after your reported onset date, you will be eligible for Medicare.

Supplementary Security Insurance (SSI) is not paid from taxes, so it is best for those with little or no work history, or parents applying for children. In most states, you will also be automatically enrolled in Medicaid once approved for SSI. You are allowed to work while on SSI, but individuals cannot earn more than $733 a month in countable income, and couples cannot earn more than $1,100 ($1,100 is the total countable income limit for a couple with SSI, if an SSI-eligible individual is married to someone who is not eligible, then the SSA does a process called “deeming” where they factor in the ineligible spouse’s income and resources to determine payment amounts.). Individuals and couples also cannot have more than $2,000 and $3,000 worth of assets. If a person/couple owns a home, that home is not counted toward their income or resources as long as it is their primary residence.

Requirements for Pemphigus and Pemphigoid

The SSA evaluates all applications they receive first with the Blue Book, their official list of impairments and medical requirements. If you meet or equal a condition in the Blue Book, you will be automatically medically eligible for benefits This means that an individual can qualify for benefits based off of their condition, but the decision is ultimately up to a disability examiner, so an individual may have to file an appeal if the examiner denies their application. .

Pemphigus and pemphigoid can be found in Section 8.00—Skin Disorders of the Blue Book. You need to provide medical evidence of the following:

  • Bullous disease (pemphigus, bullous pemphigoid), with extensive skin lesions that persist for at least three months despite continuing treatment as prescribed;
  • Chronic infections of the skin or mucous membranes, with extensive tissue death or extensive ulcerating skin lesions that persist for at least three months despite continuing treatment as prescribed.

If you do not meet a Blue Book listing but feel your conditions restricts you from performing SGA, you may still be approved with a medical-vocational allowance based on your limitations. Applicants do not need to do anything for a medical-vocational allowance. The medical-vocational allowance is a determination made by the SSA during the application process after they determine that someone  is not medically eligible by the Blue Book criteria. This determination takes into account a person’s ability to do the work they have been doing, whether they would be able to be re-trained for another job, whether they can perform any type of work that they’ve done in the last 15 years among other factors.

Applying for Social Security Disability

Talk to your doctor before completing the SSI application. Because the claim can take so long to process, be reviewed, and a determination made, it may not be worth applying if your doctor does not think your chances are good enough. If you do decide to apply, a detailed statement from your doctor about the limitations caused by your pemphigus or pemphigoid is crucial to the claim.

The SSA offers a convenient application on their website for SSDI. SSDI is Social Security Disability Insurance – meaning that it is based off of your work history and income, and its premiums are paid with payroll taxes. SSI is a needs based program and because of that has income limits, restrictions on resources, and a lower maximum benefit amount. If you’re not comfortable applying online or you are applying for SSI, you will need to make an appointment at your local SSA office. You can find a list of documents (such tax information and a birth certificate) you will need, in addition to important medical evidence (labs, imaging tests, and surgical reports) on the SSA’s website.

Deciding whether you should continue working or go on Social Security Disability is a tough decision. It can add to your stress level and worsen your disease activity. Before you rush into any decisions you should take inventory of how you are feeling physically, emotionally, and spiritually. Your job or career can have a significant impact on these aspects of your health. It’s important to understand how your job is affecting you. If you feel like you need to be on disability you should consider the following:

  • Will you be on long-term or short-term disability?
  • How will it affect your recovery and ability to reach remission?
  • How will it affect your insurance coverage and drug costs?
  • How will affect you financially?

Once you have decided, contact your physician and let them know that you need their assistance in the process. Your physician will need to provide information that confirms that your condition is severe and that you can’t do the work you previously did due to your condition. Apply immediately at www.ssa.gov so you can start the process.

Both you and your physician will receive a health questionnaire about your condition. Make sure that you and your doctor list all impairments that prevent you from working including medication side effects. Be aware that an interview may be held to determine your health condition. Keep copies of all your paperwork, health records, and track your conversations. Get to know your case worker as they will have influence in the decision process.

In many cases Social Security Disability claims can be denied the first time. Don’t let this discourage you! You can always file an appeal with additional medical information that can substantiate your claim. The IPPF can also help provide information about the disease that may help educate individuals regarding the severity of the disease.

Bullous Skin Disorders are included under listed impairments and in many cases Quick Disability Determinations (QDD) can be made depending on the severity of your disease. Receiving benefits, like your disease, take time so the sooner you apply the better! Although the process may seem daunting, your health may depend on advocating for yourself.

Don’t be afraid to contact the IPPF if you have a question or just “Ask a Coach”! Remember, when you need us, we’re in your corner!