Sjögren’s disease, also known as Sjögren’s syndrome, is an autoimmune disorder in which your immune system attacks the moisture-producing glands in the eyes and mouth, leading to chronic dryness in these areas. Sjögren’s disease can also affect other parts of the body, including the joints, skin, and organs such as the lungs, kidneys, and nervous system.
The exact cause of Sjögren’s disease is not known, but it is believed to be related to genetic and environmental factors. It is more commonly found in women and typically occurs in middle-aged or older individuals.
If you suffer from Sjögren’s disease, you may be experiencing intense symptoms that interfere with your ability to carry out daily activities, including work. In this article, we’ll discuss how Sjögren’s causes disability, whether you can receive disability benefits for Sjögren’s disease, how insurance companies evaluate Sjögren’s disease disability claims, and how The Maddox Firm can help prove your Sjögren’s short or long term disability claim.
How Does Sjögren’s Disease Cause Disability?
Common symptoms of Sjögren’s disease include:
Dry eyes
Dry mouth
Fatigue
Joint pain and stiffness
Swollen salivary glands
Skin rashes and/or dryness
Oral and eye infections
Peripheral neuropathy
Difficulty concentrating and/or impaired memory
Treatment for Sjögren’s disease focuses on relieving the symptoms of dryness, such as using artificial tears or saliva substitutes, as well as treating any underlying medical conditions that may be contributing to the disease. Immunosuppressive drugs may also be used in some cases to help reduce inflammation and slow the progression of the disease, though they may also cause their own side effects that contribute to disability.
Some people afflicted with Sjögren’s disease are able to function normally, but others may experience more intense and frequent symptoms that prevent them from working. For example, your job may require constant phone communication, and the chronic mouth dryness caused by Sjögren’s can make it difficult to speak. Sjögren’s disease may also cause joint pain and stiffness, which make it difficult for you to sit, stand, or walk for extended periods. You may also suffer from significant fatigue due to your Sjögren’s disease which interferes with your ability to complete a normal workweek. Or you may notice that your ability to concentrate or remember certain details has decreased, which could also be caused by Sjögren’s.
Sjögren’s disease can cause a wide range of symptoms that significantly impact your ability to perform daily activities, thus leading to disability.
Can I Receive Disability Benefits for Sjögren’s Disease?
Yes, it is possible to receive disability benefits for Sjögren’s disease. However, it will depend on the nature of your condition and the associated physical and cognitive symptoms.
Your disability insurance policy will lay out what criteria you must meet to receive short or long term disability benefits due to your Sjögren’s disease. One important term to look for is your policy’s definition of disability. Generally speaking, most disability policies define disability as the inability to perform the “substantial and material” duties of your own occupation. This means your Sjögren’s disease need not impair you from performing all activities of daily living, but if it impairs your ability to perform one or more of your essential job functions, you may qualify for disability benefits from your insurance company. Of course, you should always refer to your policy to verify the definition of disability.
Some other general criteria for receiving disability benefits for your Sjögren’s disease include:
You must be treating regularly with an appropriate doctor (and following that doctor’s treatment recommendations).
If your policy has a pre-existing clause, you must be in compliance with it.
If approved for benefits, you must also file for Social Security Disability (“SSDI”) benefits.
How Do Insurance Companies Evaluate Sjögren’s Disease Disability Claims?
To receive disability benefits, you will need to prove to your insurance company that your Sjögren’s disease impedes your ability to work. Your insurance company will not approve you for benefits at face value. You must provide them with compelling and objective evidence demonstrating your Sjögren’s disease symptoms and how they prevent you from working. Should you fail to do so, your insurance company will likely deny your claim due to lack of evidence.
The two general components to your Sjögren’s disease disability claim are your medical disability and your inability to work. Below we’ll explain the different types of evidence you may submit to support each of these components.
Medical Disability Due to Sjögren’s Disease
One of the most important types of evidence your insurance company will consider is objective medical evidence of your Sjögren’s disease diagnosis and symptoms. Objective medical evidence includes office visit notes from your treating providers, diagnostic testing, medical testing results, imaging, and any other medical records.
Diagnostic Testing
Sjögren’s disease is typically diagnosed via a combination of medical history, physical examination, and laboratory tests. An immunologist and/or rheumatologist are appropriate specialists to diagnose and treat Sjögren’s disease.
During a physical examination, your doctor will look for signs and symptoms of Sjögren’s disease, such as dry eyes and mouth, swollen salivary glands, and joint pain. Your doctor may also check for evidence of other autoimmune disorders, such as rheumatoid arthritis and lupus, which may occur along with Sjögren’s disease.
Blood tests are often used to detect antibodies that are commonly present in people with Sjögren’s disease. These antibodies include:
Anti-SSA/Ro antibodies
Anti-SSB/La antibodies
Rheumatoid factor (RF)
Antinuclear antibodies (ANA)
In addition to blood tests, your doctor may also perform a biopsy of the salivary gland to check for signs of inflammation and damage.
Diagnostic imaging tests, such as magnetic resonance imaging (MRI) or ultrasound, may also be used to evaluate the salivary glands for signs of inflammation and damage.
Objective Medical Evidence of Sjögren’s Disease Symptoms
Evidence of your Sjögren’s disease diagnosis is only one part of proving your medical disability to your insurance company. More important will be proving the presence, severity, and frequency of your symptoms that stop you from working.
Some types of objective medical evidence of your Sjögren’s disease physical symptoms may include: