The U.S. Social Security Administration (SSA) administers the Social Security Disability Insurance program and the Supplemental Security Income program. As part of their process, immune system disorders are evaluated under Listing of Impairments 14.00 for adults and 114.00 for children. At the request of the SSA, the National Academies of Sciences, Engineering, and Medicine assembled a committee to review selected conditions related to the immune system. In particular, the SSA was interested in the current status of the diagnosis, treatment, and prognosis of immune system disorders including systemic lupus erythematosus (SLE), scleroderma, polymyositis, Sjögren’s syndrome/disease, and inflammatory arthritis.

This report provides an overview of the current status of the diagnosis, treatment, and prognosis of these immune system disorders in the U.S. population and the relative levels of functional limitation typically associated with them, common treatments, and other considerations.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON SELECTED IMMUNE DISORDERS AND DISABILITY
• Reviewers
• Acronyms and Abbreviations
• Summary
  • OVERALL FINDINGS AND CONCLUSIONS
  • DISEASE-SPECIFIC FINDINGS AND CONCLUSIONS
• 1. Introduction
  • STATEMENT OF TASK
  • IMMUNE DISORDERS
  • CONCEPTUALIZING DISABILITY
  • MEASURING FUNCTIONAL STATUS IN IMMUNE SYSTEM DISORDERS
  • THE SOCIAL SECURITY ADMINISTRATION’S DISABILITY DETERMINATION PROCESS
  • APPROACH TO THE TASK
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Cross-Cutting Issues
  • DEPRESSION AND ANXIETY
  • PAIN
  • FIBROMYALGIA AND CENTRALIZED PAIN SYNDROMES
  • FATIGUE
  • COGNITIVE FUNCTION
  • TREATMENTS, SIDE EFFECTS, AND WHAT TREATMENTS INDICATE ABOUT DISEASE SEVERITY
  • TREATMENT SETTINGS AND AVAILABILITY
  • VARIABILITY OF DISEASE ACTIVITY AND FLARES
  • COVID AND IMMUNE DISORDERS
  • REFERENCES
• 3. Systemic Lupus Erythematosus
  • CLINICAL FEATURES, DIAGNOSIS, AND DISEASE COURSE
  • TREATMENT AND MANAGEMENT
  • DISEASE-SPECIFIC FUNCTIONAL LIMITATIONS
  • CHILDHOOD-ONSET SLE
  • SUMMARY
  • REFERENCES
• 4. Scleroderma
  • CLINICAL FEATURES, DIAGNOSIS, AND DISEASE COURSE
  • TREATMENT AND MANAGEMENT
  • DISEASE-SPECIFIC FUNCTIONAL LIMITATIONS
  • JUVENILE SCLERODERMA
  • SUMMARY
  • REFERENCES
• 5. Myositis
  • CLINICAL FEATURES, DIAGNOSIS, AND DISEASE COURSE
  • TREATMENT AND MANAGEMENT
  • DISEASE-SPECIFIC FUNCTIONAL LIMITATIONS
  • JUVENILE DERMATOMYOSITIS
  • SUMMARY
  • REFERENCES
• 6. Inflammatory Arthritis
  • RHEUMATOID ARTHRITIS
  • PSORIATIC ARTHRITIS
  • JUVENILE IDIOPATHIC ARTHRITIS
  • SUMMARY
  • REFERENCES
• 7. Sjögren’s Disease/Syndrome
  • CLINICAL FEATURES, DIAGNOSIS, AND DISEASE COURSE
  • TREATMENT AND MANAGEMENT
  • DISEASE-SPECIFIC FUNCTIONAL LIMITATIONS
  • CHILDHOOD SJÖGREN’S SYNDROME
  • SUMMARY
  • REFERENCES

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2022. Selected immune disorders and disability. Washington, DC: The National Academies Press. https://doi.org/10.17226/26595.

Digital Object Identifier: https://doi.org/10.17226/26595 Library of Congress Control Number: 2022943145

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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