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Christopher Le

Can the Blue Book Help with My Mixed Connective Tissue Disease SSD Claim?

Mixed connective tissue disease (MCTD) can be quite challenging. This rare condition can be characterized by features frequently seen in systemic lupus erythematosus, systemic sclerosis, and polymyositis. While the early stages of MCTD might be fatigue, joint pain, and fever, those with more advanced disease might suffer from problems with the lungs or heart. Since MCTD is a progressive disease, many individuals eventually stop working due to the condition.


According to the Blue Book, MCTD is diagnosed when the clinical findings and blood test results of two or more immune diseases overlap. MCTD is listed in 14.06 of the Blue Book. To be approved for disability benefits for MCTD, individuals must have involvement of two or more organs or body systems with one of the organ systems involved to at least a moderate level of severity. In addition, at least two of the following constitutional signs or symptoms must be present:

  • Severe fatigue as defined by a frequent sense of exhaustion that results in significantly reduced physical activity or mental function

  • Malaise as defined by a frequent feeling of illness, body discomfort, or lack of well-being that results in significantly reduced physical activity or mental function

  • Fever

  • Involuntary weight loss


On the other end, one may be approved for social security disability benefits with at least two constitutional symptoms present and one of the following:

  • Limitation of activities of daily living

  • Limitation in maintaining social functioning

  • Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace


What Evidence Do I Need to Prevail In My MCTD Claim?

Those with MCTD will need to provide SSA with a complete medical history, including a physical exam completed by their treating physician. Your physician should document all of your symptoms, especially the constitutional symptoms mentioned above.


As with many autoimmune diseases, MCTD is a progressive disease that at first may be mild, but often becomes worse as time goes on. Therefore, your long medical history showing how your disease has progressed and worsened is crucial.


Those with MCTD will also need to produce reports of lab findings, such as results of the antinuclear antibody (ANA) blood test. Additionally, any diagnostic imaging relevant to your disease should also be added. SSA will want to know what kind of treatment you‘ve received thus far for your MTCD, as well as how you’ve responded to the prescribed treatments.

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