Source: https://socialsecurityprofessionals.com/immune-system-disorders-child/
Timestamp: 2020-04-02 22:36:19
Document Index: 14621590

Matched Legal Cases: ['§ 416', '§ 416', '§ 416', '§416', '§416', '§ 416']

114.00 Immune System Disorders - Social Security Professionals
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114.00 Immune System Disorders2018-04-032018-04-03https://socialsecurityprofessionals.com/wp-content/uploads/2018/03/text-logo.pngSocial Security Professionalshttps://socialsecurityprofessionals.com/wp-content/uploads/2018/03/text-logo.png200px200px
114.04 Systemic sclerosis
114.05 Polymyositis and dermatomyositis
114.06 Undifferentiated and mixed connective tissue disease
114.07 Immune deficiency disorders, excluding HIV infection
114.08 [Reserved]
114.10 Sjögren’s syndrome
114.11 Human immunodeficiency virus (HIV) infection
b. Immune system disorders may result in recurrent and unusual infections, or inflammation and dysfunction of the body’s own tissues. Immune system disorders can cause a deficit in a single organ or body system that results in extreme (that is, very serious) loss of function. They can also cause lesser degrees of limitations in two or more organs or body systems, and when associated with symptoms or signs, such as severe fatigue, fever, malaise, diffuse musculoskeletal pain, or involuntary weight loss, can also result in extreme limitation. In children, immune system disorders or their treatment may also affect growth, development, and the performance of age‑appropriate activities.
c. We organize the discussions of immune system disorders in three categories: Autoimmune disorders; Immune deficiency disorders, excluding human immunodeficiency virus (HIV) infection; and HIV infection.2. Autoimmune disorders (114.00D). Autoimmune disorders are caused by dysfunctional immune responses directed against the body’s own tissues, resulting in chronic, multisystem impairments that differ in clinical manifestations, course, and outcome. They are sometimes referred to as rheumatic diseases, connective tissue disorders, or collagen vascular disorders. Some of the features of autoimmune disorders in children differ from the features of the same disorders in adults. The impact of the disorders or their treatment on physical, psychological, and developmental growth of pre-pubertal children may be considerable, and often differs from that of post-pubertal adolescents or adults.
(ii) If you are of preschool age through adolescence (age 3 to attainment of age 18), weakness of your pelvic girdle muscles that results in your inability to rise independently from a squatting or sitting position or to climb stairs may be an indication that you are unable to ambulate effectively. Weakness of your shoulder girdle muscles may result in your inability to perform lifting, carrying, and reaching overhead, and also may seriously affect your ability to perform activities requiring fine movements. We evaluate these limitations under 114.05A.
b. We will make every reasonable effort to obtain the results of your laboratory testing. Pursuant to § 416.919f, we will purchase examinations or tests necessary to make a determination in your claim if no other acceptable documentation exists.
b. We will make every reasonable effort to obtain the results of your laboratory testing. Pursuant to § 416.919f, we will purchase examinations or tests necessary to make a determination of your claim if no other acceptable documentation exists.
d. Progressive multifocal leukoencephalopathy (PML, 114.11D) is a progressive neurological degenerative syndrome caused by the John Cunningham (JC) virus in immunosuppressed children. Clinical findings of PML include clumsiness, progressive weakness, and visual and speech changes. Personality and cognitive changes may also occur. We require appropriate clinical findings, characteristic white matter lesions on MRI, and a positive PCR test for the JC virus in the cerebrospinal fluid to establish the diagnosis. We also accept a positive brain biopsy for JC virus or other generally acceptable methods consistent with the prevailing state of medical knowledge and clinical practice to establish the diagnosis.
c. We will use the rules on medical equivalence in § 416.926 to evaluate your HIV infection if you have fewer, but longer, hospitalizations, or more frequent, but shorter, hospitalizations, or if you receive nursing, rehabilitation, or other care in alternative settings.
6. Neurological manifestations specific to children (114.11H). The methods of identifying and evaluating neurological manifestations may vary depending on a child’s age. For example, in an infant, impaired brain growth can be documented by a decrease in the growth rate of the head. In an older child, impaired brain growth may be documented by brain atrophy on a CT scan or MRI. Neurological manifestations may present in the loss of acquired developmental milestones (developmental regression) in infants and young children or, in the loss of acquired intellectual abilities in school-age children and adolescents. A child may demonstrate loss of intellectual abilities by a decrease in IQ scores, by forgetting information previously learned, by inability to learn new information, or by a sudden onset of a new learning disability. When infants and young children present with serious developmental delays (without regression), we evaluate the child’s impairment(s) under 112.00.
b. Under 114.11I2 and 114.11I3, we use the appropriate table under 105.08B in the digestive system to determine whether a child’s growth is less than the third percentile.
(ii) For children from age 2 to attainment of age 18, we use the body mass index (BMI)-for-age corresponding to the child’s gender (Table III or Table IV).
H. How do we consider your symptoms, including your pain, severe fatigue, and malaise? Your symptoms, including pain, severe fatigue, and malaise, may be important factors in our determination whether your immune system disorder(s) meets or medically equals a listing or in our determination whether you otherwise have marked and severe functional limitations. In order for us to consider your symptoms, you must have medical signs or laboratory findings showing the existence of a medically determinable impairment(s) that could reasonably be expected to produce the symptoms. If you have such an impairment(s), we will evaluate the intensity, persistence, and functional effects of your symptoms using the rules throughout 114.00 and in our other regulations. See §§416.921 and 416.929. Additionally, when we assess the credibility of your complaints about your symptoms and their functional effects, we will not draw any inferences from the fact that you do not receive treatment or that you are not following treatment without considering all of the relevant evidence in your case record, including any explanations you provide that may explain why you are not receiving or following treatment.
2. Important factors we will consider when we evaluate your functioning include, but are not limited to: Your symptoms (see 114.00H), the frequency and duration of manifestations of your immune system disorder, periods of exacerbation and remission, and the functional impact of your treatment, including the side effects of your medication (see 114.00G). See §§416.924a and 416.926a for additional guidance on the factors we consider when we evaluate your functioning.
3. We will use the rules in §§ 416.924a and 416.926a to evaluate your functional limitations and determine whether your impairment functionally equals the listings.
2. Individuals with immune system disorders, including HIV infection, may manifest signs or symptoms of a mental impairment or of another physical impairment. For example, HIV infection may accelerate the onset of conditions such as diabetes or affect the course of or treatment options for diseases such as cardiovascular disease or hepatitis. We may evaluate these impairments under the affected body system. For example, we will evaluate:
114.02 Systemic lupus erythematosus, as described in 114.00D1. With involvement of two or more organs/body systems, and with:
A. One of the organs/body systems involved to at least a moderate level of severity;
B. At least two of the constitutional symptoms and signs (severe fatigue, fever, malaise, or involuntary weight loss).
114.03 Systemic vasculitis, as described in 114.00D2. With involvement of two or more organs/body systems, and with:
4. Atrophy with irreversible damage in both upper extremities, resulting in the inability to perform fine and gross movements effectively as defined in 114.00C7.OR
114.06 Undifferentiated and mixed connective tissue disease, as described in 114.00D5. With involvement of two or more organs/body systems, and with:
114.10 Sjögren’s syndrome, as described in 114.00D7. With involvement of two or more organs/body systems, and with:
114.11 Human immunodeficiency virus (HIV) infection. With documentation as described in 114.00F1 and one of the following: