A Rare Disabling Condition: Hypogammaglobulinemia

Hypogammaglobulinemia, a 21 letter mouthful that is as difficult to understand as to pronounce. On the surface, it is a rare immune disorder marked by a reduction in gamma globulins (serum proteins). A reduction in gamma globulins predispose an individual to various infections. In other words, if someone suffering from hypogammaglobulinemia were to apply for Social Security disability benefits, then that person would most likely suffer from multiple impairments. Hypogammaglobulinemia does not have a specific heading under the Social Security Administration's Listing of Impairments. Thus, the condition is often poorly evaluated by adjudicators, forcing claimants suffering from the disease to have to wait for a hearing in front of an Administrative Law Judge to argue their disability case.

Once in front of an Administrative Law Judge ("ALJ"), there are many different ways to present a hypogammaglobulinemia case. While there is no specific heading for hypogammaglobulinemia in the Listing of Impairments, it could fall within the scope of Listing 14.07: Immune Deficiency Disorders, Excluding HIV Infection. To meet 14.07A, a claimant would need to suffer from Sepsis, Meningitis, Pneumonia, Septic Arthritis, Endocarditis, or Sinusitis and it would need to be resistant to treatment or require intravenous treatment three or more times in a year or require hospitalization. 14.07B has to do with stem cell transplantation and while it is a form of treatment for hypogammaglobulinemia, it is less common to meet part B. 14.07C requires repeated manifestations of the condition resulting in at least two of the constitutional symptoms (fever, involuntary weight lostt, severe fatigue, etc.) and one of the following at the marked level: 1. Limitation of activities of daily living; 2. Limitation in maintaining social functioning; and 3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace. If an ALJ finds that a claimant suffers from hypogammaglobulinemia and meets Listing 14.07, that person will then be found to meet the medical requirements for disability benefits.

Another way to look at a hypogammaglobulinemia case would be to analyze the effect of the treatment itself. Many claimants suffering from the condition are required to take monthly gamma globulin injections to temporarily boost their immune system. Both the effectiveness of the injections and time commitment vary greatly. Some injection periods take over six hours to complete. The day or two after the injection can leave the claimant feeling extremely fatigued or sick. If a claimant would have to miss at least three days a month from work just for gamma globulin treatments, it would make it very difficult for that individual to hold down full-time employment. That claimant's Residual Functional Capacity would be greatly reduced.

A more common way of reviewing a hypogammaglobulinemia case would be to see whether the infections themselves meet a listing. Claimants applying for Social Security disability benefits with hypogammaglobulinemia often suffer for example from bronchitis or asthma. While a claimant might not meet Listing 14.07, that same individual might meet Listing 3.03 for Asthma.

Hypogammaglobulinemia is a rare immune disorder. Many claimants applying for disability benefits with the condition are denied repeatedly and are forced to argue their cases in front of an ALJ. Once in front of an ALJ, there are many different ways to review this type of case, making it quite challenging and easy to overlook its nuances. If you suffer from hypogammaglobulinemia and are applying for disability benefits, it is highly recommended that you seek legal representation, especially if you are waiting for a hearing in front of an ALJ.