Applying For Disability With Mixed Connective Tissue Disease

Undifferentiated, or mixed connective tissue disease can be the basis for a Social Security Disability application.  Mixed connective tissue disease has signs and symptoms of a combination of disorders — primarily lupus, scleroderma and polymyositis. For this reason, mixed connective tissue disease is sometimes referred to as an overlap disease.  Examples of connective tissue are fat and cartilage.  These connective tissues are found throughout the body and are vital to the shape and function of many of its parts.

About 80% of people who have this disease are women. Mixed connective tissue disease occurs worldwide and affects people aged 5 to 80, often peaking in incidence during adolescence and in the 20s. Its cause is unknown, but it seems to be an autoimmune disorder.

In the beginning stages, patients who have MCTD have symptoms similar to those of patients with other connective tissue disorders, including:

  • fatigue
  • muscle pain with no apparent cause
  • joint pain
  • low-grade fever
  • Raynaud phenomenon (reduced blood flow to the fingers, toes, ears, and nose). This causes sensitivity, numbness, and loss of color in these areas.

Less common early symptoms may include:

  • severe polymyositis, often in the shoulders and upper arms
  • acute (intense) arthritis
  • aseptic meningitis (inflammation of the brain and spinal cord meninges, not caused by a bacteria or virus)
  • myelitis (inflammation of the spinal cord)
  • gangrene (death and decay) of fingers or toes
  • high fever
  • abdominal pain
  • neuropathy (nerve disorders) affecting the trigeminal nerve in the face
  • hearing loss

The “classic” symptoms of MCTD are:

  • Raynaud phenomenon
  • swollen “sausage-like” fingers, sometimes temporary but at other times progressing into sclerodactyly (thin fingers with hardened skin and limited movement)
  • inflamed joints and muscles
  • pulmonary hypertension (high blood pressure in the blood vessels of the lungs)

Blood tests are done to detect an antibody to ribonucleoprotein, which is present in most people who have mixed connective tissue disease. A high level of this antibody without the other antibodies present in other similar disorders is characteristic of mixed connective tissue disease.

If doctors suspect certain organs are affected, they may do other tests, such as magnetic resonance imaging (MRI) or a muscle biopsy (removal of a piece of muscle tissue for examination and testing), to detect problems.

Following an application submitted due to undifferentiated and mixed connective tissue disease, Social Security will evaluate the case to determine if the claimant meets or equals a listing.  A listing is a set of criteria specific to a condition that, if satisfied, would automatically qualify a claimant for disability benefits. Listing 14.06 is the listing specific to undifferentiated and mixed connective tissue disease:

14.06 Undifferentiated and mixed connective tissue disease. As described in 14.00D5. With:

A. Involvement of two or more organs/body systems, with:

1. One of the organs/body systems involved to at least a moderate level of severity; and

2. At least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss).


B. Repeated manifestations of undifferentiated or mixed connective tissue disease, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:

1. Limitation of activities of daily living.

2. Limitation in maintaining social functioning.

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

If you do not meet or equal the above listings, you can still qualify for disability benefits if the impairment prevents you from doing your past relevant work or other work that exists in significant numbers in the national economy.