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Facts about Polymyalgia Rheumatica and Filing for Disability

How to prove you are disabled
and win disability benefits

1. Polymyalgia rheumatica causes mild, arthritic inflammation in the shoulder and hip joints, leading to muscle aching, stiffness and pain. The most commonly affected muscles are the neck, shoulders, upper arms, thighs and hips.

2. Onset of polymyalgia rheumatica most often happens overnight, where the individual goes to bed feeling normal and wakes up with the condition. Polymyalgia rheumatica is not typically a chronic lifetime condition; rather, it heals itself after one to two years.

3. Aside from muscle symptoms, polymyalgia rheumatica also makes the affected individual feel fatigued, weak and generally unwell, and it causes the patient to lose weight and have anemia.

4. The pain from polymyalgia rheumatica can occur on one or both sides of the body, typically beginning on one side and progressing. Pain can be mild to severe and can cause trouble sleeping or staying asleep. It is typically worse after laying or sitting for an extended period of time.

5. Giant cell arteritis is associated with polymyalgia rheumatica, although not particularly common. Those with giant cell arteritis are much more likely to develop polymyalgia rheumatica, than are people with polymyalgia rheumatica to develop giant cell arteritis. Giant cell arteritis causes arteries to become inflamed. The temples are most often affected, but the neck and arms may be as well.

6. It is uncertain what causes polymyalgia rheumatica to develop, but it happens when the immune system starts attacking the lining of joints, such as in the hip and shoulder. White blood cells are normally responsible for fighting off foreign invaders that cause sickness, but in this case they also attack the joint tissues.

7. Although it may cause severe pain, polymyalgia rheumatica is considered to be a less severe condition overall than rheumatoid arthritis and other inflammatory conditions.

8. Women develop polymyalgia rheumatica twice as often as men do, and onset is almost always over the age of 60.

Can you qualify for disability benefits with this condition?

Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records. This includes whatever statements may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis).

It will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).

Why are so many disability cases lost at the disability application and reconsideration appeal levels?

Speaking as a former Disability Claims Examiner, I can state that there are several reasons:

1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant and his or her disability attorney will generally obtain and present this type of statement to a judge;

2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. At the hearing level, of course, this is exactly what happens. And a number of disability representatives will also take such steps even earlier, at the reconsideration appeal level;

3) Disability judges, unlike disability examiners who decides cases at the first two levels of the system, can make independent decisions without being overturned by immediate supervisors--which happens frequently.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Information on the following topics can be found here: Social Security Disability Questions

Social Security Disability SSI decisions | The Disability Decision Process and What gets taken into Consideration | Getting Denied for Disability Benefits | Questions about Social Security Disability Approvals and Being Approved | Social Security Disability Hearings | Social Security Medical Examinations | Social Security SSI Doctors | Social Security Disability Representation | Social Security Disability SSI Reviews