Facts about Arachnoiditis and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Arachnoiditis is a condition that involves the protective covering of the spinal cord, specifically the membrane called the arachnoid. With arachnoiditis, the arachnoid becomes inflamed, causing nerve pain and other symptoms.
2. Inflammation in the arachnoid membrane occurs as a reaction to a variety of factors. This includes infections, injuries, surgery or other spinal procedures. Use of injections, such as steroids, into the spinal cord may also result in arachnoiditis.
3. In addition, severe inflammation such as that which occurs with arachnoiditis, may cause long term damage to the tissues affected. This scarring can cause nerves in the spine to become stuck together, causing further symptoms.
4. Arachnoiditis affects all patients differently, although regardless of specific symptoms the condition is typically limiting. Pain, numbness, tingling, and loss of proper control and functioning of the bowels, bladder and reproductive organs are all potential symptoms. It may also be difficult to control movement in the arms and legs.
5. The portion of the spine where the arachnoid is inflamed has a lot to do with symptoms. For example, bowel, bladder and sexual function are only affected if the inflammation is located in the lower part of the spine. Most commonly, the nerves to the lower back and upper legs are affected.
6. Wheelchairs are generally not good for those with arachnoiditis, because sitting can worsen the pain. However, walking and standing may be inhibited at the same time. Segways and similar new devices, as well as standing wheelchairs, may be the best option if the individual can stand assisted for extended periods of time.
7. Arachnoiditis is chronic, meaning that the condition is long lasting and there is no known cure. Treatment aims at alleviating symptoms, especially pain. Physical therapy, pain management techniques and prescription medication can all make the condition more manageable, although it will inevitably cause some level of debilitation.
Qualifying 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 and treatment notes that 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 also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits 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. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
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?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
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. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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