Dystonia and Filing for Disability
Dystonia is a severe physical medical condition that can be listed on a disability application with the Social Security Administration. This condition generally would fall under the classification of neurological impaiments. If it were listed in the SSA Blue Book impairment listings it would be evaluated under section 11.00, Neuroglocial System - Adult.
While Dystonia does not have its own impairment listing, disability specialists may evaluate a person's symptoms under the listing criteria of another condition such as Parkinson's, seizure disorder, MS, Myasthenia Gravis, or Traumatic Brain Injury. If they are able to meet or equal any of these listings the disability claim will medically qualify for disability benefits with no further evaluation.
However, a person's dystonia condition may not meet or equal an impairment listing and this would mean they would need to prove they have severe condition that prevents them from working at a level that earns what Social Security considers to be subtantial gainful income or SGA.
Proving they have a severe impaiment and are unable to perform SGA can be done through A) the information contained in their medication records, and through B) a functional capacity analysis based on the information they provided in their work history; specifically, the types of work they have done, the functional requirments of each of their past jobs, as well as the job skills they may have to transition into other kinds of work.
Note: How the disability decision is made.
Many disability applicants are surprised to learn that simply being diagnosed with a certain condition is not a requirement that necessarily qualifies a person to SSD or SSI disability benefits. Social Security considers the ways and extent to which a person if functionally limited, because this impacts their ability to engage in work activity.
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 Dystonia
1. Dystonia is an uncommon condition that affects the muscles and causes involuntary contracting and uncontrollable twisting of the affected part of the body.
2. Dystonia is inherited if symptoms start in childhood, but most cases begin in older adulthood. Young people may experience symptoms throughout the body, while adults tend to only have one affected body part. Symptoms can be mild or severe, and can interfere with a person's day-to-day tasks and activities.
3. Most often the neck, face or hand is affected. Symptoms usually occur with a specific movement and are exacerbated by stress, fatigue and anxiety.
4. The extent to which dystonia affects quality of life depends on severity and the affected body part. For example, eyelid contractions can cause functional blindness.
5. Dystonia in the neck can cause painful and involuntary twisting and turning of the head to the side, or cause it to fall forward or backward.
6. If the jaw and tongue are affected, speech may be slurred or eating and swallowing may become difficult.
7. When the hand and forearm are affected, pain and cramping can inhibit writing, playing music, or carrying objects.
8. The cause of dystonia is unknown, although sometimes an underlying condition leads to dystonia. Traumatic brain injury, stroke, brain tumor or oxygen deprivation can lead to dystonia. Poisoning and drug reactions, as well as infections can also lead to dystonia.
9. Sometimes dystonia is difficult to diagnose because symptoms look like other neuromuscular disorders such as Parkinson's disease, carpal tunnel syndrome, and Tourette's syndrome.
10. Treatment is focused on minimizing symptoms. When possible, limiting movements that trigger muscle contractions helps relief symptoms. Living a healthy lifestyle by getting enough sleep and physical activity, reducing stress and anxiety levels is also important. Medications used for Parkinson's disease and seizure treatment may also be affective, as can Botox injections.
Qualifying for disability benefits with Dystonia
Whether or not you qualify for disability with dystonia 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.
As a disability lawyer working on a case is keenly aware, 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 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 your doctor. 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 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) Before the Social Security Disability hearing, 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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