Facts about Myasthenia Gravis 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) Myasthenia gravis affects the voluntary muscles of the body, also known as the skeletal muscles. It is a chronic neuromuscular disease, and is also an autoimmune disorder.
2) Myasthenia gravis is most common in men over the age of 60 and women under the age of 40, although it can develop in any sex at any age.
3) The most common sign of myasthenia gravis is a weakening of the muscles, especially in the arms and legs, eyes, and face. Many times those with the disease will have trouble talking, chewing or swallowing and may have drooping eyelids, double or blurred vision, breathing issues, and have problems controlling facial expressions, causing them to a droopy expression.
4) It is not a very common autoimmune disease and only affects about one or two people out of every 10,000.
5) Muscle weakness due to myasthenia gravis usually improves after periods of inactivity and rest, and gets worse during periods of activity and movement.
6) Myasthnia gravis is caused by antibodies destroying or blocking the muscles receptor sites for neurotransmitters, which cause less nerve signals to reach the muscles, resulting in muscle weakness.
7) Researchers have found that many adults with the disease have unusually large thymus glands, and some have thymus tumors. It is thought that the thymus gland may be responsible for producing the antibodies that that block and destroy the receptor sites.
8) Myasthenia gravis can be made worse by certain illnesses, high levels of stress, persistent fatigue, intense heat, and certain medications.
9) Lupus, rheumatoid arthritis, diabetes type 1, and thyroid diseases are all associated with myasthenia gravis, including Graves disease and Hashimoto's disease.
10) Medications to help reduce the autoimmune process and improve muscle function, such as immunosuppressants and cholinesterase inhibitors, are used to help treat the myasthenia gravis. Surgery to remove the thymus, otherwise known as thymectomy, is sometimes needed.
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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