Facts about Neuralgia 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) Neuralgia is a chronic pain condition that occurs when an individual feels the sensation of pain without any actual stimulation of pain receptor cells.
2) There are two categories of neuralgia, central and peripheral. Peripheral neuralgia is caused by trauma to the actual nerves involved, while central neuralgia is caused by injury to the central nervous system.
3) In trigeminal and atypical trigeminal neuralgia conditions affect the touch, temperature and pressure nerves in the face. Trigeminal neuralgia causes short attacks of severe pain that can be brought on by every day movements and activities like facial expressions and face washing. Attacks last under two minutes but are considered among the worst of human pain sensations. Atypical trigeminal neuralgia is different because it is constant aching pain.
4) The pain from trigeminal neuralgia has been described by patients as sharp stabbing pain or pain that burns or itches.
5) Postherpetic neuralgia has the most directly obvious cause, as it occurs after an outbreak of shingles. For this reason it is not usually difficult to diagnose.
6) In general, a neuralgia diagnosis is difficult to determine, and the condition is often misdiagnosed. Description of symptoms and trying different types of medications or procedures and observing the response are key to diagnosis.
7) Regular pain medications do not alleviate the pain of neuralgia. Instead, anticonvulsant medications and antidepressants are used.
8) Surgery to stimulate the affected nerve or nerves is also an option. This works by fooling the brain into recognizing input from the nerve normally. Other surgery options destroy nerve fibers to stop the pain and moving the vessels compressing the nerve to implant soft cushioning between them.
9) Complementary therapy such as nerve stimulation and hot-cold compresses and alternative medicine therapies such as acupuncture and chiropractic care are common in an attempt to manage pain. The response of the condition to these therapies varies widely among individuals.
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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