Facts about Restless Leg Syndrome 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. Restless legs syndrome affects primarily the legs, causing discomfort and the urge to move when sitting or lying down. It is considered a spectrum condition, meaning that some people have symptoms that may be described as minor annoyance, while others experience great disability. The condition generally progresses and becomes worse with age.
2. Anyone at any age can experience restless legs syndrome, even children. However, the condition occurs more often in women than in men.
3. Symptoms of restless legs syndrome occur in the leg muscles, such as the calves and thighs. The feet and arms may also be affected. Sensations have been described as crawling, tingling, cramping, pulling, tense, uncomfortable, itchy, aching and burning, along with many others.
4. The urge to move is a primary symptom. This relieves the discomfort at least while in movement, sometimes temporarily afterward. Symptoms may go into remission, disappearing for periods of time then reappearing again.
5. The symptoms usually get worse in the evening and are less noticeable during the day. Aside from discomfort, this also causes sleeping problems which is typically the biggest complication of the condition.
6. Restless legs syndrome may occur with periodic limb movements of sleep, a condition that causes flexing and extending of leg muscles while sleeping. In severe cases these movement may occur while awake. In many cases, patients are not aware of the muscle movement and do not even experience sleep disruption.
7. Medications commonly used to treat Parkinson's disease can be helpful for those with restless legs syndrome, because they limit chemical messages in the brain to reduce leg motion. Some epilepsy medications may also help with treating restless legs syndrome.
8. Muscle relaxants and sleep medications help treat the sleep problems caused by restless legs, but they do not stop the sensations.
9. Effective medications and the right combination of medicines will vary by individual. Doctors will help find the best individualized treatment through trial and error.
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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