Facts about Spasticity 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.

  • How to apply for disability and the information that Social Security needs

  • Who will qualify for disability and what qualifying is based on

  • Requirements for disability - Qualifications Criteria for SSD and SSI

  • How to Prove you are disabled and win your disability benefits

  • Facts about the condition

    1. Spasticity is a central nervous system disorder that cause muscles to receive signals from the brain and spinal cord to contract constantly, causing the affected muscles and tendons to become tight and stiff.

    2. Spasticity can cause problems performing normal daily activities, since movement, walking and even speaking can be hindered by the condition.

    3. The disorder usually occurs with another condition, commonly cerebral palsy and multiple sclerosis, also well as metabolic conditions like Lou Gehrig's disease. Spinal cord and severe head injuries, as well as brain damage or trauma can all trigger spasticity if any part of the central nervous system controlling voluntary movement becomes damaged.

    4. Spasticity is a variable condition, affecting individuals differently. The affected muscles and the severity both vary. There may be mild cases with only small impairment of normal functioning, or the condition may be severe enough to cause a lot of pain and breakdown of joints and muscles.

    5. Generally symptoms include exaggerated muscle tone, uncontrollable movement such as rapid muscle contractions and leg-crossing, fixed joints, exaggerated tendon reflexes and shortened tendons.

    6. For a long time, neuroscientists believed that there were some benefits to having spasticity, particularly for those with conditions like cerebral palsy.

    7. The arguments supporting that belief include the aid of increased muscle tone in the ability to stand or walk, and prevention of a variety of symptomatic conditions that occur with decreased mobility. This includes prevention of muscle atrophy, deep vein thrombosis and pressure ulcers.

    8. Now, however, the medical and research profession has come to believe that the long-term joint and muscle problems associated with spasticity in cerebral palsy overshadow the idea of possible benefits.

    9. The notion still exists that spasticity in other conditions, like multiple sclerosis, may still provide these benefits.

    10. Researchers are attempting to find ways to eliminate spasticity through neurosurgical procedures, believing that, if it is possible, elimination of the condition should occur very early in life.

    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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