Tinnitus and Filing for Disability
Tinnitus can be a severe medical condition, therefore it should be listed if a person is filing for SSD or SSI disability benefits. This condition is most often classified as a hearing impairment. If it were listed in the SSA Blue Book impairment listings, it would be covered in the adult listings section 2.00, Special Senses and Speech - Adult.
How tinnitus is evaluated
Tinnitus affects one in five individuals and is commonly listed on disability applications. However, it does not have its own listing in the SSA Blue Book. It is most often evaluated under listing 2.07, Disturbance of labyrinthine-vestibular function. The listing requires a history of frequent attacks of balance disturbance, tinnitus, and progressive loss of hearing verified by an audiometry test.
If a person cannot meet this listing they may be evaluated under listing 2.10, Hearing loss not treated with cochlear implantation. If a person has severe hearing loss, they may qualify for disability.
Getting approved with tinnitus when you don't meet the listing
If a person is unable to meet an impairment listing, they must prove they can no longer work and earn wages that are considered substantial gainful income by Social Security because of their tinnitus.
This can be accomplished by A) providing medical records that contain objective testing indicating that their tinnitus causes signficant limitations and B) the information contained in their vocational work history; specifically, the type of work they performed, the functional requirements of those jobs, and if they possess any job skills that could transition to other types of work.
SSA looks at your age, education level, job skills, work history, training, and other factors to determine the kinds of work for which a person is qualified and able to do considering their functional limitations. A person may be able to qualify through a medical vocational allowance provided that the SSA RFC (residual functional capacity) shows that they are unable to meet the requirements of any of their past work, or other kinds of work due to their hearing loss.
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.
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.
Facts about tinnitus
1. Tinnitus, a symptom of a variety of conditions, causes phantom (not real) noises in the ears. These noises may sound like ringing, buzzing, roaring, clicking, whistling or hissing, and can vary from low or high pitch.
2. Severity of tinnitus varies ' some people may experience very loud noise or very quiet noise, and some may experience noise at all times or just some of the time. Tinnitus is not dangerous, but it is an annoyance and may impact quality of life.
3. Impact on quality of life may lead those with tinnitus to seek treatment for anxiety and depression, stress, irritability, fatigue, memory problems.
4. Tinnitus can be subjective or objective. Subjective tinnitus is only heard by the affected individual, while objective tinnitus can be heard by a doctor during an ear exam. Objective tinnitus is rare, and is caused by problems with muscle tissue, blood vessels or bone of the inner ear.
5. Tinnitus is most commonly caused by normal hearing loss associated with age, typically 60 years and older, noise-related hearing loss (leading to either short or long-term tinnitus), excessive build up of earwax, and bone problems, such as stiffening, in the inner ear.
6. Medications can cause tinnitus, which typically increases along with the dosage. Antibiotics, malaria medication, cancer treatments, diuretics and very high doses of aspirin may cause temporary tinnitus.
7. White males over the age of 65 are the most likely to develop tinnitus. Those who have hearing loss or have been exposed to extended periods of loud noise without protecting the ears are at a higher risk for developing tinnitus.
8. Devices that create white noise may help mask the sound. Medications such as certain antidepressants and anxiety medications may be helpful in severe cases. Sometimes alleviating tinnitus is as simple as removing earwax buildup, changing a medication, or treating an underlying condition.
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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