Social Security Disability:
Disabling Medical Conditions

A broad spectrum of physical and mental disorders or impairments may prove so disabling to certain individuals that they can no longer work full time, competitively, or even under sedentary conditions. On this page you will find a list of some of the most frequently experienced physical and mental medical disorders by social security disability claimants. These disorders are recognized by the Disability Determination Services as conditions that will potentially lead to significant impairment and which may limit your ability to do even sedentary work on a competitive basis in our national economy. Click on any category for more detail.

Back and Neck Conditions

Many of the social security disability cases we see involve individuals who experience severe chronic back and neck pain which commonly also radiates into other parts of the body. Whatever the underlying cause, this particular type of pain often proves especially excruciating and ultimately debilitating when individuals can no longer concentrate due to the intense psychological distraction their condition creates. Frequently these individuals need to move around and can only sit or stand for a limited period of time. Also elevation of the legs to a semi–reclining position is the only way these individuals can get any relief from the constant pain they are experiencing. It is not uncommon that sufferers experience “good days” where pain is significantly lessened followed by “bad days” where they may be totally bedridden. Neck conditions can create similar symptoms and limitations in an individual’s use of their arms and range of motion of the neck itself.

Because of their postural limitations these individuals may be unable accomplish the activities of their daily life such as cooking, cleaning and even maintaining proper hygiene. Additionally, these individuals cannot complete these tasks in a timely manner. Often the physical limitations along with the side effects of strong narcotic-based medications (which can include nausea, dizziness, drowsiness, lethargy, and concentration problems) preclude full time work.

You are covered under the Social Security disability laws for a variety of conditions, including:
• Arthritis
• Degenerative Disc Disease
• Herniated and Bulging Discs
• Osteoporosis
• Spinal Stenosis
• Spinal Cord Injuries
• Spondylosis

Because the experience of pain itself is completely invisible to an outside observer, treatment records are usually necessary to establish the nature and severity of your case. This is established by documentation from the following treatment records:
• MRI Reports
• Physical Therapy
• Prescription Pain Medications
• Steroid Injections
• Surgery
• TENS Units
• X-Rays

Diabetes

Diabetes mellitus is a medical condition where the body has become incapable of removing and storing glucose from circulating blood, either because it has become insensitive to the effects of insulin release (which helps deposit glucose into the cells) or because an individual’s pancreas has become altogether incapable of producing insulin. As a result the excess circulating blood sugars basically starve cells of energy, damage blood vessels, and cause a sticky thickening of the blood that impairs its efficient movement through the body. Although Type II diabetics fall into the former category of insulin insensitivity, if their condition goes untreated it can result in the destruction of insulin-producing pancreatic cells as well. Both Type I and tpe II diabetes—if not well controlled–can cause irreparable damage, making it impossible for a person to maintain full-time employment.

Signs of chronic diabetes can include blurred vision, unusual thirst, and fatigue. Permanent damage to nerves, blood vessels, skin, and other organs such as the kidneys can result from high blood sugar levels and can be so severe as to prevent full-time work. Long-term complications of impaired blood flow can lead to glaucoma, loss of sensation, deep pressure ulcers (most commonly on the feet), inefficient wound healing, necrotizing infections, limb loss, and at worst diabetic coma leading to death. You are covered under the Social Security disability laws for a variety of conditions associated with diabetes, including:

• Kidney Failure
• Ischemia
• Heart disease
• Diabetic Neuropathy: Loss of Sensation in the Hands and Feet
• Retinopathy

Lupus

Lupus is a type of autoimmune disease where one’s own immune system targets and attacks certain types of connective tissues and organs because for unknown reasons they start to become recognized as harmful foreign pathogens inside the body. There are two main types of Lupus, Systemic Lupus Erythematosus (SLE) and Discoid Lupus; the former is often just referred to as “Lupus.” Unlike SLE, the pathology of Discoid Lupus is primarily limited to the outbreaks of scaly skin rashes that evolve into skin lesions. Often these individuals experience irritability because of the severity their rash. No two cases of Lupus will present in exactly the same way, and the severity of one’s disease can range from relatively mild to potentially life threatening. Lupus is sometimes hard to diagnose because many of its symptoms occur in unpredictable outbreaks and may look like other diseases including multiple sclerosis or chronic fatigue syndrome. Symptoms can include generalized inflammation, fatigue, depression, headache, arthritic joints, myalgias (muscle pain), neuralgias (neurologically sourced pain, tingling, and numbness), anemia, skin rash, pleurisy (sharp, tight chest pains of surrounding lung tissue) body orifice ulcers, alopecia (hair loss), and cognitive dysfunction. Long-term complications of systemic lupus can involve damage to the nerves, lungs, blood vessels, heart, and kidneys. These individuals require constant monitoring of their blood proteins and enzymes.

Both the symptoms and the end organ damage caused by Lupus can limit an individual’s ability to perform full time work. The most common treatments for Lupus and other autoimmune diseases are steroid-based drugs, which can slow the painful and destructive inflammatory processes but also have a number of serious side effects when taken long term including suppressed immune function, depression, elevated blood pressure, osteoporosis, cataracts, and weight gain. You are covered under the Social Security disability laws for a variety of conditions at severe severity levels associated with lupus, including:

• Mylar Butterfly Rash (a rash covering the cheeks and nose bridge)
• Chronic Fatigue
• Easy Bruising
• Migraine Headaches
• Joint Pain, Swelling and Stiffness
• Pulmonary complications
• Significant Weight Loss or Gain
• Skin Lesions

Mental Impairments and Psychological Disorders

Mental impairments and psychological disorders are often the basis for a disability claim, especially in younger individuals for whom there are few outward signs of a debilitating physical condition. These claims are even stronger if the individual also has physical limitations, however. Taking into consideration the severity of your limitation will necessitate that records showing your full treatment history are available.

You are covered under the Social Security disability laws for a variety of mental impairments and psychological disorders, including:

• Anger
• Anxiety
• Bipolar Disorder
• Borderline Personality Disorder
• Depression
• Post-traumatic Stress Syndrome (PTSD)
• Schizophrenia
• Schizoaffective Disorder
• Severe agoraphobia
• Sub-average intellectual functioning

The medications used to treat these conditions can sometimes have side effects severe enough to prevent an individual from doing competitive work. Drowsiness, fatigue, dizziness, concentration deficits, and problems with timely completion of tasks can be caused not only by the psychological condition but also by the required medications. As a result, your symptoms may be fairly well controlled by the medication, but the side effects of the medications themselves can create a long-term disability. This is especially true for certain types of pharmacological interventions used to treat severe anxiety, schizophrenia, or bipolar disorder; these medications can have strong sedative effects. In addition, many anti-psychotic medications have the added risk of heart complications, increased susceptibility to type II diabetes, and development of a permanent involuntary movement disorder known as tardive dyskinesia.

Compliance with doctors’ treatment recommendations is the key to success for a mental impairment. Regular treatment is essential with psychological cases; people can often not compete in the workforce when they have depression, anxiety, or post traumatic stress disorder (PTSD) because even routine stressors encountered in the context of a work environment will become too overwhelming to the individual. PTSD, for example, is a condition not limited to soldiers on the battlefield—it can develop in [i]any[/i] individual who has experienced a traumatizing events such as rape, natural disaster, auto accidents, childhood abuse, or other forms of extreme violence.

Records reflecting your doctor’s efforts to manage your condition over time are essential in these types of cases. Compliance with therapy is essential so that you can show the Administrative Law Judge (ALJ) the nature and extent of your impairment; otherwise he may be given the mistaken impression that the degree to which you experience your symptoms is simply because you are not giving a sufficient effort to treat them. Also it is imperative that you stay on any medications your doctor has prescribed.

Multiple Sclerosis

Multiple Sclerosis (MS) is a disease which causes degeneration of the myelin sheaths in the brain and spinal cord, thereby interrupting communication between neurons in the central nervous system. This demyelination occurs when some of your body‘s own immune cells are able to gain access through the blood brain barrier–which is normally not possible—and attack the neural insulation as though it were an invading virus or bacteria. MS produces diffuse neurological symptoms including fatigue, paresthesias (tingling and numbness), muscle weakness and spasms, ataxia (inability to coordinate muscle movements), incontinence, swallowing and speech difficulties, chronic or shooting pains, double vision, concentration deficits, depression, mood instability, and cognitive dysfunction. Limitations associated with MS include problems with speech, vision loss, and motor control. As MS progresses, the sufferer my experience temporary remittance of symptoms followed by acute “flare ups,” which usually increase in severity. Although some treatments are now available to slow the progression of disease, they are usually only moderately effective and often have severe side effects which range from chronic nausea and flu-like symptoms to immunosuppression and heart damage. After several years of battling the disease, most suffers find that they are unable to do full-time work.

It is often the debilitating fatigue associated with MS that tips the case in the claimant’s favor. Character statements made by friends, family and clergy can be helpful in this regard. The claimant should be aware that the Administrative Law Judge makes credibility findings. If the individual has a good work history the claimant is entitled under the social security laws to a presumption of credibility. Because of the nature of the disease, cases need proper documentation and longitudinal treatment records. This is also important when the ALJ makes his findings regarding the credibility of a claimant’s symptoms regarding disabling chronic fatigue.

Rheumatoid Arthritis (RA)

Rheumatoid Arthritis (RA), like lupus, is a systemic autoimmune disorder. RA tends to affect the joints of the hands and feet, although larger joints such as the knee are occasionally involved. Because the body’s own immune system is attacking the membrane lining of these areas, the chronic inflammation can result in painful, swollen, tender, and stiff joints. Many RA sufferers experience enlarged and stiff knuckles, which can make even simple activities such as opening a jar difficult. Some individuals also experience fatigue. As the condition progresses or goes untreated, the range of movement of the hands and fingers can become severely impaired to an extent where an individual cannot do full-time work. Long-term complications of RA can include localized osteoporosis and permanent malformation of the fingers, hands, and feet from excessive tissue proliferation. Carpal tunnel syndrome sometimes results from compression of the wrist nerves. Other associated complications of the inflammatory processes can include atherosclerosis, pulmonary fibrosis, pericarditis (inflammation of the heart sac), and anemia. In most cases RA symptoms are treated with non-steroidal anti-inflammatory drugs, which may be either prescribed or bought over the counter. However, drugs which attack the underlying disease processes such as corticosteroids, methotrexate, or etanercept (Enbrel) must be used to slow progression.