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Does The Social Security Administration Provide Disability Coverage For Parkinson’s Disease?

 Social Security Administration

A progressive, degenerative disorder of the central nervous system, Parkinson’s disease is also known as idiopathic parkinsonism, PD, and primary parkinsonism. This chronic disorder results from the loss or weakening of dopamine-producing brain cells. Dopamine is a neurotransmitter that controls muscle movement throughout the body. There are treatment options to manage the symptoms and make life easier for patients. It is estimated that nearly one million people in the United States live with PD. The patient may not be able to work as the disease progresses, and therefore may qualify for social security disability benefits. Medical record review for social security disability lawyers gains significance in this regard. When the SSA (Social Security Administration) considers a disability claim for Parkinsonian syndrome, they will consider the patient’s adherence to the prescribed treatment. Parkinson’s disease is treated with certain medications, and physical therapy may also be recommended to help with maintaining muscle strength and flexibility.

Symptoms to Look for in the Medical Record

The symptoms of PD vary from person to person, and the primary signs of this condition include the following.

  • Slowness of movement or bradykinesia
  • Tremor of the hands, legs, arms, jaw and face
  • Impaired balance and coordination
  • Stiffness or rigidity of the limbs and trunk
  • Sleep disturbances
  • Depression
  • Urinary problems
  • Constipation
  • Pain
  • Dementia/confusion
  • Fatigue
  • Fear or anxiety
  • Cognitive changes

Eligibility Requirements for SSDI

To qualify for social security disability benefits, a patient has to meet the specific requirements included in Section 11.06 of the SSA’s Blue Book Listing of Impairments. The patient must have received medical treatment for Parkinson’s disease for at least three months, and this should be evident when a medical chart review is performed. The patient must have a condition that is characterized by either A or B in spite of adherence to the prescribed treatment for at least 3 consecutive months, as stated in https://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm#11_06

A. Disorganization of motor function in two extremities resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities.

Or

B. Marked limitation in physical functioning and in one of the following:

  • Understanding, remembering, or applying information
  • Interacting with others
  • Concentrating, persisting, or maintaining pace
  • Adapting or managing oneself

Even if a patient’s symptoms do not match exactly with the SSA’s guidelines for listing 11.06, he or she may still qualify for the benefits if they can prove that their condition is severe enough to limit their ability to carry out basic work-related activities, resulting in a residual functional capacity that prevents them from working; or that their condition is equal in severity to another condition in the Listing of Impairments.

Determining the Merit of the Case

As a medical record review company with expertise in the field, we understand that medical records, the patient’s age, education, and earlier work experience, are major factors that the SSA will consider as eligibility evidence. To determine the merit of the case, a professional medical review team would be looking at the following things.

  • Whether the medical history is comprehensive and accurate
  • Whether there is a record of usual activities that the claimant could not do on particular days
  • Detailed history of the claimant’s current and past medications
  • Whether the claimant has been meeting his/her doctor regularly and adhering to the prescribed treatment
  • Whether a confirmed diagnosis is available from a specialist such as a neurologist
  • Whether there is a record showing how the claimant’s illness has affected him or her on the job

Parkinson’s Disease May be Eligible for SSDI and Medicare

A person with Parkinson’s disease can claim SSDI benefits and Medicare.

  • SSDI benefits are available to those who were able to work at one point but can no longer work for at least 12 months because of the disabling condition. The SSA must be convinced that the claimant is indeed disabled and has a certain amount of work credits. Work credits are calculated based on the claimant’s age and how long he/she has worked.
  • A claimant who qualifies for SSDI benefits with Parkinson’s disease will also qualify for Medicare. He/she automatically gets Medicare Part A and B after they get one of the following.
  • SSDI benefits for 24 months
  • Certain disability benefits from the RRB for 24 months

Supporting medical evidence is crucial to get the claim granted, and the more medical documentation and evidence available, the shorter will be the time to get the claim granted. In case the SSA denies the application, a person with PD can always appeal the decision. Social security disability attorneys handling Parkinson’s disease-related claims can consider the support of a medical record review company to review the applicant’s medical records. This will help determine the merit of the claim at an early stage itself so that an informed decision can be made on whether to accept the case or not. Moreover, the review team will provide an accurate summary of the medical records that helps the attorney to have a clear view of the important medical facts.

Disclaimer: The content in this blog is sourced from related internet resources including government websites, and is meant for informative purposes only. For a professional opinion, consult a social security disability attorney.

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