The SSA (Social Security Administration) uses the guidelines in their Blue Book to determine whether a person’s disability is severe enough to qualify him or her for disability benefits. For any disability determination, medical record review is an indispensable first step. There are different sections in the Blue Book, each dealing with conditions affecting a specific body function or system, and neurological conditions are included in the eleventh section. Just as any other disability, to qualify for SSDI benefits, the neurological disorder must last for more than a year or end in the patient’s death.
What Causes Neurological Impairments?
Neurological disabilities can be the result of any of the following:
- Physical trauma that leads to a brain or spinal cord injury, or nerve damage.
- Respiratory system problems.
- Infections caused by fungi, viruses, or bacteria.
- Problems with the circulatory system.
- Complex disorders with no well-defined cause.
- Degenerative central system disorders.
Major Symptoms to Be Documented in the Medical Record
Based on the particular neurological condition, the symptoms and intensity of neurological disabilities may vary. These include the following among others.
- Tremors and involuntary movements
- Muscle weakness
- Sensory disturbances
- Speech difficulties
- Breathing trouble
- Mental impairments
Some of the neurological disabilities that may qualify for disability benefits are:
- Amyotrophic lateral sclerosis
- Cerebral palsy
- Degenerative diseases such as Friedreich’s ataxia, spinocerebellar degeneration
- Brain tumors
- Central nervous system vascular accidents
- Cerebral trauma
- Multiple sclerosis
- Myasthenia gravis
- Muscular dystrophy
- Parkinson’s disease
- Peripheral neuropathies
- Spinal cord or nerve root lesions
Medical Chart Review Helps Identify the Symptoms
Any of the above impairments need to be established by a detailed medical chart review, which will help identify the diagnosis, as well as the various treatments provided. Also, the extent of disability can be accurately determined. Most neurological problems have clear-cut SSA guidelines regarding what exactly is considered eligible for SSDI benefits. Before total disability is determined, the applicant will have to demonstrate that he/she has been under the care of a physician, taken all the prescribed medicines, and that the symptoms are still serious and debilitating enough that he or she cannot be expected to engage in work on an ongoing basis. Here again, medical records review becomes significant as a tool to identify all the qualifying factors.
When providing medical record review for attorneys, a medical review service would look for important things such as a complete medical history; neurological exam findings; electrophysiological, neuroimaging, and other test results; current as well as previous medications and treatments; and the applicant’s doctor’s opinion on what he/she can and cannot do. In a disability claim for neurological problems, the medical documentation submitted has a significant role to play as regards whether or not the claim is approved. For instance, a claimant with a spinal condition that prevents him or her from working must include the relevant MRI and CT scans that show the extent of damage. Disability benefits are given only for severe spinal cord injuries. A disability claim for Parkinson’s Disease must include evidence showing the two symptoms of the condition, namely, rigidity; and bradykinesia or tremor in two extremities that create ongoing problems with the ability to stand, or movement gait.
Medical Vocational Allowance for Neurological Disability
If a claimant’s neurological impairment is severe, but does not meet a listing in the SSA’s Blue Book, he or she can apply for a Medical Vocational Allowance. This is an exception that enables claimants who don’t meet the Blue Book requirements to still be eligible for SSDI benefits. To get this allowance, claimants have to submit a form for a Residual Functional Capacity (RFC) evaluation that has to be filled out by the treating physician. The SSA will assess the RFC, the claimant’s age, work history, and skill set to find out if there is any kind of work the claimant can perform. Only if the SSA is convinced or determines that the claimant cannot work, will they approve the disability claim.
Symptoms of neurological problems are often sporadic, which makes it difficult for the treating doctor to document all symptoms as and when they occur. Since the patients cannot observe themselves when they are having an episode, it is vital that someone who witnessed the symptoms document their observations regarding the severity and extent of the episode. Moreover, as some neurological disorders are more difficult to diagnose and document than others, the SSA may take longer to process a disability claim. Claimants can consider having a social security disability attorney file their claim. The attorneys typically work with medical chart review companies that quickly review the medical records and extract the relevant medical evidence that the SSA requires. This helps the claim to be processed more quickly and successfully.
|Read our infographic on Neurological Disorders That Qualify For SSDI [Infographic]