¦ April 9, 2013
Important information for people with spinal cord injuries
Applying for Social Security Disability with paralysis

By Ram Meyyappan, www.socialsecurity-disability.org 

Paralysis can result from various circumstances. It may be caused by an accident or injury or may be associated with a disease or disorder. Regardless of cause however, paralysis is always due to nerve damage, and dependent upon the extent of the paralysis and the area(s) of the body affected, you may qualify for Social Security Disability (SSD) benefits.

Qualifying for SSDwith Paralysis

As paralysis may be due to different causal factors, there are several listings in the Social Security Administration’s (SSA’s) Blue Book which can apply to an application for disability benefits with this condition. Following are just a few of the sections of the SSA’s Blue Book which may be applicable to your paralysis claim:

• Section 1.04 – Disorders of the Spine
• Section 11.00 – Spinal Cord or Nerve Root Lesions, due to any cause
• Section 11.09 – Multiple Sclerosis
• Section 13.13 – Malignant Neoplastic Diseases of the Nervous System
• Section 14.02 – Systemic Lupus Erythematosus

Meeting a ListedCondition with the SSA

The first step in the SSA’s review of your application is to see if it meets the listing criteria of a condition that appears in the Blue Book. For instance, if your application is to qualify under Section 1.04 –Disorders of the Spine, then the medical evidence in your file must show:

• A spinal cord injury, OR
• Other damage to the spinal cord, AND
• Compression of the nerve root which has led to loss of sensation and control in the affected area(s) of the body

If your application does not meet the listing for acondition in the Blue Book, it will next be reviewed by the SSA under the listings of similar conditions to see if it matches one of those conditions. In other words, if your paralysis is equal in severity to a listed condition, you may qualify for SSD based on the match.

Qualifying for SSD without matching or meeting a listed condition

If your application and medical records don’t meet or match a listed condition with the SSA, you may still qualify for disability benefits under a medical vocational allowance. In order to do so, your “residual functional capacity (RFC)” must be shown to be so severely impacted by your paralysis that it prevents you from getting and keeping a job or earning a gainful living. An RFC analysis reviews your ability to perform basic, everyday tasks, including typical job functions.

If your paralysis affects your legs, then your ability to perform jobs that require you to stand, walk, balance, stoop, kneel or crouch would be severely limited by your condition. If, on the other hand, your paralysis affects your arms or hands, then your ability to perform job duties that require the use of your hands and arms would be negated by your condition.

Medical Documentation and Your SSD Paralysis Application

Your application for disability benefits must contain substantial documentation supporting your claim, including thorough medical records showing the severity and duration of your paralysis. In addition to documenting the extent of your paralysis, your medical evidence must pinpoint a cause, including an organic reason for the nerve damage.

Regardless of the reason for your paralysis, your medical evidence should include records like:

• Imaging test results, like MRIs and CAT scans that show the compression of the nerve root or other damage to the spinal cord
• EMG results that document the failure of nerves in the affected region(s) to properly transmit impulses to the muscles
• Physical exam notes that document the lack of reflex responses in the affected body area(s)
• Lab reports and other diagnostic evaluations ruling out conditions that could cause similar symptoms, particularly those for which effective treatments exist
• Records of all the treatments that have been attempted to address your paralysis
• Evidence detailing the reason your paralysis cannot be corrected via surgical or other means

Whether your application meets or matches a listed condition with the SSA or must be evaluated under RFC for potential approval under a medical vocational allowance, your medical records are key components necessary for proving your disability. As such, they must be extensive and thorough.

You should additionally keep in mind that any evidence lacking in your SSD application may result in the SSA requiring an independent evaluation of your medical condition by a contacted physician. That evaluation is necessary in order to fill in the gaps in your records and to allow the SSA to make a determination on your eligibility.   

Getting Help with your disability application

Because there are many different conditions that can result in paralysis and because the extent or severity of your paralysis can also affect your eligibility for SSD, you may wish to seek assistance in applying for benefits and in collecting the necessary documentation for supporting your claim. A Social Security advocate or disability attorney can assist in these tasks. If your initial application for disability benefits is denied, an advocate or attorney can additionally assist in filing subsequent appeals.