Neuropathy can class as a disability if a person meets certain criteria that the Social Security Administration (SSA) sets. These relate to symptoms that indicate disorganized motor functions or marked physical and mental functioning limitations.
Specifically, the disorganized motor function must be present in two extremities, such as the arms and legs. These symptoms may manifest as an inability to stand up or as balance issues when walking. Also, “marked” in this context refers to serious impairment in performing work-related activities, such as interacting with colleagues.
To apply for benefits, people must submit records that include symptoms, the condition’s progression, and results of diagnostic tests, such as imaging and nerve biopsies. They must also provide a treatment record that includes medications, nonmedication interventions, physical therapy, and assistive devices.
Keep reading to learn the criteria for neuropathy as a disability, the diagnostic and treatment evidence necessary to provide proof, and tips for applying.
Peripheral neuropathy can vary from mild to severe and stem from various causes, such as diabetes and trauma. To understand how it can be a disability, it helps to know how the condition affects the body.
The peripheral nervous system involves the nerves that send and receive messages to and from the central nervous system. The central nervous system comprises the brain and spinal cord.
- motor nerves, which control muscle movement
- sensory nerves, which transmit feelings of touch, temperature, and pain
- autonomic nerves, which control involuntary functions, such as breathing, digestion, and heart function
Symptoms of neuropathy depend on which nerves the condition affects. Below is more information on which symptoms affect which nerves:
- Motor nerves: The most common symptom of motor nerve involvement is weakness. Others may include:
- painful muscle cramps
- muscle twitching
- muscle shrinking
- Sensory nerves: Damage to sensory nerves may cause pain and the loss of:
- the sense of touch
- Autonomic nerves: Harm to autonomic nerves may result in:
- swallowing problems
- gastrointestinal problems
- heat intolerance
When neuropathy becomes severe, it may lead to limitations in muscle function that prevent standing and walking. It may also manifest in limitations that interfere with remembering information or interacting with colleagues. When either of these symptoms occurs, it can be a disability because it hinders a person’s ability to work.
The SSA has a Blue Book that lists the criteria necessary for someone to qualify for any disability. Formerly, this reference was a print publication with a blue cover, but it is now available only online. It lists the requirements for peripheral neuropathy under section 11.14.
Proving that neuropathy is a disability involves providing evidence that shows a person has met one of two criteria. One criterion entails having an impairment of the motor function of two extremities, which refers to the arms and legs. The impairment must result in an extreme limitation in any of the below:
- balancing when standing or walking
- standing up from a seated position
- using the upper extremities — the arms and hands — which seriously hinders the ability to perform work-related tasks
The other criterion entails having impairments in physical functioning that present as a marked, or obvious, limitation in any of the following:
- Persisting, concentrating, or maintaining pace: This mental function denotes the ability to focus on a task, work on it with a consistent pace, and complete it in a timely manner.
- Remembering, understanding, and applying information: This refers to a person’s ability to recall, learn, and use information when performing their job duties. It includes problem-solving and recognizing and correcting mistakes.
- Adapting or managing oneself: This involves managing emotions and controlling behavior. Related abilities include setting realistic goals and maintaining personal hygiene.
- Interacting with others: This means someone can work with supervisors, coworkers, and the public. For example, they ask for help when necessary and have the skill to handle conflicts with others.
A neuropathy diagnosis has to come from a medical source, such as a hospital or clinic. When a suitable source has established a diagnosis, a person can use nonmedical sources to provide evidence of disease severity.
Nonmedical evidence can come from:
- the claimant
- family members
- educational personal
- social welfare personnel
In addition to diagnosis and treatment, someone must show that their neuropathy has caused them to miss work for 12 consecutive months.
The specific evidence relating to a person’s diagnosis may involve records of their symptoms and the condition’s progression. It also may consider the results of physical examinations, including:
- nerve biopsy to determine the type of nerve damage
- electrodiagnostic testing, such as nerve conduction velocity and electromyography tests, which evaluate muscles and the nerves controlling them
- autonomic testing, such as blood pressure and heart rate monitoring
- quantitative sensory functioning to evaluate the damage to nerve endings
- imaging, such as MRIs and CT scans, to rule out tumors or compressions
The records should also document any physical limitations within the Blue Book, such as difficulties with standing or balancing.
Evidence of treatment should include a record of:
- nonmedication treatments
- physical therapy or other therapies
- the use of splints, casts, and assistive devices, such as wheelchairs
Some tips for applying for disability under neuropathy include:
- Getting up-to-date medical tests: Because neuropathy can increase in severity over time, a person needs to make sure that nerve tests, muscle function tests, and scans are current. If someone’s tests date back to a time before their condition has progressed to its current state, they will not adequately reflect the disability.
- Getting a residual functional capacity (RFC) test: The RFC test assesses a person’s ability to perform typical daily activities, such as lifting, reaching, and standing. Any licensed doctor can conduct it.
- Collecting evidence of the inability to work: This may include documents, such as work history and testimonies from former managers.
The SSA considers neuropathy a disability if the condition is severe enough to cause extreme limitations in the motor function of two extremities. Alternatively, it qualifies as a disability if it results in marked limitations in mental and behavioral work-related skills.
The evidence of disability can come from medical sources, such as clinics, and nonmedical sources, such as employers.
Before applying, experts recommend getting up-to-date medical tests that indicate the current state of a person’s condition. They also advise having an RFC test and collecting evidence of the inability to work, such as former manager testimonies.