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Polymyalgia Rheumatica and Social Security Disability benefits

Polymyalgia rheumatica is a condition which causes claimants to suffer stiffness and muscle pain in their shoulders, hips, thighs and neck. Symptoms may come and go and are most prevalent in individuals who are over the age of 50. Women are also twice as likely as men to experience this condition.

The medical community is unsure of what causes this condition, although it is suspected to be caused by a disruption in a person’s immune system or due to other causes such as chemical imbalances, infection, genetics, or physical trauma. It is estimated that as many as 1.9 million adults in the United States may be suffering from this condition.

Doctors generally attempt to control the symptoms of polymyalgia rheumatica through anti-inflammatory drugs or corticosteroids, although these medications can have severe side-effects.

Common symptoms of polymyalgia rheumatica

• Pain in the individual’s shoulders
• Pain in the individual’s buttocks, hips, lower back and neck
• Upper arm tenderness
• Limited range of motion in the shoulders, hips, neck and lower back
• Stiffness after prolonged inactivity
• Fatigue and exhaustion
• Low grade fever
• Depression
• Unexpected weight loss
• Anemia

Winning Disability benefits for Polymyalgia Rheumatica

The first course of action, if you have this condition, is to get the proper medical tests. Tests can include laboratory tests, a physical examination and a detailed medical and family history. This information will be needed to differentiate your diagnosis from other conditions such as fibromyalgia.

Meeting a Listing for a Disabling Health Condition

The Social Security Administration has two methods they use to determine if a claimant is disabled and unable to work. First, they will evaluate the claimant’s condition and determine if it “meets or equals a listing” on their SSA Medical Listing of Impairments (also known as the Blue Book).

If the claimant’s condition is not listed or does not meet a listing in the Blue Book, the SSA will determine how much residual capacity the claimant has to perform substantial gainful activity. This is done through the medical vocational allowance process.

There is not a listing specifically for polymyalgia rheumatica, although it may be possible to prove that your condition equals in severity another condition, i.e. rheumatoid arthritis, which is evaluated under Listing 14.00 Immune System Disorders.

Winning benefits for Polymyalgia Rheumatica through a Medical Vocational Allowance

If your condition does not meet in severity a condition in the SSA Blue Book, the Social Security Administration will review your residual functional capacity (RFC) to work and determine if you should be awarded benefits through a medical vocational allowance.

So how will the SSA make their disability determination? They will evaluate your ability to perform work-related tasks despite your polymyalgia rheumatica and the related symptoms.

The Social Security Administration will first determine if you have the residual functional capacity to perform heavy, medium, light or sedentary work. Proving that you cannot work will entail providing medical evidence that your condition causes severe limitations to perform work. For instance:

• Your condition causes extreme weakness and fatigue
• Your condition causes severe side effects to your medication
• You will need frequent and extended breaks: standing up and walking around or having to lie down
• You will need to see your doctor too frequently to maintain a normal work schedule
• You have severe limitations to lift, pull or reach
• You have the inability to ambulate effectively
• You have severe limitations to use your hands, arms and fingers

If the Social Security Administration determines that you do not have the residual functional capacity to work (given your age, medical condition, work history, or education level) they will award you either SSDI or SSI benefits, assuming you meet the nonmedical criteria of either the Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) program