According to the Mayo Clinic, "Polymyositis (pol-e-mi-o-SI-tis) is a persistent inflammatory muscle disease that causes weakness of the skeletal muscles, which control movement. Medically, polymyositis is classified as a chronic inflammatory myopathy — one of only three such diseases." Claimants suffering from polymyositis frequently experience muscle weakness, joint and muscle tenderness, fatigue, lack of breath and difficulty swallowing.
Claimants who have muscle weakness will generally experience it on both sides of their bodies. Polymyositis is progressive and will affect muscles primarily in the hips, thighs, upper arms, neck and shoulders.
Can I get SSDI for Polymyositis?
The Social Security Administration (SSA) has two methods for determining whether claimants are disabled and qualify for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI): winning benefits by meeting a listing on the SSA Listing of Impairments or winning benefits through a medical vocational allowance.
Winning SSDI for Polymyositis by meeting a listing on the SSA Listing of Impairments
The first way to win benefits, and the easiest, is to have a condition which "meets or succeeds" a listing in the SSA Listing of Impairments. This listing, also known as the Blue Book, is a listing of conditions and symptoms the SSA considers automatically disabling.
If your condition is on this list and you can prove you have the severity of the symptoms listed, assuming you meet the nonmedical requirements of SSDI (condition will last 12 months, you have enough work credits to be considered insured, and you are less than your full retirement age) you should be immediately approved for SSDI.
The good news is that polymyositis is listed in the Blue Book under 14.00 Immune System Disorders, Section 14.05 Polymyositis and Dermatomyositis. The bad news is that just having this diagnosis does not mean you will meet the listing. Under the listing there are very specific symptoms which must be present, and because this condition is progressive, if you have just been diagnosed with polymyositis it is likely your condition may not be as severe as the listing.
Winning SSDI for Polymyositis through a Medical Vocational Allowance
Many claimants with polymyositis may be denied because they do not have evidence that they are suffering from the symptoms listed in the SSA Blue Book. If you have been denied but your condition is severe you may simply need to go to the doctor and generate more medical evidence about the severity of your condition. Specifically, you need medical evidence which states your symptoms and how they are as severe as the symptoms on the listing.
If the SSA states that your condition does not meet a listing and they believe you can still work but you do not think you can, you will need to provide evidence to them to prove you are disabled because you do not have the ability to work and hopefully you can win benefits through a medical vocational allowance.
Unfortunately, if your condition does not meet a listing you are likely to be denied SSDI benefits at the application level. If you are denied, you will have 60 days from the date of your denial letter to file an appeal. Many disability applicants choose to talk to a disability lawyer if they are denied to have them file the appeal.
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