If you have myositis, you may be able to qualify for Social Security Disability benefits. Myositis can have severe symptoms that are disabling, including weakness, swelling, and muscle damage. Here is a closer look at applying for disability benefits with myositis.
What Is Myositis?
Myositis is often difficult to diagnose, and the doctor may perform muscle and skin biopsies, blood tests, perform physical exams, review the patient’s medical history, and perform other diagnostic testing. Myositis refers to disease involving chronic inflammation of the muscles, which often includes other symptoms. Myositis is also called idiopathic inflammatory myopathy (IIM).
There are various forms of myositis, including necrotizing myopathy (NM), dermatomyositis (DM), polymyositis (PM), sporadic inclusion body myositis (sIBM), and juvenile forms of myositis (JM). Myositis is an autoimmune disease, which means that the body’s immune system that usually fights off viruses and infections, becomes misdirected and starts attacking the body’s healthy tissue.
Anywhere from 50,000 to 75,000 people in the U.S. have myositis, which means that all forms of myositis are rare. The cause of the condition is unknown, but research has led experts to believe that some individuals have a genetic predisposition to have an autoimmune disease.
How To Medically Qualify For Social Security Disability Benefits With Myositis
The SSA uses a medical guide, which is called the Blue Book. If you can meet the criteria of a listing in the Blue Book, your claim would be approved. Dermatomyositis and polymyositis can qualify for disability benefits through the Blue Book. The listing covering polymyositis and dermatomyositis is Listing 14.05. To qualify per the listing, the following must apply:
A. Proximal limb-girdle (pelvic or shoulder) muscle weakness and medical documentation of at least one of the following:
- A documented medical need for a walker, bilateral canes, or bilateral crutches or a wheeled and seated mobility device involving the use of both hands; or
- An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements, and a documented medical need for a one-handed, hand-held assistive device that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand, or
- An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete work-related activities involving fine and gross movements;
OR
B. Impaired swallowing (dysphagia) with aspiration due to muscle weakness.
OR
C. Impaired respiration due to intercostal and diaphragmatic muscle weakness.
OR
D. Diffuse calcinosis with limitation of joint mobility or intestinal motility.
OR
E. Repeated manifestations of polymyositis or dermatomyositis, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:
1. Limitation of activities of daily living.
2. Limitation in maintaining social functioning.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
How To Qualify If You Don’t Meet A Listing
If your myositis does not meet the criteria of a Blue Book listing, you can still qualify for disability through a medical vocational allowance. That approach takes your age, work history, medical issues, educational background, transferrable skills, and other factors into consideration.
Your physician can complete a residual functional capacity (RFC) form, which details your restrictions and limitations. An RFC form for disability presents a clear picture of what you can and cannot do.
Starting The Application
You can start the application process online or by calling 1-800-772-1213 and speaking with a representative. If you need help filing for disability you can schedule an in-person appointment at your local SSA field office. You will need to complete the application in detail and provide supporting documentation, including hard medical evidence.
Resources Found Via:
- https://www.ssa.gov/benefits/disability/
- https://www.myositis.org/about-myositis/
- https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm#14_05
- https://www.disabilitybenefitscenter.org/how-to/how-to-file-the-residual-functional-capacity-rfc-form
- https://www.ssa.gov/applyfordisability/
- https://www.disabilitybenefitscenter.org/blog/help-apply-for-benefits
So, sIBM is not listed in the “Blue Book”? How do those patients qualify if not recognized?