Lymphedema is a condition that causes swelling in one or more parts of the body, usually the arm(s) and/or leg(s). While it can be hereditary (primary lymphedema), it most commonly occurs as a side effect to cancer treatment or an infection of the lymph nodes (secondary lymphedema). Lymphedema can range in intensity from mild to severe. But is it severe enough to qualify for Social Security Disability (SSD) benefits? Here’s what you should know about lymphedema and SSD benefits before you apply.
Lymphedema as a Disabling Condition
The Social Security Disability blue book contains more than 100 medical conditions, each with their own set of criteria that must be met to be considered disabled for SSD purposes. In addition to meeting the listing criteria, the disability must either last, or be expected to last 12 months, or result in death. Because lymphedema does not always meet either of these criteria, it is not considered disabling enough to have its own listing in the SSA’s blue book.
But that doesn’t mean an individual who suffers from lymphedema is ineligible for SSD benefits. Instead, they may be eligible if they meet the blue book criteria for another disabling condition, or if they qualify for a medical vocational allowance.
Other disabling conditions
To qualify for SSD benefits on the basis of another listing, your medical record must show that your lymphedema meets or exceeds the criteria for another disabling condition. Symptoms of lymphedema may include one or more of the following:
- Swelling of either all or a portion of the arm or leg, including fingers or toes;
- Feeling of heaviness or tightness;
- Restricted range of motion;
- Aches or discomfort;
- Recurring infections, and;
- Fibrosis (hardening and thickening of the skin)
Two listings in the SSA’s blue book have similar symptoms that may allow an applicant suffering from lymphedema to qualify for benefits.
If the lymphedema severely impairs your ability to use your arms or legs, you may qualify for SSD under listing 1.02, Major Dysfunction of a Joint, which includes chronic joint pain and stiffness with either limitation of motion or abnormal motion as one of its criteria.
If the lymphedema causes swelling in at least two-thirds or one or both legs, you may qualify for SSD under listing 4.11, Chronic Venous Insufficiency.
If your lymphedema is a side effect of cancer treatment, you may qualify for SSD under the listing for your specific type of cancer.
Medical Vocational Allowance
If your symptoms do not meet any of the listings in the SSA blue book, you may be able to obtain a medical vocational allowance if your medical records and work history for the prior 15 years show that you are:
- Unable to return to work, either in the position you held immediately prior to becoming disabled, or any position held in the prior 15 years, and;
- Unable to perform any other work based on your job skills, age, educational level and residual functional capacity (what you can do despite the limitations imposed by the lymphedema).
Limitations that affect your ability to work may be physical or mental. Physical limitations include impairment to your ability to walk, stand or sit, reductions in the amount of weight you can lift or carry, and limitations in your ability to reach or bend. Mental limitations may include impaired ability to pay attention or concentrate, perhaps due to pain or discomfort associated with the lymphedema.
Once the disability examiner (the SSA official who reviews your benefits application) reviews your medical and work history, he will complete the residual functional capacity assessment or RFC. The RFC lists all the limitations caused by the lymphedema. He will then use the RFC to determine whether you can perform the tasks required of any of the jobs you held in the 15 years prior to applying for benefits. If the answer is yes, the application will be denied.
If, however, the answer is no, the disability examiner will then determine whether you could perform any job, taking into consideration your age, education, work history and functional limitations. If the disability examiner (or an administrative law judge, if your application is decided on appeal) determines that given your age, education, work skills and functional limits prevent you from doing any type of work, your application for SSD benefits will be approved.
You can increase the chances that you will be granted a medical vocational allowance by getting your physician or specialist to complete a medical source statement, which requests information on the lymphedema’s impact on your ability to work, in addition to submitting all medical notes, imaging, and other medical records that support your lymphedema diagnosis.
Do you need to apply for SSD benefits or have you been denied your application for benefits? Consider the Law Office of Neil H. Good for your representation. Call #866-352-5238 or complete our online evaluation form here.