What Conditions Qualify as a Disability?

Disabling Conditions

If you have suffered a serious condition that has left you disabled and unable to work, you may qualify for disability benefits. But going up against large insurance companies and getting through all the government red tape with Social Security is complex and difficult to prevail without the right legal team representing you.

With more than 30 years focused exclusively on disability benefits law, we have significant experience with a wide range of disability cases involving insurance companies, Social Security and often both. We’ve helped tens of thousands of clients with various disabling conditions and have vast understanding of what Social Security and insurance carriers consider disabling and how to best secure disability benefits.

Disability insurance companies are not focused on your best interest and Social Security staff although well-meaning, do not have the time or ability to provide thorough, individualized assistance. OPR Disability Law is 100% committed to our clients’ best interests and we have the largest staff of all Arizona Disability Attorneys to support you. Our entire law firm is dedicated to fighting for disability insurance benefits.

While this list does not include all disabling conditions, it covers some of the most common. We do strive to continuously add helpful information about more conditions. If you’re unable to work and don’t see the condition that is disabling you listed here.

What Are Gastrointestinal (GI) Disorders?

Gastrointestinal (GI) disorders refer to diseases involving the GI tract. This includes the esophagus, stomach, small intestine, large intestine, and rectum, as well as the accessory organs of digestion such as the liver, gallbladder, and pancreas. GI disorders include conditions such as Irritable Bowel Syndrome (IBS), Crohn’s Disease, Gastroesophageal Reflux Disease (GERD), Celiac Disease, Gallstones, Pancreatitis, Gastroparesis, Liver Diseases (Cirrhosis, Hepatitis, etc.), Ulcerative Colitis (UC), Diverticulitis, Anal Fissures, Perianal Abscesses, and Colon Cancer. Symptoms can include diarrhea, nausea/vomiting, constipation, bloating, abdominal pain, weight loss, anemia, fatigue, and rectal bleeding. While some GI disorders can be managed with medication or dietary changes, others may be resistant to treatment, highly symptomatic, or result in surgical intervention. Some GI disorders are temporary, while others are life-long.

When Do/Does GI Disorders Become Disabling?

A GI disorder can result in a disability when it interferes with your ability to perform your job duties. If you can answer “yes” to any of the following questions, you may have a disabling GI disorder, potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Do you need frequent restroom breaks?
  • Are there times when you urgently need to use the restroom at a moment’s notice?
  • Do you experience involuntary weight loss or malnutrition?
  • Do you experience bowel incontinence (i.e. accidents)?
  • Do you have frequent complications or flare-ups from your GI disorder?
  • Have you had multiple surgeries but continue to experience ongoing symptoms or problems?
  • Does your diagnostic imaging or other testing reveal active GI disease despite treatment?
  • Do you experience significant fatigue or weakness secondary to your GI disorder?
  • Does your GI disorder result in severe pain or discomfort?
  • Do you miss work because of your GI issues?

What Do Social Security and Insurance Companies Consider In Finding Disability Based on GI Disorders?

Proving disability under an insurance policy is highly dependent on the policy language, but generally, insurance companies look to whether your complaints of symptoms are credible. They do this by examining the medical evidence and comparing your reported functionality to the medical records. As with the majority of Social Security disability cases, objective medical evidence is key to the potential success of your claim under the regulatory requirements for Social Security Disability Insurance (or “SSDI”). Certainly, objective medical evidence helps the potential success of a private disability claim. Routine treatment with a specialist and diagnostic testing (such as colonoscopies or abdominal angiograms) can constitute objective medical evidence. Depending on the severity of your GI disorders, you may even meet what is referred to as a Social Security “listing.” Contact our Firm to learn more about whether your GI disorder qualifies you for disability benefits. We are here to help.

What Else Should I Know When Seeking Disability Benefits for GI Disorders?

Oftentimes, GI disorders result in your inability to work consistently because symptoms are unpredictable. For example, if you have Crohn’s Disease, you cannot predict your pain levels or the bathroom breaks you might need in any given day. Insurance companies may try to evaluate whether you are disabled based on a single day of functionality instead of evaluating you as a “whole person” and your ability to consistently work on a routine basis over a period of time. Carefully documenting your symptoms by reporting those symptoms to your doctors and even keeping a journal can be used as helpful evidence of your disability.

Multiple Sclerosis (“MS”) is an autoimmune disease that attacks the central nervous system. MS can result in severe neurological impairments, which can cause an array of symptoms such as fatigue, weakness, impaired coordination and imbalance, numbness, tingling, pain, bladder and bowel dysfunction, vision problems, muscle spasticity, muscle spasms, problems with speech, difficulty swallowing, and cognitive deficits. With MS, a person’s immune cells attack and destroy otherwise healthy nerve sheathes (known as myelin) and nerve fibers. This process is called demyelination. The disease course of MS varies between each person. While some people with MS can work for many years, others quickly become incapacitated by it.

When Does MS Become Disabling?

MS can result in a disability when it interferes with your ability to perform your job duties or even routine daily activities. If you can answer “yes” to any of the following questions, you may have disabling MS, potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Have you had brain MRIs that show new or worsening lesions in the brain or spinal cord?
  • Have you developed optic neuritis?
  • Do you experience significant fatigue requiring frequent breaks and naps?
  • Do you experience cognitive dysfunction that is interfering with your job duties?
  • Do you have difficulty ambulating?
  • Do you utilize assistive devices to help with ambulation?
  • Do you experience difficulty with coordination and small movements?
  • Do you experience bladder or bowel incontinence?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On MS?

Objective medical evidence is paramount. Consequently, routine treatment with a neurologist will be almost essential to not only managing your condition, but also establishing the evidence of treatment you will need for a prevailing claim. Objective medical evidence, such as brain MRIs and lumbar punctures, is incident to treatment for this condition, and is generally necessary to confirm the diagnosis and prove the claim. Depending upon the severity of your symptoms, you may even meet what is referred to as a Social Security “listing,” if your symptoms include motor function difficulties in two extremities resulting in certain physical limitations. Contact our Firm to learn more about whether your MS qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for MS?

MS affects people in very different ways. Some people have cognitive decline, while others experience physical issues that become debilitating, such as an inability to maintain balance or use their extremities. Whatever the manifestation, many people with MS are able to work while managing their symptoms. Unfortunately, however, the disease’s progression can sometimes outpace treatment. We see insurance companies deny MS disability claims based on the “nothing’s changed” fallacy: Because you were working with MS for a period of time, you should be able to continue working with MS. But even absent new lesions, MS medications can stop working, or symptoms can develop or worsen due to exacerbating factors (such as stress). For this reason, it is important to document your changing, or worsening symptoms, and stay up-to-date on diagnostic testing.

MS can have a significantly negative impact on your work ability and your quality of life. We understand you are going through a difficult time. Our Firm can help with the disability process and ensure you have the evidence necessary to support your claim for benefits.

Degenerative Disc Disease (DDD) is a generic term referring to the deteriorative changes of the spine. It can result from an injury or it can be progressive in nature. It can involve the cervical (neck), thoracic (mid-back), and lumbar (lower back) sections of the spine. DDD and related disorders include osteoarthritis, disc herniation, spinal stenosis, radiculopathy/sciatica, scoliosis, and spondylolisthesis. Symptoms vary depending on the cause of the DDD, but they can include pain, decreased range of motion, muscle spasms, numbness, tingling, weakness, or sharp, radiating pain in your legs or arms if there is nerve root compromise (i.e. radiculopathy). Whether you work outdoors or at a desk, a bad back can inhibit your ability to perform work.

When Does DDD Become Disabling?

Degenerative disc disease is common, and it can cause significant symptoms limiting your ability to lift weights, stand, or walk, among other things. If you can answer “yes” to any of the following questions, you may have a disabling back condition, potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Do you have diagnostic imaging (MRI, CT Scan, or x-ray) or electromyography (EMG) testing demonstrating compromise of a nerve root?
  • Do you experience radiating pain, numbness, or weakness in your legs and/or arms secondary to DDD?
  • Do you have diagnostic imaging of your back noting “moderate-to-severe” or “severe” findings?
  • Do you experience back pain that is significant enough to interfere with your ability to work or conduct activities of daily living?
  • Has spinal surgery been recommended?
  • Has a spinal cord stimulator been recommended or do you currently have one implanted?
  • Have you undergone multiple failed back surgeries?
  • Do you routinely treat with an orthopedic physician, pain management practitioner, or neurologists for your DDD?
  • Have you exhausted multiple conservative treatment options for DDD, such as medications (opioids, NSAIDs, muscle relaxers, etc.), steroid injections, nerve blocks, physical therapy, chiropractic treatment, or a TENS unit?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On DDD?

Degenerative disc disease and its related disorders are commonly seen in both Social Security disability and long-term disability practices. Routine treatment with primary care physicians, orthopedic physicians, pain management practitioners, neurologists, and others, may be necessary to properly manage the condition and provide the requisite proof of disability you will need if you intend to file for Social Security disability or long-term disability benefits. In both types of cases, consistent treatment with a specialist is oftentimes important to prove the severity of the condition. Insurance carriers and the Social Security Administration may also employ consulting physicians to review your medical evidence to try to discern whether you are capable of working. They will compare your statements regarding your physical limitations to the medical evidence. For that reason, regular, consistent treatment is essential to the establishment of disability. Contact our Firm to learn more about whether your degenerative disc disease qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for DDD?

Insurance companies and the Social Security Administration are likely to seize upon the neurological aspects of this disease. Lumbar radiculopathy can manifest in several ways, such as shooting pains into the upper or lower extremities, weakness, numbness, or tingling. There are various clinical techniques treatment providers can utilize that will detect radiculopathy. This can also be confirmed on diagnostic imaging. What is also important to remember is that pain will impact different people in different ways. If you’re in pain, no matter the severity of your radiculopathy, there are numerous treatment modalities one can pursue that could illustrate to your insurance company or the Social Security Administration the severity of your condition.

Fibromyalgia is a chronic disorder typically characterized by widespread muscle pain and tenderness, but you may also experience fatigue, sleep disturbances, cognitive dysfunction, depression, and anxiety. It is a condition recognized by the American College of Rheumatology, American Medical Association, American College of Physicians, World Health Organization, and Social Security Administration, among other preeminent health organizations and entities. The precise cause of fibromyalgia is unknown, but research suggests it is related to problems with the central nervous system’s processing of pain. It manifests in many ways and can limit your ability to work or perform routine daily activities.

When Does FMS Become Disabling?

If you can answer “yes” to any of the following questions, you may have fibromyalgia, potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Do you have pain that is diffuse throughout your body?
  • Is the pain chronic, sharp, or severe?
  • Do you have a combination of fatigue, difficulty sleeping, mental fogginess, depression or anxiety?
  • Do you suffer from mood swings or nervousness?
  • Do you experience muscle stiffness or soreness?
  • Do you have non-restorative sleep?
  • Do you have frequent, severe headaches?
  • Do you have numbness and/or tingling in your extremities?
  • Have you ever had treatment with a rheumatologist?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On Fibromyalgia?

Fibromyalgia is also not amenable to easy verification using standard laboratory testing or diagnostic studies. X-rays, blood work, and other tests cannot confirm the existence of fibromyalgia. In fact, a patient with fibromyalgia will often present with normal test results. While this can prove difficult in a disability case, experienced legal practitioners understand how to interpret the clinical signs that can corroborate your reported symptoms. Treatment with a specializing rheumatologist may be necessary not just to manage the condition, but to provide the requisite proof of ongoing functional limitations you will need in your disability case. As with mental health disorders (discussed in some detail below), some long-term disability policies include provisions limiting the payment of benefits for disabilities primarily resulting from fibromyalgia. Importantly, however, fibromyalgia may only represent a small part of your overall clinical picture, and there may be other impairments that contribute to your inability to work. Contact our Firm to learn more about whether your fibromyalgia qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for FMS?

Fibromyalgia includes a wide range of symptoms that can be limiting in various ways. In a Social Security setting it is important to understand that specific symptoms need to be documented for the Agency to recognize your condition. That is one reason why treatment with the appropriate specialist is so important, if it is available. It is also incumbent upon you to know whether you suffer from other diseases or conditions that have overlapping symptoms. Some insurance policies restrict the length of time benefits will be paid for fibromyalgia, but sometimes an individual can have several conditions that mimic the effects of fibromyalgia.

Systemic Exertion Intolerance Disease (SEID), formerly known as Chronic Fatigue Syndrome, is a disease characterized by chronic, severe fatigue lasting for at least six months. The diagnosis also requires a concurrent symptom or symptoms, such as a cognitive impairment, joint pains, headaches, or tender lymph nodes, among others.

When Does SEID Become Disabling?

If you can answer “yes” to any of the following questions, you may have disabling SEID potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Did you experience significant fatigue over a period lasting at least six months?
  • Does the fatigue become worse with physical activity?
  • Do you also experience confusion or the inability to concentrate?
  • Do you routinely experience feelings of anxiety?
  • Do you suffer from joint or muscle aches?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On SEID?

To prevail on a claim for Social Security disability benefits, it is imperative to remember that the Social Security Administration will not recognize impairments without clinical signs or objective evidence to substantiate your reported symptoms. A diagnosis of SEID is not easily verifiable. Consequently, a physician may make the diagnosis after excluding other possible options. Moreover, a diagnosis like SEID might co-exist with other impairments that limit your functioning in various ways. Contact our Firm to learn more about whether your SEID qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for SEID?

It can be difficult to secure benefits on the basis of SEID alone because it is not easily verifiable or amenable to objective confirmation. The support of a treating physician can be very helpful in this type of case. If your treating doctor supports your application for disability benefits, having him provide a statement or complete an assessment form to corroborate your disability could prove essential to your case.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how a person feels, thinks, and behaves and can lead to a variety of emotional and physical problems. It may also cause difficulties in doing normal day-to-day activities, and in some cases, suicidal thoughts. Symptoms often include feelings of sadness, anger, irritability, frustration, loss of interest, sleep disturbances, lack of energy, changes in appetite, anxiety, slowed thinking, feelings of worthlessness, difficulty thinking and/or concentrating, frequent thoughts of death, and unexplained physical problems. Anxiety disorders cause feelings of intense, excessive, and persistent worry and fear about everyday situations. These feelings often interfere with daily activities, are difficult to control, are out of proportion to the actual danger, and can last a long time. Symptoms include feeling nervous or powerless; having a sense of impending danger, panic, or doom; fatigue; and trouble concentrating or thinking about anything other than the present worry. Psychotherapy and medication are the primary treatment options for Major Depressive Disorder (“MMD”) and Anxiety Disorder NOS, and Generalized Anxiety Disorder.

When Do Depression and Anxiety Become Disabling?

If you can answer “yes” to any of the following questions, you may have a disabling mental disorder potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Do you suffer from feelings of sadness, anger, irritability, frustration, loss of interest, sleep disturbances, lack of energy, changes in appetite, anxiety, slowed thinking, feelings of worthlessness, difficulty thinking and/or concentrating, frequent thoughts of death, and unexplained physical problems?
  • Do you experience feelings of intense, excessive, and persistent worry and fear about everyday situations?
  • Do you routinely experience mood swings or anger outbursts?
  • Have you treated with a psychologist or psychiatrist?
  • Have you ever received inpatient psychiatric treatment at a hospital or other facility?
  • Have you had strained personal relationships inside and outside of the workplace?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On Depression and Anxiety?

Mental health concerns can impair an individual’s ability to function just as easily and just as severely as any physical condition. There are numerous mental health disorders that can cause debilitating symptoms, but a few of the more common are depressive disorders and anxiety disorders. While many long-term disability policies include provisions limiting the payment of benefits for disabilities primarily resulting from mental or nervous disorders, there is no such limitation in the Social Security disability program. Medications or behavioral therapy may be necessary to treat these disorders. Specifically, treatment with a specializing psychiatrist or psychologist might be necessary to manage your condition and to provide the requisite proof of treatment in a disability claim. Notably, depression and anxiety can also be worsened in cases of severe physical impairments. In both long-term and Social Security disability cases, the consulting physician is supposed to review all impairments to determine the sum total of your functional limitations. Contact our Firm to learn more about whether your depression or anxiety qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for Mental Health?

While many insurance companies include limitations in their policies on the amount of benefits they will pay out for these conditions, it is important to understand that mental health is sometimes only part of the overall picture. In a disability case, an experienced attorney can use your clinical and diagnostic evidence to illustrate that your limitations come from multiple sources. In a Social Security disability case, there is no limitation on mental health disability benefits. In either case, adherence to your medication regimen is essential.

Cardiomyopathy is a disease of the heart muscle in which it becomes enlarged, thick, or rigid. It causes the heart to become weaker and less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure or irregular heartbeats called arrhythmias. Symptoms of cardiomyopathy and related disorders can include loss of breath, swelling in the extremities, fatigue, bloating, and abnormal heart rhythm. Treatment options can range from medications (such as blood thinners, ACE inhibitors, or Beta blockers) to surgical intervention or pacemaker implantation.

A myocardial infarction, also known as a heart attack, occurs when a thrombus, or blood clot, blocks the flow of blood to the heart. Treatment options can vary depending on the severity of the attack, but they can include medications, stent placements, and bypass surgery. Though heart attacks are acute events, they can have residual effects that last for much longer.

A cerebrovascular accident, commonly known as a stroke, occurs when blood flow to the brain is interrupted by a blockage or an artery rupture. Treatment can include anti-coagulant medications and rehabilitation involving physical and speech therapy. The recovery process can be lengthy and intensive, and sometimes a full recovery to your prior activity level is not really attainable.

Individuals with these types of cardiac impairments will often establish with cardiologists (and in the case of a stroke, a neurologist) for ongoing treatment, depending upon the severity of the condition. Again, routine treatment with a specialist physician, if warranted, is oftentimes necessary to manage your condition and to establish the requisite proof in a Social Security disability and long-term disability context.

When Do Cardiac Conditions Become Disabling?

If you can answer “yes” to any of the following questions, you may have a disabling cardiac condition:

  • Do you experience loss of breath, swelling in the extremities, fatigue, bloating, and abnormal heart rhythm?
  • Have you ever been hospitalized for a reason related to your cardiac impairments?
  • Have you ever treated with a cardiologist?
  • Have you ever experienced intense, clutching chest pain?
  • Have you ever experienced chest pain with discomfort or tightness in the arms or neck?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On Cardiac Impairments?

Individuals with cardiac impairments will often establish with cardiologists for ongoing treatment, depending upon the severity of the condition. In the case of a stroke, a neurologist will also be involved. Again, routine treatment with a specialist physician, if warranted, is oftentimes necessary to manage your condition and establish the requisite proof in a Social Security disability and long-term disability context. Contact our Firm to learn more about whether your cardiac impairments qualify you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for Cardiac Impairments?

In any disability case, you need to be able to show not just what you have been diagnosed with, but what your limitations are. Social Security disability and long-term disability determinations are about limitations, more so than diagnoses. For instance, while shortness of breath with physical exercise may not impact you much if you do not have a physical job, there are other symptoms such as fatigue, swelling, dizziness, and chest pain that could limit your ability to perform even a sedentary job. If you suffered from a cerebrovascular accident, there may also be cognitive difficulties which will preclude you from performing full-time work. The key is understanding your impairment and how it limits you.

A traumatic brain injury, or “TBI,” is caused by sudden trauma to the brain causing focal or diffuse damage. Ongoing disabilities resulting from a TBI include problems with thinking, memory, and reasoning (i.e., cognition); sight, hearing, touch, taste, and smell (i.e., sensory processing), communication (expression and understanding), and behavioral or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness). Many patients with a severe TBI suffer from cognitive disabilities, including the loss of many higher-level mental skills including functions such as planning, organizing, abstract reasoning, problem solving, and making judgments. Recovery from cognitive deficits is greatest within the first six months after the TBI and more gradual after that.

Therapy is the primary treatment for a TBI. It can include physical, occupational, and speech-language rehabilitation. Neuropsychiatric evaluations are helpful in assisting to identify cognitive deficits and appropriate means of care. Although there is no medication specifically for a TBI, many patients are prescribed psycho-stimulants, antidepressants, anti-parkinsonian drugs, anticonvulsants, and other medications for their symptoms.

When Do TBIs Become Disabling?

Ongoing disabilities resulting from a TBI include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavioral or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness). Most patients with a severe TBI suffer from cognitive disabilities, including the loss of many higher level mental skills including executive functions such as planning, organizing, abstract reasoning, problem solving, and making judgments, “which may make it difficult to resume pre-injury work-related activities.” Recovery from cognitive deficits is greatest within the first six months after the TBI and more gradual after that.

What Do Social Security and Insurance Companies Consider In Finding Disability Based On TBIs?

The Social Security Administration, as well as any long-term disability insurance carrier, will consider the various physical, mental, and cognitive limitations that resulted from the injury. An individual’s limitations are often illustrated through his course of treatment. Therapy is the primary treatment for a TBI with the purpose of improving the patient’s ability to function at home and in society. This includes physical, occupational, and speech-language rehabilitation. Neuropsychiatric evaluations are helpful in assisting to identify cognitive deficits and appropriate means of care. Although there is no medication specifically for a TBI, many patients are prescribed other types of medication to address their symptoms. Contact our Firm to learn more about whether your TBI qualifies you for disability benefits.

What Else Should I Know When Seeking Disability Benefits for TBIs?

Establishing your cognitive difficulties with objective testing is important. This type of testing can sometimes be covered by your medical insurance. In a Social Security disability case, the Agency itself may pay for testing to be performed. Recovering from these types of injuries can also be a long, arduous process. Establishing your limitations via psychometric testing can help prove how your cognitive difficulties impair your ability to perform your job.

Otological disorders refer to hearing and balance disorders stemming from a dysfunction of the ear. This includes Sensorineural Hearing Loss (SNHL), Autoimmune Inner Ear Disease (AIED), Meniere’s Disease, Benign Paroxysmal Positional Vertigo (BPPV), Vestibulopathy, Tinnitis, Acoustic Neuroma, Barotrauma, Cogan’s Syndrome, Congenital Deafness, and Otosclerosis. The cause of otological disorders varies from congenial, immune diseases, trauma/injury, and environmental causes. Regardless of the reason, otological disorders can be disabling.

When Do Otological Disorders Become Disabling?

If you can answer “yes” to any of the following questions, you may have a disabling otological potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Do you have frequent bouts of balance disturbance (vertigo)?
  • Have you had abnormal/positive findings on vestibular testing?
  • Is your hearing loss significant even with a hearing aid and established by audiometry or other testing?
  • Does your hearing loss/tinnitus affect your ability to effectively follow a conversation?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On Otological Disorders?

Again, establishing your limitations through diagnostic testing is key. The Social Security Administration may schedule and pay for this type of testing. If you are applying for LTD benefits, then your medical coverage will also likely pay for this testing. Be mindful that a disability case based upon otological disorders can involve balancing difficulties as well as hearing loss. A case about otological disorders is not necessarily a case about hearing loss. *Insert LTD blurb.

What Else Should I Know When Seeking Disability Benefits for Otological Disorders?

The ability to hear and understand verbal speech is essential for daily interaction. It is easy to understand, therefore, why a significant impairment in this ability could preclude you from working. If you have had an injury resulting in significant hearing loss, or you have a deteriorative condition that has caused you difficulties, consult with a physician regarding the appropriate testing. This will be necessary for establishing your disability based on an otological disorder.

Ophthalmic disorders are abnormalities of the eye, the optic nerve, the optic tracts, or the brain that may cause a loss of visual acuity or visual fields. Ophthalmic disorders include Blindness, Age-Related Macular Degeneration, Cataracts, Macular Edema, Glaucoma, Retinal Detachment, and Uveitis. Symptoms range from vision loss, blurred vision, scotoma, floaters, swelling, pressure, and pain. Many ophthalmic diseases are temporary and resolve with treatment or surgery; however, others are persistent.

When Do Ophthalmic Disorders Become Disabling?

If you can answer “yes” to any of the following questions, you may have a disabling ophthalmic disorder potentially entitling you to disability benefits under your private policy or from the Social Security Administration:

  • Does your loss of visual acuity with the use of corrective lens significantly limit your ability to distinguish detail, read, or do fine work?
  • Does your loss of visual fields significantly limit your ability to perceive visual stimuli in your peripheral vision?
  • Do you have balance or safety issues resulting from your inability to see?
  • Have you had recurrent ophthalmic conditions requiring multiple surgeries?
  • Do you experience severe eye pain, pressure, or swelling on a regular basis?
  • Do you experience headaches or eye fatigue on a regular basis?

What Do Social Security and Insurance Companies Consider In Finding Disability Based On Opthalmic Disorders?

The Social Security Administration may schedule and pay for testing necessary to establish these conditions. Visual acuity and visual fields testing may be necessary to explain your visual problems. Statutory blindness (defined as central visual acute of 20/200 or less in the better eye after use of a corrective lense) is a basis for a finding of disability under the Social Security “listings.”

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