Neurontin (Gabapentin) is often prescribed by doctors for nerve pain associated with neuropathy. Pregabalin (Lyrica) is also prescribed for this purpose. Neuropathy is commonly caused by diabetes. This is because high blood sugar levels can result in damage to the nervous system over time. In addition to pain, neuropathy can cause a burning, tingling sensation. It can also result in a loss of functional capacity. It can limit someone’s ability to stand and walk. It can also affect the hands, causing a loss of gross and fine motor coordination, our Indiana social security attorney explains.
These symptoms can be disabling. Someone should be considered disabled if they have neuropathy which results in an extreme limitation in the ability to stand up from a seated position, balance while standing and walking, or use the upper extremities. Individuals over 50 years old with a severe case of diabetic neuropathy are also likely to be considered disabled. If such an individual can no longer stand or walk for the majority of the workday and is unable to perform his or her past work, this person is very like to be approved for disability benefits.
In evaluating a case like this, Social Security will also consider whether this person has the skills to perform a sedentary job, like a position working on a computer in an office. However, it’s possible that the side effects of a medication like Lyrica or Gabapentin may prevent someone from performing skilled work. For example, memory problems, difficulty concentrating, or sleepiness may make someone unable to perform the detailed, complex tasks generally associated with skilled sedentary work. If the side effects of a medication prescribed for a severe impairment make someone unable to sustain a full-time work schedule, this can be disabling, as well.
Other Side Effects With Day-to-Day Work Life
Hand-use problems can also limit someone’s ability to perform sedentary work. Most sedentary positions involve significant use of the hands and many involve computer keyboard usage throughout the day. If neuropathy prevents someone from efficiently typing or otherwise using the hands extensively, this person may not be able to perform many sedentary jobs.
Even if neuropathy is someone’s primary disabling impairment, Social Security will still consider the combined effects of all of someone’s impairments when evaluating a claim for disability. This is important in a diabetic neuropathy case. Diabetes can affect numerous body systems. It can result in retinopathy and vision loss. Even if the vision loss doesn’t render someone “legally blind,” Social Security should still evaluate how someone’s visual limitations affect their ability to work. Vision loss can create safety concerns and can also make someone unable to focus on something like a computer screen.
Diabetes can also cause kidney disease. This can put someone in a position where they experience fatigue and malaise which may make them unable to work a full-time schedule. It can also interrupt the work day by requiring frequent trips to the restroom. If the kidney disease necessitates dialysis or a kidney transplant, these are clear-cut cases of disability.
In other cases, Social Security will review a claimant’s laboratory results to assess their kidney function. If these results show significant compromise and satisfy certain metrics, this person can be considered disabled if they also suffer from peripheral neuropathy.
If chronic kidney disease requires three hospitalizations in a year, each of which last at least 48 hours and are at least 30 days apart, the person who was hospitalized should be considered disabled. This person would meet Social Security’s Listing 6.09. Meeting a listing means a Social Security claimant is considered presumptively disabled. However, someone can also be found disabled if they equal a listing. A combination of impairments can equal a listing for a specific impairment.
For example, say someone with diabetes is hospitalized for three days in January for complications of chronic kidney disease. Then, in April, this person is hospitalized for 48 hours with an episode of diabetic ketoacidosis. (This happens when diabetes causes a dangerous chemical imbalance in the body.) Later, in September, this diabetic person develops a foot infection that requires a four-day hospitalization.
This person should be found to equal Listing 6.09 because their diabetes has required hospitalization consistent with the extent contemplated by Listing 6.09 for chronic kidney disease, even though all of the hospitalizations were not directly related to the kidneys. If, instead of a foot infection, someone with neuropathy in the legs was hospitalized for over 48 hours after suffering a fall, I would also argue that this person equals this listing.
This might be a tougher sell (after all, a fall could happen to anyone), but if it’s clear that the person has diabetic neuropathy which causes balance problems, this would seem to be a reasonable case of someone with a combination of impairments equaling a listing.
If you suffer from diabetic nerve pain, you should work with your doctor on optimizing your medication regimen to find the best balance for maximizing pain relief and minimizing side effects. Hopefully, your doctor can help you with a prescription that allows you to continue to effectively carry out Activities of Daily Living, or ADLs. These are tasks like grocery shopping, cleaning the house, cooking a meal, laundering clothes, washing dishes, and driving.
When an Administrative Law Judge conducts a hearing in a Social Security case, the judge will usually question a claimant about ADLs. The listing for peripheral neuropathy provides that if someone has a “marked,” or particularly extreme limitation in physical functioning and a “marked” limitation in either understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; or adapting or managing oneself, that person should meet the listing and be considered disabled. Therefore, a consideration of the limitations someone has in carrying out ADLs would seemingly be very relevant to this listing.
If you have applied or are considering applying for disability, it’s very likely that your case will go to a hearing like this with an Administrative Law Judge. Keller & Keller’s attorneys can help prepare your case for this hearing so that your case is presented as effectively and persuasively as possible. Please feel free to contact us to discuss this.