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Meniere's Disease and Social Security Disability

Meniere’s Disease - Condition and Symptoms

Meniere’s Disease is a disorder of the inner ear. Attacks of Meniere’s Disease are quite debilitating, requiring several hours of recovery. Several of these attacks may occur in a short period of time or they may be isolated incidents that happen every few years. People with Meniere’s Disease often feel that they are tilted or falling, even when standing straight, which causes them to jerk “upright,” causing a sudden fall. These falls can be quite serious and result in injury. Between attacks, most people have few or no symptoms. Their hearing loss tends to recover after an attack, but as time goes on, permanent hearing loss is common.

The underlying cause of Meniere’s Disease is unknown. Traditionally, the condition was thought to be caused by fluctuating fluid levels in the ear on account of structural problems. Others suggested causes to be viral infections of the inner ear, head injury, a hereditary predisposition, and allergies. Some researchers believe there is a link between Meniere’s Disease and immune system diseases.

To diagnose Meniere’s Disease, your doctor will look at your symptoms, perform hearing tests to determine your hearing loss, and examine your ear for any structural problems. He or she will also perform medical tests to attempt to rule out other causes of your symptoms, such as tumors, Lyme disease, migraine, multiple sclerosis, etc. These tests may include MRI scans, allergy testing, glucose levels, thyroid tests, and more. A diagnosis of Meniere’s Disease will be based on your having certain types of symptoms and on the exclusion of other possible causes of those symptoms. Only a post-mortem exam can definitively diagnose Meniere’s Disease.

Symptoms of Meniere’s Disease can range from mild to extreme, and include vertigo, hearing fluctuation and progressive hearing loss, “fullness” in the ear (caused by fluid retention), tinnitus, shocks, unsteadiness, and extreme sensitivity to visual impulses. The vertigo suffered by those with this condition tends to be the most debilitating symptom, and it occurs with little or no warning. An acute attack of Meniere’s Disease can include severe vertigo, nausea, imbalance, sweating, and vomiting and can last anywhere from twenty minutes to four hours.

Meniere’s Disease can be treated with medications, such as motion-sickness drugs, anti-nausea drugs, diuretics, and steroids. There are also non-invasive therapies, such as the use of a hearing aid and the application of pressure to the inner ear to reduce fluid. Vertigo can sometimes be alleviated by injections of medication directly to the inner ear. Occasionally, doctors recommend surgery, but most people respond to medicine, especially when combined with lifestyle and dietary changes.

There is no known cure for Meniere’s Disease.

Filing for Social Security Disability with a Meniere’s Disease Diagnosis

The Social Security Administration (SSA) discusses Meniere’s Disease under Section 2.00 of the Blue Book, Special Senses and Speech. As with all disorders, the SSA defines a disability as the inability to engage in any substantial gainful activity by reason of a medically determinable severe impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. Your medical records must diagnose your Meniere’s Disease, and the symptoms of the disease must be so severe that even with treatment you are prevented from working.

The requirements for Meniere’s Disease are addressed in Section 2.07, Disturbance of labyrinthine-vestibular function (Including Meniere’s Disease) which states that in order to qualify for disability benefits, your condition must be characterized by a history of frequent attacks of balance disturbance, tinnitus, and progressive loss of hearing AND you must have disturbed function of vestibular labyrinth demonstrated by caloric or other vestibular tests AND you must have hearing loss established by audiometry.

Hearing impairments are discussed in Section 2.08 (hearing not restorable by a hearing aid) and must be shown by either:

  1. An average hearing threshold sensitivity for air conduction of 90 decibels or greater, and for bone conduction to corresponding maximal levels, in the better ear, determined by the simple average of hearing threshold levels at 500, 1000, and 2000 Hz; OR
  2. Speech discrimination scores of 40 percent or less in the better ear.

The SSA recommends that your doctor differentiates the report of rotary vertigo from that of dizziness, light headedness, unsteadiness, confusion, or syncope. The SSA prefers that records indicate prolonged observation and serial re-examinations, and requests the following:

  1. A comprehensive neuro otolaryngologic examination with a detailed description of the vertiginous episodes, including notation of frequency, severity, and duration of the attacks.
  2. Pure tone and speech audiometry with the appropriate special examinations, such as Bekesy audiometry, are necessary.
  3. Vestibular function is accessed by positional and caloric testing, preferably by electronystagmography.
  4. When polytomograms, contrast radiography, or other special tests have been performed, copies of the reports of these tests should be obtained in addition to appropriate medically acceptable imaging reports (X-ray, CAT scan or MRI [with or without contrast], myelography, and radionuclear bone scans) of the skull and temporal bone.

Your Meniere’s Disease Disability Case

If you are disabled because of Meniere’s Disease and the condition is so severe it prevents you from working, you may be entitled to Social Security Disability benefits. Although total disability based on a diagnosis of Meniere’s Disease can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified Social Security Disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services (DDS) can help ensure that your Meniere’s Disease disability case will have the highest possible chance of success.