If you have Arnold-Chiari Malformation that has resulted in severe symptoms that have made you unable to work, you may be eligible to receive Social Security disability benefits. A chiari malformation (CM) is a defect in the brain structure. Because the skull is abnormally structured in individuals with the disorder, the brain stem and cerebellum are compressed causing a decreased flow of the fluid that is there to protect the brain and spine.
There are four kinds of CM, with Type 1, the adult form, being the most common.
As the skull and brain grows, the condition doesn’t become evident until the child is older or already an adult. The pediatric form, which is Type 2, is evident at birth. The other two kinds, Type 3 and Type 4, are not near as common but they are severe. In Type 3, the cerebellum or the brainstem pushes out through an irregular skull opening. The brain doesn’t develop properly in Type 4. Arnold-Chiari Malformation is a rare condition that can impact individuals very differently ranging from no symptoms to severe life-altering symptoms.
If your conditions are severe enough to impact your daily life and prevent you from working to earn a gainful income, you may be approved for Social Security disability benefits. The Social Security Administration (SSA) oversees the program that is designed to provide monthly benefits to disabled individuals to help them with their living expenses every month.
The Cost of Treating Arnold-Chiari Malformation
If you have an advanced form of the disorder, you may be recommended for surgical intervention. It is a form of brain surgery, so it has substantial risks that are monetary, timely, and medical in nature. The main benefit of the procedure is to prevent progression, but the condition is rarely progressive.
The surgery is for those who suffer from signs that make reference to the posterior fossa. It isn’t effective for all cases of dizziness or headaches. There are no medications or treatments for the underlying cause of the malformation. You may be prescribed medications for the symptoms, such as dizziness and headaches. You will have regular visits with a neurologist for your condition. The surgical procedure itself, along with the follow-up care and the anesthesiologist, is estimated to cost more than $100,000 but it is also dependent on whether it is covered by your insurance policy and how much your copays and deductibles are regarding the surgical procedure.
Chiari Malformation Symptoms
Chiari malformation (CM) is when the lower part of the brain presses on and through an opening in the base of the skull and cerebellum into the spinal canal. The cerebellum is the part of the brain that controls balance.
Normally the cerebellum and parts of the brain stem are found above an opening in the skull that allows the spinal cord to pass through it. When part of the cerebellum extends below this opening and into the upper spinal canal, it is called a CM.
Symptoms of CM
A few people with CM have no symptoms at all but, in other sufferers, symptoms may include the following:
ringing in the ears;
problems with hand coordination and fine motor skills;
muscle weakness or numbness;
headache, particularly following sudden coughing, sneezing, or straining;
excessive drooling, choking or vomiting;
difficulty with swallowing or speaking;
difficulty eating and an inability to gain weight;
curvature of the spine;
problems with breathing;
problems with balance.
Is Chiari Malformation a Disability?
Yes, Chiari Malformation is a disability according to the SSA, as long as you can qualify under the Blue Book, even though the Social Security Administration (SSA) doesn’t have a specific Blue Book listing for CM. However, you may be able to qualify under a different listing depending upon your symptoms.
For example if you experience balance problems when diagnosed with Chiari Malformation and you are unable to work for at least 12 months you may meet a Blue Book listing under 11.00: Neurological Disorders. If you are unable to stand up from a seated position, maintain balance while standing and walking and you are not able to complete work-related activities these limitations are considered under the Blue Book listing 11.00, so as long as you can prove you have these limitations you should be able to qualify for disability benefits. Under the same listing there are listed problems with hand coordination and fine motor skills which are a symptom of CM.
If you experience excessive drooling, choking or vomiting you should find these symptoms in the Blue Book listing 5.00 which is related to the digestive system. The SSA assesses the effects of treatment for these symptoms, including medication, therapy, or surgery by determining if there are improvements in the symptoms, signs, and laboratory findings of the digestive disorder.
The SSA will require certain information about your symptoms including the treatment that has been prescribed and the dosage, method, and whether your health has improved as a result of the treatment.
As dizziness is also a symptom of CM and there are several listings for dizziness in the Blue Book if you meet the criteria found in Section 3.02, chronic pulmonary insufficiency or Section 4.04, ischemic heart disease; and Section 4.11, chronic venous insufficiency it may make it easier to qualify for disability benefits.
How to Medically Qualify for Disability Benefits
The SSA uses a medical guide, which it refers to as the Blue Book, to determine whether someone meets the requirements to be eligible for disability benefits. A diagnosis of CM alone is not enough to gain benefits approval. Disability Determination Services will need to determine if the symptoms you experience from CM are severe enough to keep you from continuing at your regular job. If they determine you can’t continue with your past work, they will have to see if there are any other kinds of work that you can do or learn to do.
There are several listings for dizziness that you may want to review and see if you meet the criteria, such as Section 3.02, chronic pulmonary insufficiency; Section 4.04, ischemic heart disease; and Section 4.11, chronic venous insufficiency.
There is no listing for CM in the Blue Book, and there are no similar disorders so it has no clear requirements set forth to determine if you meet the qualifications of disability with your CM diagnosis. Disability Determination Services will have to consider several things to determine if you are disabled.
They will look at your symptoms, their frequency, how they impact your abilities to perform your daily duties and your job, your daily living and how you are limited in performing activities. If you cannot meet the medical requirements, you can still qualify for disability with a residual functioning capacity (RFC).
Using a Residual Functioning Capacity for Disability Approval
If you don’t meet the criteria of a listing in the Blue Book, you may still be eligible for disability benefits using the residual functioning capacity (RFC) form. Your treating physician will complete the form and clearly list any medical conditions, symptoms, restrictions, and limitations that you have and how they keep you from working full-time. As an example, if CM causes you to suffer severe headaches and dizziness, you may not be able to work around machinery, bend over and lift items, or stand for long periods.
You may not be able to work where you are exposed to overhead risks because your brain isn’t as protected because of the decreased fluid there to protect the brain and spine. You may suffer from fainting spells that are unexpected, so you can’t walk frequently or work in a hazardous industry. The dizziness and headaches may cause blurred vision that leaves you unable to handle sedentary tasks and complete paperwork. Frequent repositioning may be necessary because of your pain and swelling in lower extremities.
The RFC is considered as part of a medical-vocational allowance, which also considers your age, work experience, transferrable skills, and education level to determine if you can perform some other kind of work for a living. If it is determined that your RFC clearly states your inability to work, you will be approved for benefits.
Applying for Disability Benefits
The average disability claim takes at least five months for approval. A disability attorney or advocate can help you with your claim and improve your odds of being approved for benefits. If you haven't spoken with a Social Security attorney or advocate yet, consider doing so today.