Disability for Myasthenia Gravis: Benefits

and Filing Information | Disability Secrets

by Lorraine Netter, Contributing Author

Myasthenia gravis (MG) is an autoimmune neuromuscular disease that affects the muscles in
the body. It is a chronic disease that causes certain muscles to become very weak when they
are being used for a period of time, but return to normal strength after being rested.

Disabling Symptoms of Myasthenia Gravis

The first signs of MG are usually slurred speech, problems swallowing, and weakness of the
muscles around the eyes (ocular MG). Weakness in facial muscles can cause loss of eye
control and eyelid movement, drooping of one eye, double vision, decreased ability to make
facial expressions, and problems talking and chewing properly. Muscle weakness in the neck
and chest can result in difficulty swallowing, breathing, and neck weakness. Other parts of
the body that usually experience weakness include arms, hands, fingers, and legs.

In some instances, those with MG can experience myasthenic crisis. This occurs when the
respiratory muscles become paralyzed, requiring individuals to be put on breathing machines
in order to live.

When You Can Get Disability Due to Myasthenia Gravis

Myasthenia can be fairly mild and controlled with medication, or it can progress quickly to a
disabling state. When myasthenia gravis begins to affect your muscles so much that you can
no longer work, there are two ways you may be able to be approved for Social Security
Disability (SSD) or SSI benefits: you meet the requirements of the disability listing for
myasthenia gravis, for automatic approval, or Social Security agrees that MG is affecting
your muscle function so much that you can no longer do "substantial gainful activity," or
SGA. (Generally, SGA is work that earns you more than $1,130 per month.)

Meeting the Myasthenia Gravis Listing

MG has its own disability listing in the Social Security listing of impairments that may
qualify for disability, called the blue book. To prove you meet the requirements of the MG
listing, you must prove that you have myasthenia gravis and one of the following:

Serious problems talking, swallowing, or breathing, despite following the treatment

prescribed by your doctor (usually rest and medication). Social Security will be
interested in knowing how significant your bulbar signs are (problems with talking,
swallowing, or breathing).
Considerable weakness in your arms or legs after moving them repetitively against
resistance, despite following the treatment prescribed by your doctor. Social Security
will want to know how quickly your arm and/or leg muscles lose strength after use.
Proving MG can be difficult because muscles at rest do not generally have significant noted
weakness. For this reason, it's important that your doctor brings your muscles to fatigue
during testing and records the progressive weakness of your muscles. In addition, some
patients with MG have lengthy periods of remission followed by exacerbations. However,
Social Security is aware that MG can be episodic and will consider the frequency and
duration of exacerbations and how long periods of remission last.

Medical evidence that may be used to fulfill the requirements of this listing includes electrical
impulse machines to stimulate muscles to show weakness, pulmonary function tests to
measure breathing, muscle biopsies, and physical examinations using physical endurance
tests, leg raises, and/or grip strength tests.

Showing Loss of Ability to Do Substantial Gainful Work

Some patients with MG will not meet the criteria in the above MG listing because they don't
have problems talking, swallowing, or the doctor hasn't recorded weakness in their arms or
legs that Social Security considers significant enough. These patients may nevertheless have
limitations that prevent them from successfully returning to work and being able to work
enough to earn at least $1,130 per month.

Social Security will review your medical record for limitations that your doctor has
documented and will gather them into a Residual Functional Capacity (RFC) assessment.
Your RFC shows which work activities and jobs you have the ability to do, if any.

Due to muscle fatigue in the legs and/or arms, MG can limit any type physical activity.
Specifically, if you have weakness in your legs, it makes walking or standing for long periods
of time difficult, which would limit you to sedentary work. Weakness in your arms, hands, or
fingers make completing tasks using your fingers difficult, which could rule out any
sedentary work or at least light or medium work requiring lifting or carrying items.

If MG has affected your eyesight or your speech, this rules out many jobs that require good
vision or communication, such as working with machinery, driving, working with others, and
so on.

With MG, patients can often do some work, but need frequent rest breaks due to their easy
fatigability. If you can complete some tasks required by a job, but your productivity is
decreased by 20% or more due to your MG, Social Security is supposed to grant you
disability benefits. You should record how easily your muscles are fatigued by keeping an
activity diary, where you take notes on how many minutes of an activity, including speaking,
weakens you muscles, and submit it to Social Security with your application or appeal. (For
more information, see our article on qualifying for disability due to reduced productivity.)

After your RFC assessment, Social Security decides whether, given the work activities that
your RFC says you are limited to doing, there are any jobs you can be expected to do, also
taking into account your job experience, education, and age. For information on how the
agency makes this decision, see our section on how Social Security uses the RFC to decide if
you can work.