Getting Social Security Disability Benefits for Lymphedema

Lymphedema (lim-fuh-DEE-mah) is the medical term for swelling that occurs when a key component in your immune system called lymph fluid isn't draining properly. Lymphedema most frequently occurs in the arms or legs, but can also affect the chest, abdomen, neck, and genitals.

Damage to the lymph nodes from surgery, cancer, radiation treatment, or repeated infections can result in lymphedema. Other causes range from common—such as the removal of lymph nodes following breast cancer—to quite rare (such as primary lymphedema, a hereditary condition where the vessels that carry lymph fluid develop abnormally).

If I Have Lymphedema, Can I Qualify for Disability Benefits?

The swelling caused by lymphedema can be mild and hardly noticeable, or it can be quite painful and make using the swollen limb difficult or even impossible. If swelling from your lymphedema persists for at least twelve months and keeps you from working full-time, you may qualify for Social Security disability benefits.

You can get disability benefits in one of two ways:

• meet or "equal" the requirements of a listed impairment, or
• be unable to perform any job full-time.

A listed impairment is a condition in Social Security's "Blue Book" of disorders that the agency considers especially severe. Each listed impairment has a set of requirements (such as specific test results) that need to be documented in your medical records in order for you to "meet the listing." If you don't meet the requirements exactly, but a doctor determines that your symptoms are severe enough to be medically equivalent, you can get disability by "equaling" a listing.

Meeting or Equaling a Disability Listing

Lymphedema isn't a listed impairment, but some related conditions that are often comorbid (occurring at the same time) with lymphedema are listed. If your medical records contain evidence of these related conditions, you may be able to meet or equal the following disability listings.

Listing 4.11, Chronic Venous Insufficiency

Chronic venous insufficiency occurs when veins are blocked or damaged and blood builds up in the veins. When blood pools in the legs, they can swell up—similar to lymphedema—making walking painful and difficult.

In order for your symptoms to meet listing 4.11, you'll need to show that:

• your lymphedema occurs in your leg and results in brawny edema (a particular type of swelling) over the majority of your leg, or
• you have recurring vein and skin problems (dermatitis, varicosities, or ulcerations) that haven't healed despite at least three months of treatment.

You can learn more in our article on getting disability benefits for chronic venous insufficiency.

Listing 1.18, Abnormality of a Major Joint

Although lymphedema doesn't occur in your joints, the swelling of your arms or legs can cause limited motion in your knees or elbows. Breast cancer patients in particular can find it difficult to move their arms after lymph node removal.

While you're unlikely to meet the requirements of listing 1.18 exactly (you'd need to show damage to the bone or cartilage of the joint), If your lymphedema is severe enough that you're finding it hard to walk without assistance or use your hands and arms independently, you might be able to equal the listing.

Your lymphedema might meet or equal other listings as well, depending on what part of your body is affected. If you think your symptoms are severe enough to qualify for disability based on a listing, you should ask your regular doctor to submit a statement explaining why your medical record satisfies the criteria of a listed impairment.

Qualifying for Disability Based on a Medical-Vocational Allowance

Even if you don't meet or equal a listed impairment, you can still get disability if you're unable to perform any type of work in the national economy. Getting disability benefits this way is called getting a "medical-vocational allowance" because it's based on a combination of limitations from your medical symptoms and vocational factors like your age, education, and past job skills.

To determine whether you qualify for a medical-vocational allowance, Social Security will review your medical record for any physical and mental limitations that affect your ability to work, a process known as assessing your residual functional capacity (RFC).

What Limitations Are in Your RFC?

Your RFC assessment will contain any restrictions caused by your lymphedema and any other medical conditions. For example, If you have lymphedema in your legs, your RFC may limit you from being on your feet for longer than two hours in a workday or state that you could only do a job where you're allowed to elevate your legs (in order to relieve swelling).

If you have lymphedema in your arms, your RFC may limit the types of job tasks you can do that involve writing or typing, pushing, grasping, or reaching.

How Does Social Security Use Your RFC to Decide If You're Disabled?

Social Security will compare your current RFC with the duties of your past jobs to see if someone with your RFC could do that work. If not, the agency will see if other jobs exist within the limitations of your RFC that you either already know how to do or could learn to do (unless you're close enough to full retirement age—then Social Security doesn't expect you to learn a new job.)

If Social Security finds that no jobs exist for somebody with your RFC, the agency will find that you're disabled and send you a notice of award.

Filing for Social Security Disability Benefits

You have several options when submitting an application for Social Security Disability Insurance (SSDI):

• File online at ssa.gov.
• Apply over the phone at 800-772-1213 (TTY 800-325-0078) between 8 a.m. and 7 p.m., Monday through Friday.
• Get in-person help with a representative at your local Social Security field office.

If you're applying for Supplemental Security Income (SSI), you can begin your application online, but a representative will contact you to finish submitting your application. If you're not sure which benefit program you should apply for, read our article about the differences between SSDI and SSI.

_{Updated July 19, 2023}