Tourette’s syndrome is a neurological disorder that causes involuntary vocal and motor tics. The tics frequently involve physical movements like jerking, foot stamping, kicking, and facial movements and can be accompanied by grunts, coughs, barks, or shouts. More serious Tourette’s tics can include jumping, touching, smelling, kissing, twirling, biting, and other movements that can endanger the sufferer’s (and others) physical well being. Although it is a popular belief that the uncontrollable use of obscene language and gestures is a common symptom of Tourette’s sufferers it is, in fact, a relatively rare occurrence.
People who suffer from Tourette’s frequently suffer from additional illnesses such as obsessive-compulsive disorder (OCD), attention-deficit hyperactivity disorder (ADHD), and learning disabilities.
Tourette’s syndrome has no cure, but for many people the symptoms are mild and manageable. People with more severe Tourette’s syndrome, however, can experience severe impairments in their daily functioning. For some, but not all, of these people, a combination of medications (including injections of Botox into affected muscles), psychotherapy, and family education and support can help moderate the symptoms that interrupt daily life.
Disability for Adults With Tourette's Syndrome
First, to be eligible for disability benefits, you can't be making more than $1,040 per month. In addition, you must be eligible for either SSDI, which is available to people who have a sufficient work history with employers who paid Social Security taxes, or SSI, a benefit for low-income people without a qualifying work history.
To determine whether you are medically eligible for disability, the Social Security Administration (SSA) will first look to see if your impairment meets or equals one of the conditions that qualify for automatic approval, but Tourette’s syndrome does not. Next, the SSA must determine whether the symptoms of your Tourette’s are serious enough to prevent you from working any type of job.
To assess the impact of your Tourette’s on your ability to work, the SSA will prepare a Residual Functional Capacity assessment (RFC). An RFC is a detailed report that discusses how your Tourette’s affects your ability to perform certain work-related activities. There are two types of RFC that may be used for a person with Tourette’s: a physical RFC and a mental RFC. A physical RFC will assess the impact on your ability to perform certain physical activities, while a mental RFC will assess the impact of your Tourette’s on certain mental activities.
Physical RFCs assess how an impairment affects a person’s ability to perform certain physical activities needed to work. Examples of these are the ability to stand, walk, push, lift, balance, climb, and so on. A physical RFC for a person with severe Tourette’s might state that he or she would be unable to perform any jobs that required the ability to balance, climb, or work around heavy or dangerous machinery. This limitation results from the spontaneous nature of the disease and how physical tics could compromise the worker’s, and his or her co-workers, safety. A person with this RFC would be unable to perform most warehouse jobs, construction work (including painting), and any agricultural work that involved heavy machinery.
Tourette’s syndrome can also adversely affect fine motor skills and hand-eye coordination. An RFC for a person with diminished fine motor skills or hand-eye coordination might state that he or she has a decreased ability to use his or her hands and fingers to hold, manipulate, finger and feel small objects. This limitation would make it difficult to do jobs that involved typing, sorting, and most assembly work. Jobs that require these skills include data entry, secretarial, and light industrial positions.
A mental RFC assesses how a person’s impairment affects his or her ability to perform mental and emotional work-related activities like following directions, completing tasks without assistance, getting along with others, interacting with authority, and working with others without distracting them.
Because the symptoms of Tourette’s are frequently disruptive, it can have a significant impact on workplace productivity. The symptoms of Tourette’s can also impact a person’s ability to interact with people who are unfamiliar with the syndrome or the individual. This could make it difficult to perform jobs that require frequent customer contact or work in environments that cannot be tailored to help the individual work without disrupting co-workers.
SSA's Analysis of Your RFCs
After ruling out some types of jobs because of the limitations in your RFC, if the SSA finds there are jobs remaining that you could do, the agency will deny your claim. If you hire a disability lawyer, the lawyer can help to rule out jobs the SSA says you can do, by providing the proper evidence through your doctor's notes or your testimony at the disability hearing.
You should ask your treating doctors, including therapists or psychiatrists, to complete a statement like an RFC report for you showing your functional limitations. How your doctor has characterized your Tourette's (mild, moderate, or severe) in his treatment notes can also have a big impact on the success of your case.
If you have other conditions such as OCD or ADHD, the SSA will consider these limitations in conjunction with your Tourette’s when creating your RFC. Your physician should include these impairments when preparing an RFC statement for you. Learn more about Social Security's analysis of the RFC.
Because of the unique symptoms of Tourette’s, it may be helpful to have former co-workers or supervisors write a descriptive statement about how your illness impacted the workplace. The SSA will consider supportive statements in conjunction with other evidence to decide your claim. If the SSA finds that your Tourette's did not impact your past job or jobs, the agency will deny your claim. Learn more in our article on whether supportive letter help your disability claim.
Disability for Children With Tourette's Syndrome
Unlike adults, children diagnosed with tic disorders such as Tourette's syndrome may be eligible for automatic approval of SSI disability benefits. This is because tic disorders are qualifying conditions under the SSA's listing of impairments. To be automatically approved for disability based on Tourette's syndrome, the child must experience either:
- ongoing, involuntary motor movements that are repetitive, rapid, and purposeless that affect multiple muscle groups along with multiple vocal tics, or
- ongoing difficulty with one of the following (not caused by a physical illness or disease):
- use of an arm or leg
- movement and control of the body
- physical sensation
- digestion or elimination (urinating or defecating), or
- the obsessive belief that the child has a serious disease or injury.
In addition, the child must have severe difficulties in two of the following areas:
- age-appropriate cognitive or communicative function
- age-appropriate social functioning
- age-appropriate personal functioning, or
- maintaining concentration, persistence, or pace.
The listing criteria for childhood tic disorders is complex. You should review the listing requirements for tic disorders with your child's pediatrician to determine whether he or she might qualify for SSI disability. If your child is denied disability benefits the first time, ask a disability lawyer to help you appeal the decision.