Disability Benefits for Polycystic Ovary Syndrome (PCOS)

PCOS is rarely severe enough to qualify someone for Social Security disability benefits.

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Polycystic ovarian syndrome (PCOS) is a hormone disorder in women. Symptoms of PCOS include enlarged ovaries with multiple small cysts (not related to ovulation), irregular menstrual cycles, and excess of the male hormone androgen.

The symptoms of PCOS syndrome alone are not likely to qualify someone for disability benefits, but women with PCOS, especially those who are obese, are more likely to develop type 2 diabetes, high blood pressure, cholesterol problems, metabolic syndrome, liver inflammation, depression, sleep apnea, uterine cancer, infertility, and gestational diabetes. A combination of several of these medical conditions, if severe, could qualify someone for disability.

How Can I Get Disability for My PCOS?

The basic eligibility requirement for disability is that you cannot be doing a substantial amount of work due to an impairment. Social Security defines the maximum amount of work you can do as the "substantial gainful activity" (SGA) level (for 2013, SGA is earning $1,040 a month.) Your condition must also be expected to prevent you from working at the SGA level for at least 12 consecutive months and be “severe” according to the Social Security's definition. A condition is “severe” if it significantly impacts your ability to work.

Because the symptoms of PCOS can usually be well managed with medication and lifestyle changes, it may be hard to meet the one-year requirement, which would result in a denial of benefits. It may also be hard to prove that your condition is “severe” by the SSA’s definition.

Listed conditions. If your circumstances do satisfy these basic requirements, Social Security must next determine whether your condition meets the requirements of a medical condition in its listing of impairments; if it is you can win automatic approval. Unfortunately, PCOS is not a condition that is eligible for automatic approval. This means that you will have to prove that your PCOS causes you such physical or mental limitations that you can't work.

RFC. The SSA will assess your residual functional capacity (RFC) -- what you can do on a regular and sustained basis. An RFC can be for sedentary, light, medium, or hard work. The SSA determines your RFC by preparing an RFC assessment. This is a detailed report that discusses how the symptoms of your PCOS affect your ability to do certain work-related physical activities, such as walking and carrying weight. The Social Security Administration (SSA) will also consider any non-exertional limitations, such as an inability to focus or finish work on time. (For more information, see our article on how combining exertional and non-exertional impairments can help you win your claim.)

If the SSA finds you have the RFC to do your old job, or to do any other job in the U.S., you will be denied benefits. Unfortunately, it will be difficult to prove that you cannot work because of your PCOS. This is because, as stated above, the symptoms of PCOS can usually be managed with proper medical care.

Combination of Impairments

You may be eligible for benefits if you have other medical conditions in addition to PCOS. This is because the SSA must consider the combined effect of a claimant’s disabilities (severe and non-severe) on his or her ability to work, including any side effects of medications used to treat the conditions.

Example 1

In one case, a claimant filed for disability based on PCOS, obesity, and sleep apnea. The SSA concluded that the PCOS was not severe; however, it determined that the obesity and sleep apnea were severe impairments.

The claimant’s past job was as a product inspector on an assembly line, which the SSA described as sedentary work. The claimant experienced significant daytime fatigue as a result of her sleep apnea and obesity. In addition, the claimant’s PCOS medication caused painful abdominal cramping, headaches, and confusion, all of which impacted her ability to do her job. These symptoms were documented in her medical file. Her files also documented some non-exertional impairments such as problems with memory and concentration. When the SSA considered how the combined effects of these conditions affected her ability to do work-related activities, it concluded that the claimant couldn’t do her old work. It also concluded she did not have the RFC to do any sit-down jobs; accordingly, she was approved for benefits.

Example 2

In another case, a claimant filed for disability based on PCOS and lower back pain. The claimant was on medication for her PCOS that effectively managed many of her symptoms. She also experienced only minor side effects from her medications. The SSA concluded that the PCOS was not a severe impairment. But the SSA decided that her back pain was a severe impairment; the claimant’s lower back pain was caused by spinal stenosis and limited her ability to stand. The claimant’s past work had been as a sorter, which required long periods on her feet. This job was classified as light work. Although the SSA concluded that the combined effects of her PCOS and back pain prevented her from doing her old job, it decided that she could still do sedentary work. She was therefore denied.

Visit our articles to learn learn more about how to win claims based on conditions commonly related to PCOS, such as obesity, diabetes, and depression.

by: , Contributing Author

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