Empty sella syndrome (ESS) is a medical condition that affects the "sella turcica." The sella turcica is a small bony structure located at the base of the brain that protects the pituitary gland, which controls the body's hormones. A number of things can cause the sella turcica to become enlarged or abnormally shaped, which in turn can flatten or shrink the pituitary gland. ESS occurs in about 25% of the population, but only 1% of those affected by the disease experience symptoms.
Often, people with an "empty sella" have no symptoms. The symptoms that do happen are caused by either a partial or total loss of pituitary gland function. When symptoms do occur, the most common are:
Less common but more serious symptoms include:
There are two types of empty sella syndrome—primary and secondary. Primary ESS happens when there is a naturally occurring deformity of the sella turcica that allows spinal fluid to leak into it and squish the pituitary gland. Women and those who are obese or have high blood pressure are at higher risk of primary ESS.
Secondary ESS occurs when the sella turcica is damaged by unnatural causes, like surgery, radiation treatment for a tumor, or a head injury.
If you're experiencing severe limitations because of empty sella syndrome, you might be able to get Social Security disability benefits if you're prevented from working for 12 months or more. But it's not easy; if empty sella syndrome is the only serious medical condition you have, you'll have a hard time getting disability benefits.
Social Security has three ways you can qualify for Social Security disability benefits:
Social Security doesn't have a specific listing for empty sella syndrome. But if you're experiencing severe symptoms like chronic headaches, extreme fatigue, and vision problems, Social Security might consider your limitations as serious as those in listing 11.05 for benign brain tumors. Social Security could find that your condition "equals" the benign brain tumor listing.
To decide if you're unable to work, Social Security will look at your medical records to see whether there's evidence you have a serious medical condition that limits your ability to do many work-related activities. This means you must have a diagnosis of a severe condition that's backed up by medical findings or lab tests, not just your reports of headaches or fatigue.
Fortunately, a doctor can diagnose empty sella syndrome with imaging from an MRI or CT scan. (Because people with ESS don't often experience symptoms, ESS is often diagnosed when people are getting medical treatment for other conditions, such as migraine headaches.)
If Social Security agrees that you have a severe medical condition, a claims examiner will determine your Residual Functional Capacity (RFC). Your RFC is the most intensive work you can still do (medium, light, or sedentary) despite the limitations caused by your medical condition. For example, if you have severe ESS, your doctor might limit you to light work with standing or walking a certain number of hours per day.
Your ESS might cause you to experience sharp, throbbing headaches with vision changes like blurred vision or light sensitivity, which might make it difficult to work around noise or bright lights. You may also experience fatigue and throbbing pressure-like pain at the base of your skull, which can become worse with lifting or carrying or with tasks that place pressure at the base of the skull.
An RFC from someone suffering from severe ESS might include the following limitations:
Someone with these limitations would likely be unable to perform most jobs because they would be unable to complete a full work shift, and even if they could, they would be unable to perform most of the physical requirements of even a sit-down job. For more information on how the SSA decides whether your RFC prevents you from doing any jobs, see our section on disability determinations based on RFCs.
Social Security will evaluate your claim based on your medical evidence—this includes lab tests or MRI results as well as your doctors' records. Social Security might also send you for an independent exam by a doctor who works for Social Security or might ask your doctor to complete a questionnaire about your limitations.
To get approved for disability for ESS, your records must include the following, at a minimum:
An easy way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. You may also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information, please see our article about applying for Social Security disability benefits.
If you'd like help with your application, think about working with a legal professional. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Having guidance from a lawyer or advocate can be especially helpful for rare conditions like empty sella syndrome.
Published October 25, 2021
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