Post-polio syndrome (PPS) is a condition that affects individuals who had polio, a viral infection that became epidemic in the U.S. in the 1950s. PPS strikes polio survivors years after recovering from their initial illness; on average, it affects individuals 30 to 40 years after their initial illness. Generally, the more severe the initial polio illness was, the more severe the PPS could be. Also, those who had an increased level of physical activity between the time of the initial polio illness and the start of the PPS leads to more severe PPS symptoms, which makes this syndrome especially disabling for individuals who had their initial polio illness at a young age.
The symptoms of PPS include muscle weakness that gradually gets worse, shrinking of the muscles (muscle atrophy), breakdown of joints, increased bone deformities, such as scoliosis, and fatigue. Fatigue is the most common symptom and can be the most disabling due to the severity of the fatigue. Sleep apnea, which is associated with weakened respiratory muscles, further increases fatigue as it can prevent an individual from obtaining restful sleep during the night. The symptoms generally start off gradually and get worse over time; also, there are periods of stability followed by periods of physical decline.
Individuals suffer varying degrees of symptoms from PPS. Some individuals have very mild symptoms, while others suffer symptoms that significantly interfere with their ability to function independently. For these individuals, PPS can be disabling. For example, weakness in respiratory muscles can make breathing difficult, weakness in swallowing muscles can make eating safely difficult, and mobility can also be greatly affected.
Social Security evaluates whether an individual PPS's qualifies for disability benefits under its disability listing for polio, Listing 11.11. Previously this listing used the term "Anterior Poliomyelitis, " but it was updated in 2016 to "Post-Polio Syndrome." The new listing also added an additional method of meeting the requirements for post-polio syndrome: having a serious physical problem alongside a serious problem in thinking, concentrating, or interacting with others.
In order to meet the requirements of this listing, you must show that you had polio and you are affected by at least one of the following sets of symptoms:
Note that marked means worse than moderate, but less than extreme.
In order to meet the requirements of the listing for polio, you must provide medical evidence that includes a description of your initial polio illness, although you are not required to produce old medical records from the time of your initial polio infection.
Your medical records should include your current physical impairments, with when they began and how severe they are. Medical records that support the specific symptoms noted in the polio listing (difficulty speaking, breathing, swallowing, walking, or using your arms) are essential. For example, if you have difficulty swallowing, Social Security wants to see a physician's note or note from a speech pathologist regarding your difficulties with swallowing. Your doctor's notes should include the physical activities that you can't perform and the limits that PPS puts on your ability to function independently.
If you don't meet the criteria of the polio listing, you may still qualify for Social Security disability benefits if you can prove that you are unable to return to any type of work because of your physical limitations.
Social Security will assess your remaining capability by including your limitations using a Residual Functional Capacity (RFC) form. For instance, you might have muscle weakness and mobility problems that prevent an individual from performing any physical work, but you are able to do work while sitting. For others, even sedentary work may be difficult due to extreme fatigue. Sleep apnea at night can further increase an individual’s level of fatigue during the day.
In addition, for some PPS sufferers, facial muscle weakness can make one's speech very hard to understand and may make certain work impossible.
After assessing your RFC, Social Security will compare your RFC to your education and job skills to see if there is work that you could do. For instance, if your RFC limits you to sedentary work, but you've always done heavy work and you don't have the job skills or education required for sedentary work, you may be granted disability benefits -- but only if you're over a certain age. If you're younger than 55, or in some cases, 50, Social Security will expect that you can be retrained to do other work. For more information, see our article on how Social Security uses your RFC to determine disability.