Disability Benefits for Post-Polio Syndrome through Social Security or SSI

Post-polio syndrome (PPS) is a condition that affects individuals who've had polio, a viral infection that became epidemic in the United States in the 1950s. PPS strikes polio survivors years after recovering from polio—on average, about 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 have had an increased level of physical activity between the time of the initial polio illness and the start of the post-polio syndrome might have more severe PPS symptoms, which makes this syndrome especially disabling for someone who had polio at a young age.

Symptoms of Post-Polio Syndrome

The symptoms of post-polio syndrome include the following:

• 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 when it's very severe. Sleep apnea, which is associated with weakened respiratory muscles, further increases fatigue, as it can prevent you from getting restful sleep.

The symptoms of post-polio syndrome generally start gradually and get worse over time. Someone with PPS will generally experience periods of stability followed by periods of physical decline.

Treatment for Post-Polio Syndrome

There's no cure for post-polio syndrome, and currently there's no treatment that can effectively stop or reverse the damage it causes. But there are things you can do that might help with your PPS symptoms, such as:

• exercising regularly (within your ability)
• getting enough quality sleep
• controlling your weight
• using mobility aids and other assistive devices, and
• taking anti-inflammatory medicines (as advised by your doctor).

If your PPS has caused your respiratory muscles to become weak, you might also need breathing assistance.

You should be under the care of a doctor with experience treating neuromuscular disorders. Continue seeing your doctor and following your treatment plan while you wait for the Social Security Administration (SSA) to decide your claim. Not doing so could cause your disability benefits to be denied.

Learn more about how failing to follow prescribed treatment can result in Social Security denying your claim.

Disability for Post-Polio Syndrome

Post-polio syndrome causes varying degrees of symptoms. Some people have very mild symptoms, while others have symptoms that significantly interfere with their ability to function independently. For these individuals, PPS can be disabling.

For example, someone with severe PPS symptoms could face multiple issues, such as:

• difficulty breathing due to respiratory muscle weakness
• weakened swallowing muscles that make eating safely difficult, and
• mobility impairments due to weak leg muscles.

Social Security's Blue Book Polio Disability Listing

Social Security evaluates whether someone with PPS qualifies for disability benefits under its Blue Book listing for polio (listing 11.11). Previously, this disability listing used the term anterior poliomyelitis, but it's now called post-polio syndrome. The updated listing also added fourth way to meet the requirements for post-polio syndrome: having a serious (but not extreme) physical problem alongside a serious problem in thinking, concentrating, or interacting with others.

To meet the requirements of this listing, you must show that you had polio and are affected by at least one of the following four sets of symptoms:

1. The inability to control the movement of at least two of your extremities (either an arm and a leg, both arms, or both legs), resulting in extreme difficulty balancing while standing or walking, standing up from a seated position, or using your arms.
2. The inability to speak clearly enough for others to understand you.
3. Weakness in the bulbar muscles in your head and neck, making you unable to breathe without mechanical ventilation or causing you to need a feeding tube or intravenous feeding (enteral or parenteral nutrition).
4. "Marked" physical problems along with a "marked limitation" in any one of the following:
• thinking (understanding, remembering, or applying information)
• interacting with others (having social or communication problems)
• finishing tasks (problems with concentration, persistence, or speed), or
• being able to adapt (handling change, regulating emotions, and taking care of your health).

Note that "marked" is roughly the same as "serious" (worse than moderate but less than extreme).

Medical Evidence Required to Meet a Listing With PPS

To meet the requirements of the listing for polio, you have to provide medical evidence that includes a description of your initial polio illness. But you aren't required to produce old medical records from the time of your initial polio infection.

Your medical records should include your current physical impairments, including 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, standing, 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 you can't perform and the limits that PPS puts on your ability to function independently.

Your Ability to Return to Work With Post-Polio Syndrome

If you don't meet the criteria of the polio listing, you might still qualify for Social Security disability benefits if you can prove that you can't return to any type of work because of your physical limitations.

Creating Your RFC

Social Security will assess your remaining capability to do work activities by including your limitations using a Residual Functional Capacity (RFC) form. For instance, you might have muscle weakness and mobility problems that prevent you from performing any physical work, but you're able to do work while sitting. In that care, your RFC would limit you to sedentary work. But even sedentary work might be difficult if you suffer from extreme fatigue. Sleep apnea at night can further increase your fatigue during the day.

Your PPS might also cause facial muscle weakness that makes your speech hard to understand, which might make certain types of work impossible.

Using Your RFC to See If You Can Work

After assessing your RFC, Social Security will compare your RFC to the duties of your past job to decide whether you should be able to return to it. If not, the agency will also look at your age, education, and job skills to see if there is other 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 might qualify for disability benefits—but only if you're over a certain age.

If you're younger than 50 and have a sedentary RFC, Social Security will usually expect that you can be retrained to do other work. So, to qualify as disabled before age 50, Social Security will need to see that you can't perform even the simplest, sit-down jobs. To rule out these types of jobs, you'd have to show Social Security that you had limitations like the following, which could eliminate all jobs:

• needing significantly more time than others to finish tasks
• requiring extra rest breaks throughout the workday
• having to lie down or raise your legs, or
• not being able to use your hands and fingers frequently.

For more information on how the restrictions in your RFC can get you approved for disability, see our article on how Social Security uses your RFC to determine disability.

How to Apply for Disability Benefits Based on PPS

You can apply for disability benefits for post-polio syndrome by contacting the Social Security Administration in one of three ways:

• Call Social Security's national office at 800-772-1213 (TTY 1-800-325-0778).
• Visit your local Social Security office (make an appointment first to avoid delays).
• Complete an online application at SSA.gov.

Social Security will ask for your personal information, including your birthdate and Social Security number and those of your spouse (or ex-spouse) and your dependent children. You'll also have to provide information about your work history, including whether you're still working and how much you earn.

Social Security will ask questions aimed at determining your eligibility for Social Security disability insurance (SSDI) and Supplemental Security Income (SSI) disability benefits. For instance, if you're applying for SSI—a needs-based disability program—Social Security will ask about your household income and assets like cash and investments. (Learn more about how your work and income can affect your eligibility for benefits.)

Whether you apply for SSDI or SSI, Social Security will need to see your birth certificate, proof of citizenship or immigration status (if you weren't born in the U.S.), and W2 forms (or self-employment tax statements) for the last year or two. You should also share copies of any of your medical records that you have.

But don't delay filing your disability application because you don't have all the documents or information you need. Social Security will help you gather anything you don't already have.

Learn more about how your application timing can affect how much disability you receive.