Getting Disability Benefits for Shingles and Postherpetic Neuralgia (PHN)

Individuals with shingles, a skin rash caused by the varicella-zoster virus (which also causes chickenpox), are rarely approved for disability benefits based on shingles alone. Social Security disability benefits are granted to those who are unable to work for at least twelve months due to medical reasons. While shingles certainly can cause excruciating and debilitating pain that keeps a person from working, it generally resolves within a few weeks and thus fails to satisfy Social Security's twelve-month durational requirement for disability.

However, there are many possible complications of shingles, including facial paralysis, hearing and vision loss, and postherpetic neuralgia (PHN), that could qualify a person for disability benefits. PHN occurs when nerve fibers suffer damage following a case of shingles. Symptoms include nerve pain and (less commonly) extreme sensitivity to touch, numbness, itching, or muscle weakness.

Obtaining Disability Benefits for Postherpetic Neuralgia

There's no specific disability "listing" for postherpetic neuralgia in Social Security's Blue Book, but it's possible (though rare) that your symptoms could be just as severe as one of the listed impairments in the Blue Book. If that's the case, you'll receive benefits because you "equal" a listing.

The closest listed impairment to postherpetic neuralgia in the Blue Book is Listing 11.14 for Peripheral Neuropathy. This listing states that you must suffer from either:

• The inability to control the movement of at least two extremities (either an arm and a leg or two arms or two legs). This must result in extreme difficulty in the ability to balance while standing or walking, to stand up from a seated position, or to use the arms.

OR

• "Marked" physical problems along with a "marked" limitation in any one of the following:
  • thinking (understanding, remembering, or applying information)
  • interacting with others (social problems), or
  • finishing tasks (problems with concentration, persistence, or speed).

Note that marked means worse than moderate, but less than extreme.

If your condition doesn't equal Listing 11.14 or another listing, you can still be granted disability benefits based on a "medical-vocational allowance" if your doctor feels you can't do your past job and Social Security finds that you can't switch to another job because of your age, education, work history, and Residual Functional Capacity (RFC). Your RFC is an evaluation of the maximum mental and physical abilities you possess despite your medical problems. It's critical for your disability case that you document to the extent possible the symptoms, especially the pain, you experience because of PHN and that your doctor records the limitations you have.

Documenting the Functional Limitations Caused by Postherpetic Neuralgia

Nerve pain, the primary symptom of postherpetic neuralgia, can be difficult to prove to Social Security's satisfaction. Disability examiners and judges tend to be skeptical of claims based largely on subjective symptoms, but there are a number of steps you can take to bolster your credibility.

Most importantly, you must receive consistent treatment for your PHN, preferably from a neurologist. If you fail to obtain regular treatment, Social Security will usually assume that your condition is not as debilitating as you allege. All of your relevant medical records, including clinic notes, lab tests, imaging studies, and hospital records, should be submitted to SSA prior to your hearing.

In addition, before awarding you disability benefits, Social Security usually wants to know that you have exhausted all treatment options prescribed by your doctor. There are several different therapies your doctor might prescribe, from capsaicin skin patches to antidepressant medication to painkillers. You should comply with your physician's treatment recommendations, while recognizing that some trial-and-error may be necessary before you find any relief.

Next, you should request that your treating physician provide an opinion as to your functional limitations using a Residual Functional Capacity form. In cases involving PHN, your physician should address the following areas:

• amount of weight you can lift, carry, push, and pull, both frequently (up to two-thirds of the workday) and occasionally (up to one-third of the workday)
• length of time you can sit, stand, and walk, both at once and total in an 8-hour workday
• any manipulative limitations, especially with reaching, handling, and using your fingers
• ability to maintaining attention and concentration without interruption from pain or other symptoms
• number of days per month your symptoms would cause you to miss work, arrive late, or leave early
• whether and to what extent you would need to recline, elevate your legs, or lie down to alleviate symptoms, and
• side effects of treatment that would affect your ability to work, such as fatigue or foggy thinking.

Because pain cannot be objectively measured, some disability attorneys recommend that their clients start a "pain diary" to document their daily struggles with pain. If you choose to keep a pain diary, you should note the date, the location and type of pain (burning, aching, stabbing, and so on), the intensity and duration of the pain, and any pain-relieving treatments you attempted.

How to Apply for Disability Benefits

If you're applying for Social Security disability insurance (SSDI), you can file your entire claim online on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim. Most individuals filing for SSI only cannot file the whole application online, but they can get started on Social Security's website. For more information, see our article on applying for Social Security disability benefits.

Filing a disability claim based on chronic pain conditions such as postherpetic neuralgia can be challenging. If you don't feel you can do it on your own, an experienced disability attorney can help you provide persuasive evidence of your functional limitations on your application.