Getting Disability Benefits for Shingles and Postherpetic Neuralgia (PHN)

Shingles (herpes zoster) is a skin rash caused by the varicella-zoster virus (which also causes chickenpox). Some people with shingles only experience mild to moderate symptoms that don't last too long. But there are many complications associated with shingles that can have lasting effects, such as:

• facial paralysis or hearing loss due to Ramsay Hunt syndrome
• vision loss due to ophthalmic shingles
• brain inflammation (encephalitis)
• pneumonia, and
• postherpetic neuralgia (PHN).

Is Shingles a Disability?

A disability claim based only on shingles generally won't qualify someone for benefits, because the Social Security Administration (SSA) grants disability only if you can't work for at least one year due to medical reasons.

While shingles certainly can cause excruciating and debilitating pain that keeps you from working, it generally resolves within a few weeks or months. That makes it difficult to satisfy Social Security's 12-month durational requirement for disability.

However, if you have complications from shingles that are severe enough, you could qualify you for disability benefits. Consider postherpetic neuralgia, which occurs when shingles damages your nerve fibers. Symptoms of PHN include nerve pain and (less commonly) numbness, itching, muscle weakness, or extreme sensitivity to touch. It's possible for PHN symptoms to be severe enough and last long enough to qualify as disabling.

How Can I Get 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. If you can "equal a listing," you'll qualify as disabled.

Equaling a Listing With Shingles and PHN

The closest listed impairment to postherpetic neuralgia in the Blue Book is listing 11.14 for peripheral neuropathy. This listing states that one of the following must be true:

1) You must be unable to control the movement of at least two extremities (either an arm and a leg, both arms, or both legs) that results in extreme difficulty with:

• • balancing while standing or walking
  • standing up from a seated position, or
  • using your arms.

2) You must have serious physical problems along with a serious limitation in any one of the following:

• • thinking (understanding, remembering, or applying information)
  • interacting with others (social problems)
  • finishing tasks (problems with concentration, persistence, or speed), or
  • managing yourself (regulating emotions, controlling your behavior, or adapting to changes).

For more information, see our article on the disability and peripheral neuropathy.

Qualifying for Disability Based on Your RFC

If your condition doesn't equal listing 11.14 or another listing, you can still qualify for disability benefits. You can get 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've retained despite your medical problems. Social Security will base your RFC on the medical evidence in your file. So, it's critical that you document, to the extent possible, the symptoms and pain you experience because of PHN, and that your doctor records your limitations in your medical records.

Social Security will use the information about your symptoms and limitations to determine what kind of work you can still do, given your impairment(s). For instance, if the chronic pain of PHN prevents you from doing a lot of lifting or moving around, you might receive an RFC for sedentary work. But if, because of PHN, your skin is extremely sensitive and even a very light touch is painful, you might be unable to work at even a sedentary job.

Read more about how having a sedentary or light RFC can mean an approval for disability benefits.

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 mainly on subjective symptoms, but there are some steps you can take to bolster your credibility.

Your Treatment History

Most importantly, you must receive consistent treatment for your PHN, preferably from a neurologist. If you fail to obtain regular treatment, Social Security might assume that your condition isn't as debilitating as you claim. All of your relevant medical records should be submitted to the SSA before your hearing, including:

• clinic notes
• lab tests
• imaging studies, and
• hospital records.

In addition, before awarding you disability benefits, Social Security usually wants to know that you've 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 might be necessary before you find any relief.

Your Doctor's Opinion of Your Limitations

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

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

Your Pain Diary

Because pain can't 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 following:

• the date of the pain
• 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.

Learn more about how Social Security evaluates the limitations caused by chronic pain.

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. For more information, see our article on the best way to apply for Social Security disability benefits.

Most individuals filing for SSI only can't file the whole application online, but they can get started on Social Security's website.

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 with your application. And an attorney can help you provide persuasive evidence of your functional limitations.

Does the VA Have a Disability Rating for Shingles?

The Veterans Administration (VA) rates shingles depending on how it affects you. A shingles rash could initially be rated using the General Ratings Formula for the Skin (under diagnostic codes 7806 and 7820). As a skin condition, the VA rating for shingles could be 0%, 10%, 30%, or 60%, depending on how much of your body is involved and how often you receive systemic therapy (like antiviral medications).

The VA disability rating for lingering shingles pain, or PHN, is based on the neuralgia ratings, with a maximum rating of 10%. (38 C.F.R. § 4.124.) For example, PHN that causes chronic pain over your chest or shoulder could be rated under diagnostic code 8411 for neuralgia of the eleventh cranial nerve.

Of course, to receive a VA disability rating for shingles or PHN, you'll first have to prove that your impairment is "service-connected"—that it was caused by (or made worse by) your military service. Get tips on how to establish a service connection for VA disability.