Tourette syndrome is a neurological disorder that causes involuntary vocal and motor tics. The tics frequently involve physical movements like jerking, foot stamping, kicking, and facial movements and can be accompanied by grunts, coughs, barks, or shouts. More serious Tourette’s tics can include jumping, touching, smelling, kissing, twirling, biting, and other movements that can endanger the sufferer’s (and others) physical well-being. Although it is a popular belief that the uncontrollable use of obscene language and gestures is a common symptom of Tourette’s sufferers it is, in fact, a relatively rare occurrence.
Tourette syndrome has no cure, but for many people the symptoms are mild and manageable. People with more severe Tourette's, however, can experience severe impairments in their daily functioning. For some, but not all, of these people, a combination of medications (including injections of Botox into affected muscles), psychotherapy, and family education and support can help moderate the symptoms that interrupt daily life.
First, to be eligible for disability benefits, you can't be making more than $1,170 per month. In addition, you must be eligible for either SSDI, which is available to people who paid Social Security taxes for a sufficient number of years, or SSI, a benefit for low-income people without a qualifying work history.
To determine whether you are medically eligible for disability, the Social Security Administration (SSA) will first look to see if your impairment meets the listing for neurodevelopmental disorders. (Neurodevelopmental disorders begin in childhood, although sometimes they are not diagnosed until adulthood.)
Tourette syndrome is now evaluated under Social Security’s impairment listing 12.11, for neurodevelopmental disorders. (This listing is new for adults in 2017.) The listing requirements are the same for adults and children.
For disability applicants with Tourette's, the listing states that an individual must experience recurrent motor movement or vocalization. In addition, the individual must have an “extreme” limitation of one of the following areas of mental functioning, or a severe limitation in two of them:
If Social Security finds that your Tourette's is not severe enough to meet the listing, the agency will prepare a Residual Functional Capacity assessment (RFC). An RFC is a detailed report that will discuss how your Tourette’s affects your ability to perform certain work-related activities. There are two types of RFC that may be used for a person with Tourette’s: a physical RFC and a mental RFC. A physical RFC will assess the impact of your Tourette’s on your ability to perform certain physical activities, while a mental RFC will assess the impact on certain mental activities.
A physical RFC for a person with severe Tourette’s might state that he or she would be unable to perform any jobs that required the ability to balance, climb, or work around heavy or dangerous machinery. This limitation results from the spontaneous nature of the disease and how physical tics could compromise the worker’s, and his or her co-workers', safety. A person with this RFC would be unable to perform most warehouse jobs, construction work (including painting), and any agricultural work that involved heavy machinery.
Tourette syndrome can also adversely affect fine motor skills and hand-eye coordination. An RFC for a person with diminished fine motor skills or hand-eye coordination might state that he or she has a decreased ability to use his or her hands and fingers to hold, manipulate, finger and feel small objects. This limitation would make it difficult to do jobs that involved typing, sorting, and most assembly work. Jobs that require these skills include data entry, secretarial, and light industrial positions.
A mental RFC assesses how a person’s impairment affects his or her ability to perform mental and emotional work-related activities like following directions, completing tasks without assistance, getting along with others, interacting with authority, and working with others without distracting them.
Because the symptoms of Tourette’s are frequently disruptive, it can have a significant impact on workplace productivity. The symptoms of Tourette’s can also impact a person’s ability to interact with people who are unfamiliar with the syndrome or the individual. This could make it difficult to perform jobs that require frequent customer contact or work in environments that cannot be tailored to help the individual work without disrupting co-workers.
After ruling out some types of jobs because of the limitations in your RFC, if the SSA finds there are jobs remaining that you could do, the agency will deny your claim. If you hire a disability lawyer, the lawyer can help to rule out jobs the SSA says you can do, by providing the proper evidence through your doctor's notes or your testimony at the disability hearing.
You should ask your treating doctors, including therapists or psychiatrists, to complete a statement like an RFC report for you showing your functional limitations. How your doctor has characterized your Tourette's (mild, moderate, or severe) in his treatment notes can also have a big impact on the success of your case.
If you have other conditions such as OCD or ADHD, the SSA will consider these limitations in conjunction with your Tourette’s when creating your RFC. Your physician should include these impairments when preparing an RFC statement for you. Learn more about Social Security's analysis of the RFC.
Because of the unique symptoms of Tourette’s, it may be helpful to have former co-workers or supervisors write a descriptive statement about how your illness impacted the workplace. The SSA will consider supportive statements in conjunction with other evidence to decide your claim. Learn more in our article on whether supportive letter help your disability claim.