Getting Social Security Disability for Tourette Syndrome

Tourette syndrome (often called Tourette's syndrome) is a neurological disorder that causes involuntary vocal and motor tics. The tics frequently involve physical movements like:

• jerking
• foot stamping
• kicking, or
• facial movements like grimacing.

And they can be accompanied by grunts, coughs, barks, or shouts. More serious Tourette's tics can include movements like:

• jumping
• touching
• twirling or twisting
• biting, or
• other movements that can endanger the person's physical well-being (or the well-being of others).

Although it's a popular belief that the uncontrollable use of obscene language and gestures is a common symptom of Tourette's sufferers, it is, in fact, relatively rare.

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 people with severe Tourette's, a combination of medications (including Botox injections in the affected muscles), psychotherapy, and family education and support can help moderate the symptoms that interrupt daily life. When treatment doesn't work, Tourette's can be disabling.

Is Tourette's a Disability That Qualifies for Social Security Benefits?

The Social Security Administration (SSA) defines disability as the inability to do substantial work because of a "medically determinable" physical or mental impairment that lasts at least 12 consecutive months. (20 C.F.R. § 404.1505(a).) If your Tourette syndrome is severe and impairs your daily function so much that you can't work, Social Security will consider it a disability.

Even those with milder Tourette's might qualify as disabled for Social Security purposes—particularly if they have other medical conditions. It's not uncommon for someone with Tourette's to have additional impairments such as:

• obsessive-compulsive disorder (OCD)
• attention-deficit hyperactivity disorder (ADHD), or
• learning disabilities.

Social Security must consider all your impairments when determining disability. So, the combined effect of your Tourette's symptoms and other impairments might be enough to meet Social Security's definition of disabled. (Learn more about qualifying for disability based on multiple impairments.)

Which Adults Are Eligible for Disability Benefits?

To be eligible for disability benefits, you'll first need to meet the non-medical requirements for Social Security. For starters, you can't make more than about $1,600 a month from work. If you can earn that much, Social Security will consider your work "substantial gainful activity" and won't consider you disabled.

You must meet all the eligibility requirements for at least one of the disability programs administered by Social Security:

• Social Security Disability Insurance (SSDI), which is available to people who paid Social Security taxes for a sufficient number of years, or
• Supplemental Security Income (SSI), which benefits people with low incomes (and has no work history requirement).

Learn more about the legal and financial eligibility requirements for these disability programs.

How Adults With Tourette's Meet the Medical Requirements for Disability

There are two ways you can meet Social Security's medical requirements for disability:

• meet (or "equal") the requirements of a Blue Book listing (a list of medical conditions that can automatically qualify as disabling), or
• show that your impairment prevents you from working in any type of job.

Meeting the Disability Listing for Neurodevelopmental Disorders

Social Security evaluates Tourette syndrome under impairment listing 12.11 for neurodevelopmental disorders. (Neurodevelopmental disorders begin in childhood or adolescence, although sometimes they aren't diagnosed until adulthood.) The listing requirements for Tourette's are the same for adults and children.

To meet the listing requirements with Tourette syndrome, you must experience recurrent motor movements or vocalizations. In addition, you must have an "extreme" limitation in one of the following areas of mental functioning or a severe limitation in two of them:

• interacting with others (keeping interactions free of excessive irritability and sensitivity, sustaining conversation)
• adapting or managing oneself (managing your psychological symptoms, controlling your behavior)
• understanding or using information, or
• being able to concentrate and keep pace with others.

Getting Disability for Tourette's Without Meeting the Listing

If Social Security finds that your Tourette syndrome isn't severe enough to meet the listing, the SSA will prepare a residual functional capacity assessment (RFC). An RFC is a detailed report that discusses how your Tourette's affects your ability to perform certain work-related activities.

Two types of RFCs might be used for someone with Tourette syndrome: 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. And a mental RFC will assess Tourette's impact on certain cognitive or behavioral activities.

A Physical RFC for Tourette Syndrome

Your physical RFC reflects the most you can be expected to do in a work setting, given your exertional and non-exertional physical limitations. For instance, if you have severe motor tics because of Tourette's, your physical RFC might state that you can't perform any jobs that require the ability to:

• balance
• climb, or
• work around heavy or dangerous machinery.

If you had this RFC, you'd be unable to perform most warehouse jobs, construction work (including painting), and any agricultural work that involved heavy machinery.

Or, for example, if your Tourette syndrome adversely affects your fine motor skills and hand-eye coordination because of repeated shoulder shrugging or eye blinking or darting, your RFC might state that you have a decreased ability to use your hands and fingers to:

• hold
• manipulate
• finger, and
• feel small objects.

This limitation could prevent you from doing jobs that involve typing, sorting, and assembly work. Jobs that require these skills include data entry, secretarial, and light industrial positions.

A Mental RFC for Tourette's

A mental RFC assesses how your impairment affects your 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 your workplace productivity. The symptoms of Tourette's can also affect your ability to interact with people who are unfamiliar with you or the syndrome.

These limitations could make it difficult to perform jobs that require frequent customer contact or work in environments that can't be tailored to help you do your work without disrupting your co-workers.

How Social Security Uses Your RFCs to Decide If You Can Work

After ruling out some types of jobs because of the limitations in your RFC, if Social Security finds there are jobs remaining that you could do, the SSA will deny your disability claim.

A disability lawyer can help to rule out jobs Social Security says you can still do by gathering and providing convincing evidence through your doctor's notes or your testimony at the disability hearing. (Learn more about how disability lawyers develop evidence for a Social Security claim.)

Ask your treating doctors, including therapists or psychiatrists, to complete a statement for you, like an RFC report, explaining your functional limitations. How your doctors characterize your Tourette's (mild, moderate, or severe) in their treatment notes can have a big impact on the success of your case.

Remember, Social Security will consider all your limitations in conjunction with your Tourette syndrome when creating your RFC. So, if you have other conditions, such as OCD or ADHD, be sure your doctor includes these impairments when preparing a "medical source statement" for you.

Learn more about how Social Security uses your RFC to decide if you're disabled.

Supportive Statements From Employers and Others Can Help

Because of the unique symptoms of Tourette's, it can be helpful to have former co-workers or supervisors write descriptive statements about the impact your illness had in the workplace. Social Security will consider supportive statements along with other evidence to decide your claim.

Learn more in our article on how supportive letters can help your disability claim.

Getting Disability for Children With Tourette's Syndrome

Children with Tourette's can qualify for disability benefits through the SSI program. Children generally aren't eligible for SSDI benefits (unless a parent is eligible for SSDI or retirement benefits), because children generally can't meet the program's work requirements. Learn more about the disability benefits available for children.

How a Child Meets the Financial Requirements for SSI

SSI is a needs-based program. So, for your child to be eligible for SSI disability benefits, you must have a low household income and few resources (below the SSI asset limit). But not all your income or assets count toward the limits.

Exactly how much income you can have and still qualify will depend on the following:

• the size of your family
• the source of your income, and
• where you live (some states have higher limits than others).

(Learn more about the SSI income limit, including what counts and what doesn't.)

How a Child With Tourette's Meets the Medical Requirements for Disability

Several years ago, Social Security changed the childhood disability listing for Tourette syndrome (covered under the listing for neurodevelopmental disorders, listing 112.11). It's now the same as the adult listing. So, to meet the listing, your child must have recurrent tics or vocalizations and an "extreme" limitation in one of the following areas of mental functioning or a severe limitation in two of them:

• interacting with others (not getting easily annoyed with other children, being able to have a conversation)
• managing oneself (controlling anger, staying away from dangerous situations)
• understanding or using information (keeping at grade level in school), and
• being able to concentrate and keep pace with others.

You should review the listing requirements with your child's pediatrician to determine whether your child might qualify for SSI disability. Also, school records can go a long way in helping a child get disability benefits for Tourette syndrome.

If your child's Tourette's doesn't meet the listing for neurodevelopmental disorders, the child might still qualify for disability by "functionally equalling" the listings. Social Security will consider how your child's medical conditions (including any additional impairments like ADHD or anxiety disorder) affect six areas of daily functioning.

Learn more about what it takes for a child to functionally equal the listings.

How to Apply for Social Security Disability Based on Tourette's

The process of applying for disability benefits differs somewhat depending on whether the application is for an adult or a child.

The fastest way to apply for SSDI or SSI disability benefits for an adult with Tourette's is to use Social Security's online benefits application. The online application can be accessed from anywhere anytime. And you can pause the process as often as needed without losing your place.

You can't complete a child's SSI application online, but you can get one started by completing the child disability report at SSA.gov. Again, you can pause and restart this report as many times as needed.

If you'd like to file a child's application by phone, you can request an appointment online or call Social Security at 800-772-1213 Monday through Friday from 7 a.m. to 7 p.m. local time. You can also call that number to apply for SSDI or SSI disability benefits for an adult.

Whether you're filing a child's SSI application or an adult disability application, you can apply in person at your local Social Security office. You'll want to make an appointment before you go to the office. That way, you'll reduce your wait time and ensure you get the help you need.

You also have the option to hire a disability lawyer or non-attorney representative to help you file your application. An attorney or representative can walk you through every step of the process and help you gather and prepare the documents Social Security requires. Having an experienced attorney can improve your chance of winning a claim based on a mental impairment like Tourette syndrome.

Learn more about how a disability attorney can help you with a mental health claim.