Essential tremor, also known as benign essential tremor or familial tremor, is a disorder of the nervous system that causes a rhythmic shaking in the body. The tremor can occur in almost any part of the body, but it most commonly affects the arms and hands. Essential tremors can also affect the voice box and lead to speech problems.
Although essential tremors and Parkinson’s disease appear to have similar symptoms, essential tremors do not cause other life-threatening complications (unlike Parkinson’s disease).
Essential tremors can affect a person’s ability to do fine motor skills like writing, tying shoes, using buttons, and eating. Symptoms can worsen when a person tries to reach or extend the arms.
Treatments include using specialized writing and eating utensils, occupational therapy, and medication, although most medications used to treat the tremors have the potential for serious side effects. For more severe cases, brain surgery may be used in an attempt to alleviate the symptoms of the disorder.
If your tremor is so serious that you can no longer work because your hands shake too much or you have other disruptive symptoms, you may be able to get federal disability benefits. The Social Security Administration administers two programs: Social Security disability insurance (SSDI) and Supplemental Security Income (SSI). The medical eligibility requirements for both programs are the same.
First, your tremor must have prevented you—or be expected to prevent you—from doing a significant amount of work (making over $1,200 per month) for at least 12 consecutive months. Second, you must either prove that you don't have the ability to function at a sedentary job or that your tremor fulfills the requirements for Social Security's impairment listing for Parkinson's disease.
To decide whether there is any work you can do, the SSA will prepare a detailed report called a residual functional capacity assessment (RFC). An RFC is the most you can do on a regular and sustained basis (full-time work). The report will look at how your tremors affect your ability to do certain strength-related (exertional) activities like:
If you have the RFC to do a sit-down job, you will be denied. However, if the SSA concludes your tremors prevent you from doing the full range of physical activities required to do sedentary work, you could be approved.
Before deciding that you can do the full range of activities to do sedentary work, the SSA should consider any "non-exertional," or non-strength-related, limitations that you have. Your RFC assessment should address whether your tremors, or your medications, cause any non-exertional limitations. Here are some examples of non-exertional impairments:
Having non-exertional limitations written down in your medical records is especially important to winning a claim where your strength is generally unaffected by the medical condition, such as in essential tremors.
Here are some examples of how the SSA may use a claimant’s RFC (including non-exertional limitations) to decide a claim for disability based on a benign essential tremor.
If you have tremors in both hands, another way to win your claim for disability is to prove that your condition is equivalent to one of Social Security's medical listings that is similar to your tremor; in this case, Parkinson’s disease. If your symptoms and limitations are as severe as those in the listing for Parkinson's, you could be automatically approved for benefits without having an RFC assessment. You can meet the requirements of the Parkinson's listing if you can't control the movement of both of your arms or hands, resulting in your inability to use your hands, despite at least three months of treatment.
Here is an example of how the SSA might decide a case based on equivalence to this listing.
The disability process is frequently long and can cause applicants significant stress. And there is no guarantee that you'll win benefits at the end, even if you truly cannot work. If Social Security denied your initial application for disability benefits, before you go to your hearing, it may be helpful to speak about your case with an experienced disability attorney. To find an attorney in your area, fill out our request for a consultation with a disability attorney.