Face Pain and Trigeminal Neuralgia: Social Security Disability Information

Trigeminal neuralgia is a chronic condition characterized by sudden, shock-like, or burning facial pain that can last from a few seconds to several minutes. The pain is extremely intense and can occur at seemingly random times. For instance, you might have several episodes in a row and then none for a few weeks. Or you might experience facial pain several times every day. The severity and frequency of attacks can increase over time.

Because people with trigeminal neuralgia can't usually predict when the pain will occur, it can be debilitating. Many sufferers are constantly waiting and anticipating the next episode of extreme pain.

What Causes Trigeminal Neuralgia?

The trigeminal nerve passes sensations back and forth between your brain and the different areas of your face. Medical professionals aren't entirely sure what causes trigeminal neuralgia. But it's believed to be caused when the protective sheath around the nerve gets worn away and causes the nerve to send abnormal signals to the brain.

Getting a Diagnosis of Trigeminal Neuralgia

There's no definitive test to show that you have trigeminal neuralgia, which can be a hurdle to getting disability benefits. MRIs might show a blood vessel pressing on your trigeminal nerve, and magnetic resonance angiography (MRA) could show that your trigeminal nerve is compressed.

But these tests also might not show anything conclusive. That can make it difficult to prove to the Social Security Administration (SSA) that you're disabled and can't work because of the facial pain caused by trigeminal neuralgia.

Qualifying for Disability When You Have Trigeminal Neuralgia

To be considered disabled and eligible for disability payments—through either Social Security Disability Insurance (SSDI) or the Supplemental Security Income (SSI)—you need to show three things:

• you have a "medically determinable impairment"
• your impairment has lasted or is expected to last at least 12 months, and
• your impairment is so severe that it prevents you from working.

Other physical conditions can usually be diagnosed using blood tests and X-rays, which makes it easier to prove to Social Security that you have a medically determinable impairment. But trigeminal neuralgia is often "invisible," making it difficult to prove your diagnosis is legitimate. And there often aren't tests or laboratory results that can substantiate your complaints of extreme pain.

But that doesn't mean you can't qualify for disability benefits based on trigeminal neuralgia. It's just more challenging.

Qualifying for Disability by Meeting a Listing

Usually, the easiest way to qualify for Social Security disability benefits is to show that your impairment meets the criteria for a condition on Social Security's list of impairments. Alternatively, if your medical condition can be considered equivalent in severity to a listed impairment, you could qualify as disabled.

Unfortunately, trigeminal neuralgia isn't included in the list of impairments, and it's not likely to equal a listing, either. That's because pain is usually the debilitating symptom of trigeminal neuralgia, and the listed impairments require specific test results and laboratory findings. That makes it nearly impossible for someone with trigeminal neuralgia to qualify for disability by meeting or equaling a listing.

Qualifying for Disability by Reduced Capacity to Work

Fortunately, there's another way to qualify for disability benefits that doesn't depend as much on objective test results. Social Security must look at all the evidence, including how your impairment and related symptoms affect your ability to work.

Intermittent but extreme pain can affect your ability to:

• concentrate on tasks
• keep up with work
• get along with co-workers, and
• maintain good productivity.

Social Security will determine what kind of work you can and can't do, given your condition, using a residual functional capacity (RFC) assessment. Your RFC is the most you can be expected to do, given your limitations. Your RFC will include exertional limitations (like how much weight you can lift) and non-exertional limitations (including mental and environmental limitations). For instance, if exposure to cold air triggers your pain, you can't be expected to work in a cold environment. Social Security must consider any limitations that reduce your capacity to work when evaluating your claim.

Some people battling chronic pain conditions like trigeminal neuralgia develop mental impairments like anxiety or depression. If you have a mental impairment, Social Security must consider the combined effects of your pain and mental condition on your capacity to work. (Learn how even a moderate mental impairment can help a physical disability claim.)

If Social Security finds there's no work you can perform with your reduced capacity, you can qualify for disability benefits under a "medical-vocational allowance." That's how most people with trigeminal neuralgia who qualify for disability win their claims. Not having regular attendance or having reduced productivity might be enough for Social Security to determine that you can't do even sedentary work, which could get you benefits under a medical-vocational allowance.

How Social Security Evaluates Pain

Because trigeminal neuralgia is characterized by extreme pain, in determining whether or not you're disabled, Social Security will consider all of your symptoms—including pain.

Social Security will look at how consistent your pain symptoms are with the evidence you've presented. This evidence will include medical evidence, like:

• your doctor's notes
• test results
• laboratory findings
• any operations you've had related to your pain, and
• medications you're taking (including side effects and whether or not they're helping).

Make sure you include all your medical records, even tests that rule out other impairments.

Social Security will also look at non-medical evidence, such as statements from you and others about:

• your daily activities, and how your pain limits those activities
• any efforts you've made to work, and
• the intensity and persistence of your pain.

It can help to keep a pain diary to document your pain. Learn more about how Social Security evaluates chronic pain.

How to Apply for Social Security Disability Benefits

You can apply for SSDI benefits using Social Security's online application. But you can only get an SSI application started online. You must speak with a Social Security representative to finish an application for SSI.

You also have the option to apply for SSI or SSDI by phone. Contact your local Social Security office or call Social Security's national office at 800-772-1213 (TTY 800-325-0778) to make an appointment to file by phone or in person.

No matter which method you choose, don't delay filing your disability application—waiting can reduce the amount of back pay you receive.

Where to Get Assistance With Your Trigeminal Neuralgia Disability Claim

Though it can be challenging to get disability based on trigeminal neuralgia, it's not impossible. But without help from a disability lawyer or nonlawyer representative, you might not have much chance of getting benefits for trigeminal neuralgia alone.

Many communities have legal aid or other services that assist people who can't afford lawyers, but not all of them help people apply for SSI or SSDI. You might want to contact a disability attorney or other representative to assist you in the Social Security application and appeal process.

Learn more about how a disability attorney can help with your claim.

_{Updated February 12, 2024}