Trigeminal neuralgia is a chronic condition that is characterized by sudden, shock-like or burning facial pain that can last from a couple seconds to several minutes. The pain is extremely intense and can occur at seemingly random times: Some people may have several episodes in a row and then no episodes for a couple of weeks, and some people may have episodes daily. Because people with trigeminal neuralgia cannot usually predict when the pain will occur, it is often a debilitating disorder. Many sufferers are constantly waiting and anticipating the next episode of extreme pain.
The trigeminal nerve is a nerve that passes sensations back and forth between the brain and the different areas of the face. Medical professionals are not completely sure what causes trigeminal neuralgia, but it is 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.
There is no single test that shows a person definitively has trigeminal neuralgia, which, as discussed below, can be a hurdle to getting disability benefits. MRIs can sometimes show a blood vessel pressing on the trigeminal nerve, and magnetic resonance angiography can sometimes show that the trigeminal nerve is compressed. In some people with trigeminal neuralgia, however, these tests may not show anything conclusive.
In order 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 that you have a medically determinable impairment that has lasted or is expected to last at least 12 months and that is so severe you are unable to work because of it.
Many physical conditions are diagnosed by looking at the results of things like blood tests and x-rays, which makes it easier for the Social Security Administration (SSA) to validate that you do, in fact, have a medically determinable impairment. However, as discussed above, trigeminal neuralgia is often “invisible.” That is, there are often no tests or laboratory results that can prove a diagnosis of trigeminal neuralgia and can substantiate your complaints of extreme pain.
Usually the easiest way to qualify as disabled for purposes of the SSA is if your impairment meets the criteria on a list of impairments that the SSA uses. Alternatively, if your medical condition can be considered equivalent to one of the listed impairments, you could qualify as disabled. Unfortunately, trigeminal neuralgia is not on the SSA’s list of impairments, anditisnot likely to equal a listing either. Since most people with trigeminal neuralgia have pain as their debilitating symptom, and the listed impairments require specific test results and laboratory findings, it would be difficult for most people with trigeminal neuralgia to get approved for disability this way.
Fortunately, there is a the third way to qualify for disability benefits that doesn't depend as much on objective findings. If the SSA, looking at all of the evidence, decides that your impairment and related symptoms are so severe that there is no work you can perform with your reduced capacity, you can be found eligible for disability under what is called a “medical-vocational allowance.” This will be the way most people with trigeminal neuralgia qualify for disability, if they do.
Intermittent but extreme pain can interrupt your ability to concentrate on tasks, keep up with work, get along with co-workers, and reduce your productivity. These are limitations that reduce your capacity to work, and the SSA must consider them when evaluating your claim. For more information, learn about medical-vocational allowances.
Since trigeminal neuralgia is characterized by extreme pain, it’s important for you to know how the SSA evaluates symptoms of pain. When the SSA is determining whether or not you are disabled, it will look at all of your symptoms, including pain. The SSA will look at how consistent your symptoms of pain 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 and whether or not they are helping. Make sure you include all of your medical records, even tests that rule out other impairments. The SSA 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, about any efforts you have made to work, and about the intensity and persistence of your pain. It can help to keep a pain diary to document your pain.
For more information, see our article on chronic pain and Social Security.
Even though it may be difficult to receive disability benefits based on trigeminal neuralgia, it is not impossible. However, without a disability lawyer's or nonlawyer representative's help, you don't have much chance of getting disability for trigeminal neuralgia alone. Many communities have legal aid or other services that provide assistance for people applying for SSI or SSDI. Or, you may want to contact a disability attorney or other representative to assist you in the application and appeal process.