Fibromuscular dysplasia (FMD) is a term for narrowing of the arteries that is not related to plaque and arteriosclerosis. Instead, the narrowing (“stenosis”) is caused by overgrowth of fibrous tissues in the arterial wall. The narrowing of the arteries can cause lack of blood flow to nearby organs and other complications, which depend on the location of the FMD.
FMD is more common in women and is often diagnosed in women age 30 to 50. In men, the most common place for fibromuscular dysplasia to appear is in the renal arteries (those feeding the kidney); in women, FMD most often occurs in the renal and extracranial carotid arteries (the blood vessels leading to your brain). FMD can also occur in the arteries leading to the abdomen (mesenteric arteries), the arms and legs (peripheral arteries), and less frequently in other arteries. Treatment for FMD can include angioplasty, stent placement, or medication.
For many people, fibromuscular dysplasia is not severely limiting or life threatening (with proper treatment), and in those cases, FMD does not rise to the level of a disability. That said, in some patients, especially those with aneurysms or dissections or FMD in multiple arterial beds, FMD can cause a significant loss of function and a great deal of pain. For these applicants, disability benefits may be available. However, FMD is not one of the diseases that Social Security includes in its Listing of Impairments, so you cannot get disability benefits simply by meeting a list of medical criteria. Instead, you’ll have to show Social Security how your FMD severely limits the activities you can do.
Since individuals with fibromuscular dysplasia have a higher risk of aneurysms and tears in the arteries, many doctors tell their FMD patients to avoid strenuous weight lifting, which can strain the arteries, along with contact sports and anything that might cause the neck to jerk sharply (for those with FMD in the carotid arteries). If your doctor has limited the amount of weight you can lift, make sure this limitation is recorded in your medical records; this will affect Social Security’s RFC (residual functional capacity) assessment of you. For example, if you are restricted from lifting more than 20 pounds, you would be limited to doing “light” work. If you are restricted to lifting only 10 pounds or less (as might be the case if you have FMD along with high blood pressure or other risk factors), you would be limited to doing only sedentary (sit-down) work. Being limited to these levels of work can make it more likely you’ll be found disabled.
Similarly, those who suffer from peripheral artery FMD in the legs often suffer from pain after walking or climbing stairs. Their doctors may put a restriction on the amount of time they may stand or walk. For example, if you are limited to standing and walking no more than six hours per day, you should have an RFC for light work, and if you are limited to walking and standing two hours per day, you should have an RFC for sedentary work. Those with peripheral artery FMD may also qualify for disability by equaling the peripheral artery disease listing.
Fatigue, anxiety, and depression frequently affect those with fibromuscular dysplasia. Some patients suffer exhausting fatigue, and, especially for those with carotid artery dysplasia who are aware they are walking around with their carotid arteries narrowed by 80-90% or more, fear of stroke can cause a great deal of apprehension. Carotid artery FMD can also cause symptoms like severe headaches, dizziness, tinnitus, or loud swooshing sounds in the ears, which can be distracting. FMD of the abdominal arteries can cause pain after eating and unintentional weight loss.
These symptoms can sometimes cause what Social Security calls non-exertional (non-strength-related) limitations, including difficulty concentrating or paying attention, remembering detailed instructions, or getting along with others. In addition, patients with carotid artery FMD who suffer from frequent dizziness should be restricted from working at heights or operating hazardous machinery.
Non-exertional limitations can have a big impact on the disability determination, so make sure you report these symptoms to your doctor and that they are recorded in your medical records. (For more information, see our article on non-exertional limitations.)
Some patients with FMD may be able to demonstrate they aren’t able to hold down a full-time job -- even a sedentary job -- because of the following limitations:
For more information, see our article on limitations that prevent even sedentary work.
Fibromuscular dysplasia of the renal arteries can cause high blood pressure and kidney damage, while FMD of the carotid arteries can cause headache, migraines, dizziness, TIAs (transient ischemic attacks), and stroke. In addition, tears in the artery wall (dissection) and aneurysms can appear in any artery affected by FMD. Those who have intracranial (cerebral) aneurysms (the risk is higher in those with carotid artery FMD) are at risk of brain bleeding or stroke.
Having any of these complications can tip the scales in favor of being granted disability benefits:
Migraines. Those with fibromuscular dysplasia in the carotid arteries often suffer from frequent and sudden headaches or migraines. While it is tough to get disability benefits for migraines, when combined with limitations caused by FMD, you may be able to prove that your conditions prevent you from sustaining full-time work without excessive absenses. For more information, read our article on getting disability benefits for migraines.
Aneurysm. If you’ve been diagnosed with an aneurysm in addition to FMD, you might have an easier time getting disability benefits, due to the fact that aneurysms often present more serious risks and limitations, and also because Social Security does have a disability listing for aneurysm. However, the impairment listing for aneurysm is intended to be used to assess only aneurysms that have dissection (pulling away from the artery wall) and that are in the aorta or major branches of the aorta. Some people with FMD have multiple small aneurysms that don’t cause symptoms or that have been repaired surgically, and they won’t automatically qualify for disability under the aneurysm listing. But if you do have an aneurysm with dissection, and it is increasing in size, you can argue that your condition is equal in severity to the criteria in the aneurysm listing. For more information, read our article on getting disability benefits for an aneurysm.
High blood pressure. While hypertension won’t qualify you for disability benefits, high blood pressure combined with FMD, especially you’ve suffered any organ damage due to high blood pressure or renal FMD, may make it slightly less difficult to win disability benefits. For more information, read our article on getting disability benefits for hypertension.
Stroke. If you’ve had a stroke, Social Security will use the listing for cerebral vascular accidents to assess your condition. However, just having had a stroke, or having multiple TIAs, won’t qualify you for disability under the vascular accident listing. To meet its requirements, you need to have trouble using your hands, walking, speaking, or seeing following the stroke. For more information, read our article on getting disability benefits following a stroke.