Can I Get Social Security Disability for Muscular Atrophy or SMA?

You can file a Social Security disability claim based on muscular atrophy—the wasting of muscle tissue due to inactivity. Your chances of success depend on the severity of your limitations and how long those limitations last. If you have spinal muscular atrophy (SMA), or your muscular atrophy is severe and long-lasting, you might qualify for disability benefits from Social Security.

What Causes Muscle Atrophy?

In most cases, muscular atrophy occurs as a result of another illness or injury, such as:

• a stroke
• multiple sclerosis
• post-polio syndrome
• ALS (Lou Gehrig's Disease), or
• broken limbs.

Some cases of muscular atrophy are easily observed. For example, removing a cast after a broken bone has healed might reveal a limb that's gotten smaller due to the muscles shrinking from disuse. In addition to visibly reduced muscle mass, another tell-tale sign of muscular atrophy is muscle weakness.

If you suffer from muscular atrophy but don't know the cause, describe all your symptoms to your treating physician. Your doctor will try to locate the cause of your atrophy using your medical history, reported symptoms, and tests such as:

• MRIs
• CT scans
• X-rays
• blood tests, or
• nerve conduction studies.

What Is Spinal Muscular Atrophy?

Spinal muscular atrophy (SMA) is a rare, hereditary, and very severe form of muscular atrophy. SMAs are sometimes called motor neuron diseases or anterior horn cell diseases. SMA can cause weakness of the limbs and sometimes problems with breathing and swallowing.

There are five types of spinal muscular atrophy. The type of SMA is determined based on when the condition develops and how severe the symptoms are.

Types 0 and 1 SMA

Type 0 (prenatal SMA) is detected before a baby is born. Like other forms of SMA, symptoms include weakness, absent reflexes, and hypotonia. A key sign of Type 0 SMA before birth is a lack of or irregular fetal movement. Babies born with Type 0 usually have difficulty breathing, and their limbs can feel floppy or overly loose. Infants with Type 0 SMA rarely live more than a few months after birth.

Type 1 SMA (also called Werdnig-Hoffman disease or infantile-onset SMA) is generally diagnosed in infants between birth and six months of age. The symptoms of Type 1 SMA can include those of Type 0, along with:

• muscle twitching
• diminishing muscle mass
• labored breathing, and
• malnutrition.

Infants with Type 1 SMA typically won't live past two years of age without respiratory assistance (like NIPPV or a tracheotomy).

Childhood SMA (Types 2 and 3)

Type 2 SMA is generally diagnosed in children between 6 and 18 months of age. Children with Type 2 SMA can't stand up or walk without help, though they might be able to sit up on their own and might also have respiratory difficulties. Often, children with this type of SMA will only live into adolescence or young adulthood.

Type 3 SMA (also known as Kugelberg-Welander disease) can develop in children older than 18 months. It causes mobility issues, such as difficulty with activities like:

• walking
• running
• rising from a chair, or
• climbing stairs.

Type 3 SMA can cause complications, such as curvature of the spine, reduced range of motion (due to shortening or tightening of muscles, tendons, or other connective tissues), and respiratory infections. A child with Type 3 SMA can live a normal lifespan.

Type 4: Adult-Onset SMA

Type 4 SMA (adult-onset spinal muscular atrophy) is rare and develops in those over 21, usually during early adulthood. Type 4 is generally the mildest form of SMA, and its effects are generally more pronounced closer to the torso.

Adult-onset SMA generally causes mild to moderate leg muscle weakness, leg tremors, and sometimes mild breathing problems. Many people with Type 4 SMA can lead relatively normal lives. But like other types of SMA, Type 4 is progressive, causing more significant challenges for some.

Can Muscular Atrophy Qualify for Disability Benefits?

Social Security can find children and adults with muscular atrophy disabled in a couple of ways. The qualification requirements for children and adults differ somewhat.

Children with Muscular Atrophy

Children with muscular atrophy can be found disabled by either:

• meeting the symptoms or test results that Social Security requires under one of its childhood "listings" of disorders, or
• showing that their symptoms are so severe that their condition equals the severity of the listings.

Adults with Muscular Atrophy

Adults with MA can qualify as disabled by either:

• meeting or "equaling" the symptoms or test results that Social Security requires under one of its adult listings of disorders, or
• showing limitations that make it impossible for them to do any job.

In general, if you lack the muscle mass to perform the sitting, standing, walking, lifting, and carrying required by sedentary jobs, Social Security will consider you disabled, and you'll be eligible for benefits. If you're 50 or older, Social Security's medical-vocational "grid rules" mean you might qualify for disability even if you can perform sedentary work.

Muscular atrophy, by itself, rarely forms the basis for a successful disability claim. Rather, it's usually just one of many symptoms of another condition, such as:

• stroke
• spinal cord injury
• multiple sclerosis
• Charcot-Marie-Tooth disease
• post-polio syndrome
• HIV wasting syndrome
• ALS (Lou Gehrig's Disease), or
• broken limbs.

So, when completing your disability application (and testifying at your hearing), be sure to mention all the symptoms of your primary medical condition—not just those related to muscular atrophy.

Can SMA Qualify for Disability Benefits?

SMA Type 0 and Type 1 are so severe that Social Security has added them to its Compassionate Allowances List (CAL), which allows for approval of disability benefits in as little as a few weeks. These types of SMA generally meet Social Security's listing 110.08 for catastrophic congenital disorders or listing 111.22 for motor neuron disorders.

Listing 110.08 can be met with laboratory test results that confirm a newborn or young infant has SMA.

A baby with severe limitations in movement or developmental milestones that are less than half of the child's chronological age would meet listing 111.22. An infant whose SMA has resulted in extreme difficulty breathing or swallowing would also meet the listing.

The less severe forms of SMA, classified as Types 2, 3, and 4, aren't included on the compassionate allowances list. But they can still form the basis of a successful disability claim if they're so debilitating that they meet a childhood or adult listing or prevent an adult from doing any gainful employment.

Social Security could also evaluate these forms of SMA under its disability listings for muscular dystrophy, either listing 11.13 for adults or listing 111.13 for children.

The more severe forms of adult-onset spinal muscular atrophy, such as spinal-bulbar muscular atrophy (SBMA) and progressive muscular atrophy (PMA), are similar to a couple of listed conditions. Social Security could evaluate these muscle-wasting diseases under the listing for motor neuron diseases (listing 11.22). An adult with severe SMA might also be able to equal the listing for ALS (listing 11.10).

Getting Disability for Muscular Atrophy Without Meeting a Listing

It's possible to qualify for disability benefits even if your muscular atrophy doesn't meet or equal a listing—if it's severe and long-lasting. To get disability benefits this way, Social Security must find that you can no longer do your past work or any other type of work in the national economy.

To make this determination, Social Security uses the medical evidence in your file to assess your "residual functional capacity" (RFC). Your RFC is the most you can be expected to do in a work setting, given the limitations of your condition.

For example, if your legs are weak because of muscular atrophy, you might have trouble standing from a seated position, crouching and squatting, and walking without assistance (like using a walker or cane). With these limitations, your RFC would likely have the following restrictions:

• stand and walk occasionally
• lift and carry up to 10 pounds occasionally
• no working around dangerous moving machinery
• no exposure to unprotected heights, and
• no stairs or ladders.

In this case, you'd likely receive an RFC for sedentary work (a desk job). If you can do sedentary work and you're younger than 50, you probably won't qualify for disability. If you're an older worker, you might qualify for a medical-vocational allowance—depending on your age, education, and work history. (Learn more about how medical-vocational allowances work.)

How Can You Prove the Severity of Your Muscular Atrophy?

When filing for Social Security disability benefits based on muscular atrophy, you must submit enough medical evidence to prove your claim. In addition to providing your doctor's notes, records of hospital visits, and results of objective testing, you should obtain an opinion from your doctor regarding your physical limitations. This RFC form contains the important questions your doctor needs to answer to assist in your disability claim.

Be sure your doctor addresses any exertional (strength-related) restrictions you experience, such as lifting, carrying, walking, sitting, standing, pushing, or pulling. It's also essential that Social Security is aware of any non-exertional limitations you have, including those involving:

• kneeling
• crouching
• crawling
• balancing
• stooping
• manipulating objects with your hands, and
• any mental health symptoms caused by pain, like:
• fatigue
• lack of focus, and
• depression.

Written statements (witness letters) from former colleagues, friends, and family members describing your difficulties might bolster your claim as long as they focus on physical problems they've witnessed. The more evidence you can provide to document your restrictions, the greater your chance of persuading Social Security that you can't perform any jobs in the national economy.

Is Muscle Atrophy Reversible?

Often muscular atrophy is reversible through a combination of diet and exercise, but sometimes physical therapy or surgery are required. In severe cases of muscular atrophy, especially where individuals are paralyzed or bedridden, there might be no treatment available.

Generally speaking, Social Security Administration (SSA) won't grant disability benefits to someone with muscular atrophy if that condition can be reasonably expected to improve within 12 months.

When it comes to spinal muscle atrophy, there's no cure. Instead, treatment for SMA focuses on managing symptoms and preventing complications. Research into gene therapy is ongoing and might one day produce a cure, but currently, the muscle wasting of SMA isn't reversible.

Applying for Disability Based on Muscular Atrophy or SMA

You can apply for SSDI or SSI disability benefits for yourself or another adult by completing the online application. You can also get help with an adult disability application from a Social Security representative by calling the number above or contacting your local SSA office.

A child with disabilities can qualify for disability benefits through the Supplemental Security Income (SSI) program. Adults can apply for SSI or Social Security disability insurance (SSDI) benefits. Each program has specific financial and legal eligibility requirements.

You can't apply for SSI disability benefits for a child on your own. You'll have to meet with a Social Security representative (in person or by phone) to file a child's application. Start by notifying the SSA that you need to file a child's application by:

• calling Social Security at 800-772-1213 (TTY 800-325-0778)
• completing an online notification form
• submitting a child disability report online, or
• contacting your local Social Security office.

Once you let the SSA know you need to apply, Social Security will schedule an appointment for you to speak with a representative who'll help you complete the child's application.

Learn more about applying for Social Security disability and SSI benefits.

Improve Your Chances by Hiring a Disability Attorney

It can be challenging for an adult to get approval for a disability claim based on muscle atrophy. If you've been denied benefits for MA that prevents you from working, an experienced disability attorney can help you navigate the confusing disability appeals process.

In addition to representing you at your disability hearing, your lawyer will work with your doctor to obtain the medical evidence necessary to maximize your chances of success. Disability attorneys generally work "on contingency," meaning they charge no fee upfront, and you only have to pay the attorney if you win your case.

_{Updated February 26, 2024}