Making a Successful Disability Claim Based on Narcolepsy

Narcolepsy is a nervous system disorder that causes daytime sleepiness and a strong feeling of needing to sleep. Doctors don't yet have a cure for narcolepsy, but symptoms can sometimes be controlled by scheduling naps and, in some cases, by taking prescription medicine. Narcolepsy can cause difficulty functioning at work or school and can lead to accidents and injuries for people who are so tired that they can't function or can't control the urge to nap.

What Symptoms of Narcolepsy Keep You From Working?

Common symptoms of narcolepsy include:

• excessive daytime sleepiness (EDS)
• sudden "sleep attacks," where you feel a very strong urge to sleep during the day
• cataplexy, which is where you have a sudden loss of muscle strength that can cause you to physically collapse
• sleep paralysis, where you can't move right before you fall asleep or when you are waking up, and
• hypnagogic hallucinations, which occur between sleeping and waking and can involve seeing or hearing things that aren't really there.

Narcolepsy type 1 refers to a more severe form of narcolepsy that includes cataplexy and sleep paralysis. People with narcolepsy type 2 don't experience cataplexy. Hypersomnia can mean both EDS and an umbrella term for any condition in which you feel extreme daytime sleepiness despite getting enough sleep.

How Do I Qualify for Disability if I Have Narcolepsy?

The Social Security Administration (SSA) has three ways to qualify for disability:

• your medical condition is on the list of impairments that the SSA publishes and meets the severity levels described for the specific impairment
• your condition isn't on the list but it "equals" (is similar to) another listing, or
• your impairments have a severe effect on your ability to work.

Is Narcolepsy a Listed Impairment?

Narcolepsy is not one of SSA's "listed impairments," so you can't qualify for disability this way. Don't worry; there are other ways the SSA can find that you are disabled.

Can Narcolepsy Equal a Listing?

Since narcolepsy isn't a listed condition, the SSA will look at whether your narcoleptic symptoms are "equal to" a different condition that is listed. In some cases, the SSA has found people with narcolepsy to be disabled because they equal the listing for epilepsy.

If you suffer from narcolepsy and have frequent sleep attacks, your condition may be found to medically equal to having "dyscognitive seizures," which are part of the epilepsy listing. For your narcolepsy to be considered equal in severity to the epilepsy listing, you'll need to show that you suffer from:

• sleep attacks that are similar to dyscognitive seizures and occur at least once a week for three consecutive months, or

• sleep attacks that are similar to dyscognitive seizures and occur at least once every other week for three consecutive months and cause a "marked" (severe) limitation in one of the following areas:
  • physical functioning, such as standing, balancing, or using your arms and hands
  • understanding, remembering, or using information in work activities
  • interacting with others
  • concentrating, persisting, or maintaining pace, or
  • controlling emotions and behavior and maintaining well-being in a workplace setting.

(For more information on getting disability for dyscognitive seizures, see our article on disability for epilepsy.)

Can Narcolepsy Qualify for a Medical-Vocational Allowance?

If the SSA determines that your narcolepsy doesn't equal the epilepsy listing or another listing, it doesn't necessarily mean your claim will be denied. The SSA has one more step it will go through to determine whether you're disabled for purposes of SSI or SSDI.

The SSA will look at all of the evidence in your file, which includes medical evidence and non-medical evidence, such as statements from you, your family and friends, therapists, and so on, to assess your residual functional capacity, or "RFC." Your RFC is the most intense work you can do (heavy, medium, light, or sedentary) and dictates what type of jobs you can do and what your limitations are.

If you have narcolepsy, your RFC assessment will almost certainly be limited, at the very least, to:

• no work where you need to drive
• no work involving heavy or dangerous machinery, and
• no work in high, unstable, or otherwise unsafe places.

If the SSA decides that you can't do any jobs, based on the severity of your narcoleptic symptoms and the work restrictions you need to keep yourself and others safe, you'll be eligible for disability under a "medical-vocational allowance."

What Evidence Should You Give to Social Security?

You should make sure the SSA has the following:

• statements from your treating doctor explaining how long each sleep attack usually lasts and the number of sleep attacks you're having
• statements from your treating doctor explaining whether you have been following all prescribed treatment, including taking any prescribed medications used to treat narcolepsy
• results from any tests done, including ECGs, EEGs, polysomnograms (sleep studies), and the multiple sleep latency test (MSLT), and
• documentation (including statements from your doctor and other relevant people) that describe any aftereffects of your sleep attacks that interfere with your day-to-day functioning.

If You Need Help Applying for Disability

Applying for disability, whether you apply for SSI, SSDI, or both, can be a confusing and complex process, especially for a poorly understood condition like narcolepsy. It can be difficult to win benefits based on equaling another listing without the help of a lawyer. Many communities have legal aid or other services that provide assistance and resources for people applying for disability benefits. Or, you can contact a disability lawyer or advocate, who will receive a one-time fee from your backpay (limited to a certain percentage), if you win disability benefits.

_{Updated April 2, 2022}