Peripheral neuropathy occurs when the peripheral nerves are damaged. The peripheral nerves carry messages to and from the spinal cord and brain from the rest of the body.
When peripheral neuropathy is caused by diabetes mellitus (a common cause), it's called diabetic neuropathy. Both Type 1 diabetes and type 2 diabetes, and chronic high blood sugar, can cause peripheral neuropathy and its complications.
Peripheral neuropathy can also be caused by:
Whatever the cause, peripheral neuropathy can be a debilitating condition that can affect every aspect of an individual's life.
The symptoms of peripheral neuropathy depend on which nerves are affected: autonomic, motor, or sensory, and where they are located within the body. When peripheral neuropathy involves the motor nerves, symptoms can include muscle weakness, loss of coordination, and loss of balance. When neuropathy involves the sensory nerves, symptoms may include numbness, tingling, burning, sensitivity to touch, and pain. When the autonomic nerves are affected, symptoms might include high or low blood pressure or loss of bladder control.
Limitations caused by peripheral neuropathy include a lessened ability to walk, stand, and control muscle movements. In addition, many individuals who suffer from severe peripheral neuropathy have a lack of feeling in their feet and are prone to injury. Sometimes they injure themselves without knowing it, and this can lead to infections and even amputations. For many people with peripheral neuropathy, chronic pain is also an issue, which can have an effect on their ability to work.
Neuropathy associated with diabetes mellitus can affect all peripheral nerves. Symptoms of diabetic neuropathy often include:
Diabetic neuropathy usually affects the legs and feet first, sometimes followed by the arms and hands.
When your peripheral neuropathy causes you severe limitations, Social Security could approve you for disability benefits in one of two ways.
First, the Social Security Administration ("Social Security," or the SSA) has a disability listing for peripheral neuropathies in its disability handbook (the "Blue Book"). If the claims examiner reviewing your file believes you meet the criteria outlined in the listing, your disability claim will be approved. This listing, listing 11.14, states that you must have peripheral neuropathy with either:
OR
Note that "marked" means worse than moderate, but less than extreme. The first set of criteria above requires extreme physical limitations, while the second set of criteria requires less-than-extreme limitations. That's why the second set also requires severe limitations in thinking, stamina, or social functioning.
If you don't meet the criteria of the disability listing, Social Security could still award you disability benefits using the second method. Social Security actually approves the majority of disability claims not because they meet the requirements of a listing but because of limitations caused by neuropathy.
If your peripheral neuropathies severely limit you from doing so many types of work that Social Security can't name a job that you could do, you can qualify for benefits with the second method. For instance, you might not meet the listing because you have severe but not extreme problems walking and standing, and only moderate limitations in stamina and no cognitive or social issues.
Social Security will examine claimants' medical histories and work histories to determine whether, based on their functional limitations, they have the ability to return to their past work. If not, Social Security will also look at other factors to see if they can transition to some type of less demanding work.
For disability applicants whose peripheral neuropathy has affected their balance, coordination, muscle strength, muscle control, ability to walk, or ability to stand effectively, Social Security will likely find them very limited in their ability to work.
Whether Social Security expects applicants to adjust to less demanding work depends on the skill level of their prior jobs and their age and education. For example, a claimant who is 55 and is limited to two hours of walking or standing a day usually won't be required to switch to a desk job—unless they have "transferable job skills" that could be used at that job.
For more information on how Social Security decides whether someone can return to their past work or less demanding work, see our section on how Social Security decides if you can work.
Having medical documentation of your neuropathies is very important. When claims examiners review applications, they start by looking at your medical records. Your records should include visits to your doctor's office, your doctor's treatment notes, and the results of any diagnostic testing you've had.
For neuropathy claims, Social Security may look for the following test results:
Social Security will want to see documentation that you've tried various treatments for your symptoms and that you're making an effort to improve your condition. (If you haven't tried appropriate treatments, Social Security can't really know if you would still be disabled if you were receiving appropriate care and treatment.) Here are some common aids and treatments for peripheral neuropathy:
Depending on your particular condition, Social Security may also want to know whether you've considered surgical options.
If you're applying for Social Security disability insurance (SSDI), you can file your whole claim online on Social Security's website. Applying online is generally the fastest way to apply for benefits, but you can fill out the application at your own speed. Most individuals filing for SSI only can't file the entire application online, but they can get started on Social Security's website. If you're not comfortable online, you can call Social Security at 800-772-1213 to start your claim. For more information, see our article on applying for Social Security disability benefits.
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