Getting Social Security Disability for Peripheral Neuropathy or Diabetic Neuropathy

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:

• other metabolic disorders
• nutritional deficiencies or alcoholism
• genetic disorders
• immune disorders
• certain types of cancer or chemotherapy
• infections such as HIV or herpes zoster (shingles)
• exposure to toxins, such as lead, mercury, or arsenic.

Whatever the cause, peripheral neuropathy can be a debilitating condition that can affect every aspect of an individual's life.

Symptoms and Limitations of Peripheral Neuropathy

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.

Symptoms of Diabetic Neuropathy

Neuropathy associated with diabetes mellitus can affect all peripheral nerves. Symptoms of diabetic neuropathy often include:

• numbness, tingling, and pain in the hands or feet
• loss of sensation, muscle weakness
• burning or electric pain sensations, and
• a variety of other symptoms that can affect nearly every body system.

Diabetic neuropathy usually affects the legs and feet first, sometimes followed by the arms and hands.

Disability Benefits for Peripheral Neuropathy

When your peripheral neuropathy causes you severe limitations, Social Security could approve you for disability benefits in one of two ways.

The Listing for Peripheral Neuropathy

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:

• so much difficulty moving two of your extremities (either an arm and a leg or two arms or two legs) that you're extremely limited in:
  • balancing while standing or walking
  • standing up from a seated position, or
  • using your arms.

OR

• "marked" physical problems along with a "marked" limitation in any one of the following:
  • thinking (problems understanding, remembering, or applying information)
  • interacting with others (problems asking for help, handling conflicts, or getting along with others)
  • finishing tasks (problems with concentration, persistence, or speed), or
  • taking care of yourself (being aware of hazards, adapting to change, or responding to demands).

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.

Limitations From Neuropathy That Prevent Your From Working

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.

Evidence Needed to Diagnose Peripheral Neuropathy

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:

• Nerve conduction velocity (NCV) studies, which record the electrical activity through your muscles to see if they move slower or faster than normal.
• Electromyography (EMG) testing, another type of electrodiagnostic nerve function test that measures the electrical activity of a muscle.
• Blood tests for nutritional deficiencies, IgM monoclonal gammopathy, and anti-MAG antibodies.
• Quantitative sensory testing (QST), which assesses damage to nerve endings.
• Autonomic testing, which monitors blood pressure and heart rate in different positions.
• Imaging studies, including magnetic resonance imaging (MRI) or computerized tomography (CT) scans, and
• Nerve biopsy, a surgical procedure to remove part of a nerve to look for abnormalities.

What Documentation You'll Need From Your Doctor

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:

• Assistive devices. If you're using a walker or cane, it shows Social Security that you have difficulties maintaining balance. It helps to have a prescription from your doctor for use of the assistive device.
• Mechanical aids. Your doctor might have recommended a hand or foot brace, a wrist splint, or orthopedic shoes.
• Medication. A list of any medications you're taking for neuropathy, as well as any side effects from the medication.
• Medical treatment. A description of any treatments you've tried, such as physical therapy, biofeedback, or electrical nerve stimulation.

Depending on your particular condition, Social Security may also want to know whether you've considered surgical options.

How to Apply for Disability Based on Peripheral or Diabetic Neuropathy

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.