Shingles and Social Security Disability

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Social Security Disability for Shingles

If you suffer from shingles, which is a skin rash that is caused by the varicella-zoster virus, which causes chickenpox you may be eligible to receive Social Security disability benefits. The Social Security Administration (SSA) oversees the Social Security Disability Insurance (SSDI) program. In order to receive SSDI, you need to work enough to earn an adequate number of credits and to have paid enough taxes in to the SSA.

Shingles alone is rarely approved for SSDI benefits, but there are times when shingles, usually in conjunction with some other condition, is approved. Most applicants that get disability for shingles have a concurrent disorder, such as an autoimmune disorder that compromises the body’s ability to ward off infections, or HIV/AIDS. Some people experience persistent infections and ongoing shingles flare ups. Those who suffer from shingles can have a number of debilitating effects for those that experience ongoing infections and complications.

Some of the more severe side effects and symptoms caused by shingles, include:

  • Loss of balance
  • Compromised hearing
  • Loss of vision
  • Permanent nerve damage
  • Chronic nerve pain and loss of sensation

Shingles is an extremely painful disorder that can have debilitating results. While some people just have a single bout of shingles, others experience recurring bouts that wreak continuous pain and discomfort. The disability benefits process can be lengthy. Providing as much documentation and thorough records early on is essential in getting a faster approval of benefits.

Your shingles may qualify you for disability benefits Back to top

The Cost of Treating Shingles

According to Cost Helper, famciclovir is the drug used to treat shingles. It costs about $230 for two pills which are usually prescribed to treat the problem. The brand name version of the drug, Famvir, costs about $320. The U.S. Department of Health and Human Services report that the average cost of treating shingles is $525 per patient.

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The SSA Evaluation and Medical Qualifications

As previously mentioned, there is no medical listing in the Blue Book for shingles. The Blue Book is the medical guide used by the SSA to determine if an individual is eligible for SSDI benefits. So in order to medically qualify for disability benefits for shingles, you need to either closely match or meet the listing for another medical condition or a listing for a complication that is caused by shingles.

Rheumatoid arthritis, lupus, HIV/AIDS, hepatitis and other chronic conditions that are known to compromise the immune system’s functioning are among the listed medical conditions. These are conditions that appear in the Blue Book, and they have specified criteria and note the necessary documentation for proving disability with each condition.

Review the listing for the condition you suffer from and file your application based on that condition. Your supporting documentation should show your shingles and the complications caused by them and how your everyday life and ability to work is impacted by the condition. However, your application will be reviewed by the SSA under the listing under the primary condition you suffer from with your shingles being viewed as a secondary ailment or just a symptom.

If you have suffered permanent damage from shingles, such as loss of hearing, vision, sensation, or chronic or severe nerve pain, you can file your application using one of the following Blue Book listings so your application will be reviewed by the SSA under the associated listing, which includes:

Loss of Balance and Hearing Loss – Sections 2.07 or 2.10

Neuralgia

Vision Loss – Sections 2.02, 2.03, or 2.04

You will have to prove the requirements for that particular listing in order to be approved for benefits. Neuralgia is difficult to prove because pain cannot be easily measured through standard diagnostic evaluations and the effects of chronic pain cannot be clearly documented in most instances. There are also psychological and emotional impacts as well as physical limitations caused by chronic pain but these hard to prove through medical records.

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Meeting the Criteria for Disability with a Medical-Vocational Allowance

If you don’t meet the requirements of the Blue Book, you may still be eligible for SSDI benefits using the medical-vocational allowance. The medical-vocational allowance involves considering your work experience, your age, educational level, and any transferrable skills. Once it is determined that you cannot do your past work, they determine if you can do lighter duty work, such as sedentary work.

Your physician needs to complete a residual functioning capacity (RFC), which will indicate what you can and cannot do. As an example, it will indicate if your neuralgia prevents you from standing for more than two consecutive hours. It will also indicate if you need to reposition more often than every two hours. It will indicate how far you can walk, how much you can lift, and what you can carry or if you can bend.

Once it is determined that you cannot work, you will be approved for benefits. The disability determination process can be lengthy and time consuming. Providing as much documentation as possible is essential in proving your case. You have to prove you are going to be disabled for at least a year. The first six months that you are disabled you are not eligible to receive benefits.

If you are approved for benefits, you may have some dependents, such as minor children, who are also eligible for benefits based on your claim. You can be denied benefits twice and you can file an appeal. The final step is to request a hearing before an administrative law judge for a ruling on your case.

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Applying Specific Medical Tests to Your Case

Providing documentation regarding medical tests and the results from those tests are advantageous in proving your case. It is not uncommon for the SSA to send you for a medical evaluation with the physician of their choice at their expense. This documentation is for informational purposes only and is to prove your case and make sure your condition and symptoms are as severe as you claim.

Sometimes a mental evaluation is ordered to determine if your condition has caused depression, anxiety, or stress that has impacted your emotional and mental state and also impacted your ability to work. Provide detailed physician notes and medical records to support your case and prove the severity of your condition.

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