We are often asked, “is polymyalgia rheumatica a disability?” Polymyalgia rheumatica is considered a disability if your symptoms and limitations are severe enough to prevent you from working. If so, you can file a claim for disability benefits for polymyalgia rheumatica. In this article, we’ll explain:
- What polymyalgia rheumatica is;
- How a claim for long term disability benefits for polymyalgia rheumatica is evaluated;
- How a claim for Social Security Disability benefits for polymyalgia rheumatica is evaluated;
- What evidence you need to support your claim for disability benefits for polymyalgia rheumatica; and
- How working with a disability attorney can help you win your claims for disability for polymyalgia rheumatica.
What is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory condition that causes muscle pain and stiffness. Most people with polymyalgia rheumatica experience the worst pain and stiffness in the shoulders or hips. Symptoms are usually worse in the morning and become less painful throughout the day.
Symptoms of polymyalgia rheumatica are usually felt on both sides of the body and appear suddenly. Often symptoms are first experienced in a general area such as the upper body, legs, or arms. These symptoms sometimes spread to other areas over time. They may include:
- Pain and stiffness in the shoulders, neck, or arms;
- Pain and stiffness in the hips, buttocks, thighs, or knees;
- Pain and stiffness in the elbows, wrists, or hands; and
- Limited range of motion in the affected areas.
Other symptoms of polymyalgia rheumatica may include fever, fatigue, loss of appetite, weight loss, and depression. People with polymyalgia rheumatica may experience remissions in their symptoms, which later reappear and may worsen.
Most people with polymyalgia rheumatica are diagnosed after the age of 65. Patients with polymyalgia rheumatica are rarely under the age of 50. Women and Caucasians are diagnosed more often than other demographics. While there is no known cause, people who have relatives with polymyalgia rheumatica or other inflammatory conditions are more likely to develop it themselves.
Polymyalgia rheumatica is associated with giant cell arteritis, also known as temporal arteritis, which is a condition that causes inflammation in the lining of the arteries that can cause serious health issues. This is due to the fact that polymyalgia rheumatica and giant cell arteritis frequently affect the same types of people. Patients diagnosed with polymyalgia rheumatica should also be evaluated for symptoms of giant cell arteritis.
Diagnosing Polymyalgia Rheumatica
Because most people with polymyalgia rheumatica begin to experience symptoms after the age of 50, symptoms may be confused with typical signs of aging. People with polymyalgia rheumatica may be mistakenly diagnosed with fibromyalgia, which has similar symptoms.
Diagnosis of polymyalgia rheumatica involves clinical exams and diagnostic testing. In a clinical exam, a doctor can evaluate a patient’s medical history, symptoms, and range of motion. They may also conduct neurological exams or test the patient’s reflexes. Diagnostic testing can include:
- Blood tests to check for signs of inflammation; and
- Imaging tests usually ultrasounds or MRIs, used to check for signs of other conditions that may cause similar symptoms.
Patients diagnosed with polymyalgia rheumatica are typically monitored for progression of their symptoms and signs of rheumatoid arthritis and giant cell arteritis.
Treating Polymyalgia Rheumatica
The most common treatment is oral corticosteroids. Many patients find significant improvement in their pain and stiffness with corticosteroid treatment. Oral pain relievers, such as Ibuprofen or opioids, may also be used in more severe cases. Topical creams to reduce pain or heating pads are also helpful. Pain and stiffness associated with polymyalgia rheumatica often become better with movement or exercise. Physical therapy is commonly used in conjunction with medication to help bring relief of symptoms and prevent further issues.
Like other disorders that involve chronic pain, mental health care is an integral part of the overall treatment plan. Cognitive-behavioral therapy has shown some benefit in reducing pain and improving a patient’s quality of life when dealing with this illness. Alternative therapies such as acupuncture, massage, or meditation may also be helpful when used in conjunction with other treatments.
Evaluating a Long Term Disability Claim for Polymyalgia Rheumatica
Polymyalgia rheumatica may prevent someone from working. People who cannot work that have a long term disability insurance policy should apply for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify for disability benefits under the conditions of that plan.
Definition of Disability
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their current job for the first two years of the policy and 2) be unable to work in any other position for the years following the initial 2-year period. Every plan is different, so it is important to review your policy for its specific requirements.
Evaluating a Social Security Disability Claim for Polymyalgia Rheumatica
You can also apply for Social Security Disability benefits if your condition lasts, or is expected to last, 12 months or longer. If you meet the non-medical requirements and the SSA finds that you are disabled you can receive Social Security Disability benefits. You can receive both long term disability and Social Security Disability benefits; however, the insurance company will likely reduce the amount of their payment by the amount you receive from Social Security.
Listing of Impairment
Social Security will determine that you are disabled if your condition meets the requirements of a listing on their Listing of Impairment, or Blue Book. There is not a specific listing for polymyalgia rheumatica, but you may be able to show that your condition is equivalent to another condition, such as rheumatoid arthritis, which falls under Listing 14.00 Immune System Disorders. If your condition still doesn’t meet the requirements for a listing the SSA will review your residual functional capacity to work instead, which could lead to approval through a medical-vocational allowance.
Qualifying for Disability for Polymyalgia Rheumatica
While not every case of polymyalgia rheumatica is disabling, people who have severe polymyalgia rheumatica may not be able to work because of their condition. The severe pain and stiffness may prevent someone from performing jobs involving bending, lifting, or carrying objects. Since pain and stiffness often become worse with a lack of movement, sedentary positions may be difficult or impossible. Patients may have difficulty performing basic tasks such as getting out of a chair, bathing, or getting dressed. Someone with severe symptoms may be unable to perform daily functions or work activities without the use of assistive devices. As disability evaluations involve considering the person’s total health, someone with polymyalgia rheumatica may qualify when their other medical conditions are considered. It is important to inform the insurance company of all conditions that affect a person’s ability to work.
Evidence You Need to Support your Disability Claim for Polymyalgia Rheumatica
The insurance company will need to know how to contact all the doctors who have treated you so that they can get your medical records when evaluating your claim. You may need to send those records yourself if your insurance company cannot get the information from your doctors. If you have other medical conditions that can impact your quality of life, it is essential to include information about all of your medical conditions and the treatment you receive.
The insurance company will need to see proof of your diagnosis and your ongoing symptoms, as well as evidence of how those symptoms affect your life. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do with your limitations. It is used to determine what jobs you may still be qualified to perform despite your condition. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.
Working with a Disability Attorney
If you have been denied disability benefits, do not lose hope. Many people are denied benefits the first time they apply. You have the right to file an appeal and to get more information that may help your case.
Since you are so limited by the appeals process, consider consulting a disability attorney very early on. Even with a claim for polymyalgia rheumatica, it can be tricky to navigate the claims and appeals process. Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve.
While the process can be daunting, your expert disability attorney will be able to guide you through the process. Getting expert help is often the difference between being denied and being approved for benefits. An experienced long term disability attorney can help you stay on top of your deadlines, help you gather your documents, assist you during field interviews, and give you guidance that will help you get your claim approved. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented individuals in disability cases across the United States. If you would like to talk to an experienced disability lawyer about your polymyalgia rheumatica and its impact on your ability to work, the Ortiz Law Firm offers a free consultation with no obligation to use our firm. During the call, you can ask any questions you have regarding your claim for benefits, and we will answer them. To see how we can help you win your disability case, call us at (888) 321- 8131.