Patients with Graves’ disease may be unable to work because of their disease and its related complications. If so, they are likely asking themselves, “is Graves’ disease considered a disability?” The answer is yes. When severe enough, Graves’ disease is considered a disability. Patients who find themselves unable to work because of their Graves’ disease may qualify for long-term disability (LTD) benefits and/or Social Security Disability benefits.
A long-term disability insurance company will review a disability claim to see if the claimant qualifies for disability benefits under the conditions of their disability insurance policy, but will likely take a decision made by the Social Security Administration (SSA) into consideration. Each type of claim has its own rules and requirements, so you could qualify for one but not the other. In this post, we’ll discuss what Graves’ disease is and the symptoms and complications which could qualify you for disability benefits.
What is Graves’ Disease?
According to PubMed Health, Graves disease is an autoimmune disorder that typically leads to overactivity of the thyroid gland.
Causes, Incidences, and Risk Factors
The thyroid gland is an important organ of the endocrine system. It is located in the front of the neck just below the voice box. This gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Controlling metabolism is critical for regulating mood, weight, and energy levels. Thyroid hormones also affect your nervous system function, brain development, body temperature, and other important elements.
If the body makes too much thyroid hormone, the condition is called hyperthyroidism (an underactive thyroid leads to hypothyroidism.) It is caused by an abnormal immune response that causes the thyroid gland to produce too many hormones. Graves disease is most common in women over age 20. However, the disorder can occur at any age and may affect men as well.
Symptoms
Many of the symptoms of Graves’ disease are separate conditions with their own limitations that compound your inability to work. Your symptoms should be documented in your medical information so that they are also considered during your disability evaluation. Symptoms of Graves’ disease include:
- Anxiety;
- Breast enlargement in men (possible);
- Bulging eyes;
- Difficulty concentrating;
- Double vision;
- Eyeballs that stick out (exophthalmos);
- Eye irritation and tearing;
- Fatigue;
- Frequent bowel movements;
- Goiter (possible);
- Heat intolerance;
- Increased appetite;
- Increased sweating;
- Insomnia;
- Menstrual irregularities in women;
- Muscle weakness;
- Nervousness;
- Rapid or irregular heartbeat (palpitations or arrhythmia);
- Restlessness and difficulty sleeping;
- Shortness of breath with exertion;
- Tremor; and
- Weight loss (rarely, weight gain).
Signs and Evidentiary Tests
Examination by a doctor evidences an increased heart rate. Examination of the neck might show that the thyroid gland is enlarged (goiter).
Other tests include:
- Blood tests to measure levels of TSH, T3, and free T4; and
- Radioactive iodine uptake.
Treatment
The purpose of treatment is to control the overactivity of the thyroid gland. Beta-blockers such as propranolol are often used to treat symptoms of rapid heartbeat, sweating, and anxiety until the hyperthyroidism is controlled with one or more of the following:
- Antithyroid medications; and
- Radioactive iodine.
Surgery
If you have radiation and surgery, you will need to take replacement thyroid hormones for the rest of your life, because these treatments destroy or remove the gland.
Some of the eye problems that are symptoms of Graves’ disease usually improve when thyroid activity is treated with medications, radiation, or surgery. Iodine treatments can sometimes make eye problems worse. Eye problems are worse in people who smoke, even after hyperthyroidism is cured.
Sometimes prednisone (a steroid medication that suppresses the immune system) is needed to reduce eye irritation and swelling.
You may need to tape your eyes closed at night to prevent drying. Sunglasses and eye drops may reduce eye irritation. Rarely, surgery or radiation therapy may be needed to return the eyes to their normal position.
Expectations or Prognosis
Graves’ disease often responds well to treatment. However, thyroid surgery or iodine treatments usually will cause hypothyroidism. Without getting the correct dose of thyroid hormone replacement, hypothyroidism can lead to:
- Depression;
- Sluggishness; and
- Weight gain.
Antithyroid medications can also have serious side effects.
Complications
Complications from surgery could include additional medical conditions and new symptoms:
- Hoarseness from damage to the nerve leading to the voice box;
- Low calcium levels from damage to the parathyroid glands (located near the thyroid gland);
- Scarring of the neck; and
- Eye problems (called Graves’ ophthalmopathy or exophthalmos).
Heart-related complications, including:
- Rapid heart rate;
- Congestive heart failure (especially in the elderly); and
- Atrial fibrillation.
Thyroid crisis (thyrotoxic storm), a severe worsening of overactive thyroid gland symptoms.
Increased risk for osteoporosis.
Complications related to thyroid hormone replacement, for example:
- If too little hormone is given, fatigue, weight gain, high cholesterol, depression, physical sluggishness, and other symptoms of hypothyroidism can occur; and
- If too much hormone is given, symptoms of hyperthyroidism will return.
Is Graves’ Disease Considered a Disability?
Social Security Disability for Graves’ Disease
The Social Security Administration (SSA) does not have a specific listing for Graves’ disease, but it is possible to receive Social Security Disability benefits for this disease if the SSA determines that your symptoms and limitations prevent you from performing Substantial Gainful Activity (SGA) for 12 months or longer. In order to qualify for benefits, your symptoms and limitations must be clearly stated in the medical evidence. A residual functional capacity evaluation can help to document the effects of thyroid gland disorders and any other medical conditions you suffer from. Ask your doctor(s) to fill out a residual functional capacity form and submit the completed form to the SSA. You can download a physical RFC form and/or a mental RFC form from our website.
If your complications include mental health or cardiac problems these medical conditions will be evaluated under the mental disorders listing and cardiovascular listing, respectively:
- Listing 4.00, Cardiovascular System, assesses thyroid-related heart problems.
- Listing 12.00, Mood Disorders such as anxiety, depression, and cognitive issues that can be caused by thyroid problems are assessed.
Long Term Disability for Graves’ Disease
Long-term disability claims are evaluated using the definition of disability that is defined in the disability insurance policy. The definition of disability varies between policies. In some cases, the definition of disability changes after a certain period of time (usually 24-months). You need to determine what the definition of disability is in your policy so that you know what medical information is needed to support your claim that Graves’ disease and your symptoms and limitations prevent you from working.
The residual functional capacity (RFC) form can also be used as evidence in an LTD claim. The insurance company will still review your medical records and non-medical information while trying to make a decision about your ability to work, but a thoroughly completed RFC form can make a significant impact on the outcome of your case. Unlike most medical records, an RFC form will clearly state the severity of your impairments.
Work with a Disability Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve from the SSA or the LTD insurance company for your Graves’ disease. Even if you have been denied benefits, that does not mean your fight is over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more medical information to support your case. Getting expert help is often the difference between being denied and being approved for disability benefits.
While the process to qualify for benefits can be daunting, your experienced disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help for your claim without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you are ready to take the next step and would like to talk to an experienced disability lawyer about your Graves’ disease and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how a disability attorney can help you through the claim process.