MYASTHENIA GRAVIS & BENEFITS
Myasthenia gravis (MG) is a rare autoimmune, neuromuscular condition that causes muscle weakness and fatigue. In fact, the name means “serious muscle weakness,” which is the main symptom of the condition. This weakness tends to get worse the longer the muscles are used and gets better after the muscles are rested. It is caused by a breakdown in how the nerves and muscles communicate.
Your nerve cells release a chemical messenger that attaches to receptors on muscle cells and this leads to muscle contraction. However, in people with myasthenia gravis, the immune system produces antibodies that attack or block the receptors. Therefore, this interferes with the transmission of nerve signals to the muscles.
The exact cause of myasthenia gravis is not known. But, scientist believe it occurs from a combination of genetic and environmental factors. MG can affect people of any age. However, it occurs most often in women under 40 and men over 60.
The main symptom of myasthenia gravis is muscle weakness that worsens with activity and improves with rest. The muscles that control eye and eyelid movement, facial expression, chewing, and speaking are often affected. Some individuals may also experience weakness in the arms, legs, and respiratory muscles, which can lead to trouble breathing.
HOW TO KNOW IF YOU HAVE MYASTHENIA GRAVIS
It can be hard to diagnose MG because the symptoms may appear suddenly and then go away after rest. The degree of muscle weakness can vary between people. Also, the muscle weakness usually gets worse over time and the worst symptoms appear within a few years of the first symptoms.
Here are the key steps to finding out if you have MG:
- Medical History: The doctor will begin by asking about your symptoms and medical history. They will ask questions about the pattern of muscle weakness and any family history of similar conditions.
- Physical Exam: Your doctor will perform a physical exam to assess your muscle strength and coordination.
- Neurological Exam: Your doctor will also perform a neurological exam to evaluate nerve function and rule out other possible causes of muscle weakness.
- Blood Tests: Blood tests can help detect specific antibodies that occur with MG.
- EMG: An EMG is a test that records electrical activity with a needle. This test helps assess the muscle response to nerve stimulation and can help confirm MG.
- Tensilon Test: The Tensilon test involves the administration of a medication called Tensilon through an intravenous line. The medication improves muscle weakness in those with MG, but only for a short time. If there is a significant improvement in muscle strength after you take the drug, then it suggests you have MG.
- Imaging Studies: In some cases, imaging studies such as a CT scan or an MRI can evaluate the thymus gland. The thymus gland is often abnormal in people with MG.
It is important to make sure that you see a doctor who is an expert in myasthenia gravis, because the disease can be similar to other neuromuscular disorders.
COMMON SIGNS AND SYMPTOMS OF MYASTHENIA GRAVIS
Below, you will find a list of the most common symptoms of myasthenia gravis:
- Weakness of the eye muscles that leads to blurred or double vision
- Drooping of one or both eyelids
- Changes in facial expressions
- Trouble chewing
- Trouble speaking
- Weakness in the arms, hands, fingers, or legs
- Shortness of breath
The main problem with MG is that symptoms change over time. In the first phase of the disease, which is the first 5-7 years, the symptoms are at their most severe. Some doctors believe that in the second phase of the disease, the symptoms become more stable. However, infections and stress can begin and make the symptoms worse. Finally, in the third phase of the disease, remission may occur. This can happen because you are taking medicine to control your symptoms. Or, it can occur on its own, even if you are not taking medicine for your condition.
MYASTHENIA GRAVIS EYE SYMPTOMS
More than half of people with myasthenia gravis have problems with their eyes first. The most common eye symptoms include:
- Drooping of one or both eyelids. This is also called ptosis.
- Double vision or blurred vision. This is also called diplopia.
Both symptoms may get better after closing the eyes to rest the muscles. If your muscle weakness remains only in the eyes, doctors call it ocular myasthenia gravis. More than half of the people who begin to have eye symptoms go on to develop muscle weakness in other parts of the body
FACE, THROAT, AND NECK MUSCLES
It is not very common for the muscles of the face or throat to be affected first. But, it does happen in some people with MG. For about half of people with MG, muscle weakness begins in the eyes and later spreads to other parts of the body.
The most common problems people with MG have with the muscles in their face and neck are:
- Jaw muscles feel tired while eating
- Trouble swallowing and choking
- Talking in a lower or softer tone than normal
- Changes to facial expressions
- Head feels heavy or drops forward, especially at the end of the day
MYASTHENIA GRAVIS AND THE LIMB MUSCLES
Myasthenia gravis can make limb muscles weak. This can make it harder to pick up and hold onto objects or make it harder to walk. It can be hard to open the fingers or lift a foot. For most people with MG, arm weakness is more common than leg weakness.
TREATMENT FOR MYASTHENIA GRAVIS
Although there is no cure for myasthenia gravis, the condition can be managed with various treatments. Medications are often given to improve muscle strength and reduce the attack of your immune system on your muscle receptors. In some cases, your doctor may require removal of the thymus gland.
With proper treatment, most people with myasthenia gravis can lead relatively normal lives. However, the condition is chronic and requires ongoing medical care to help your symptoms and prevent problems. Regular communication and following the treatment tips from your doctor will help manage your medical condition.
APPLY FOR SSDI & SSI BENEFITS FOR MYASTHENIA GRAVIS
If you have myasthenia gravis, then there are two types of benefits you can file for under the Social Security program: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. In order to receive benefits, you must first file an application. You can do this online at Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you have MG:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who have worked in the recent past and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history. To qualify for SSDI, you must earn enough “work credits” to qualify.
A work credit is an amount of taxable income. You can earn up to 4 work credits per year, because there are four quarters in a year. The number work credits you need depends on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, then you can only apply for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income. If you have a spouse who earns more than $4000 a month, for example, then that income will eliminate your ability to receive SSI benefits. You cannot qualify for SSI benefits, no matter how severe your myasthenia gravis, if you do not meet the income and asset rules for SSI.
SSA LISTING 11.12 FOR MYASTHENIA GRAVIS
The following is SSA’s listing 11.12 for myasthenia gravis. In order to win benefits, you must meet or equal all of the elements of the listing.
11.12 Myasthenia gravis, with A, B, or C despite adherence to prescribed treatment for at least 3 months:
A. Disorganization of motor function in two extremities, resulting in an extreme limit in the ability to stand up from a seated position, balance while standing or walking, or use of the upper extremities.
OR
B. Bulbar and neuromuscular dysfunction, that results in:
- One myasthenic crisis requiring mechanical ventilation; or
- Need for supplemental enteral nutrition via a gastrostomy or parenteral nutrition via a central venous catheter.
OR
C. Marked limits in physical functioning, and in one of the following:
- Understand, remember, or apply information; or
- Interact with others; or
- Concentrate, persist, or maintain pace; or
- Adapt or manage oneself.
MYASTHENIA GRAVIS & YOUR RESIDUAL FUNCTIONAL CAPACITY (RFC)
If you don’t meet listing 11.12, then you can still win SSDI and SSI benefits with SSA’s other rules. These rules take your myasthenia gravis symptoms, any other medical conditions, your age, work history, skills, and education into account.
When the SSA decides your residual functional capacity (RFC), they use your statements on the forms you fill out. For example, when you fill out forms about your past work, you state how much you had to lift on the job. You also tell them how much you stood or sat during a work day.
Your answers on these forms are often some of the most important statements you make. If you write on your Work History form that you lifted nothing on the job, then that is what the SSA assumes is correct. Frankly, there are no jobs where you lift “nothing.” But for some reason, many people write that down as an answer. Even desk jobs require some lifting. You might, for example, lift files, boxes of paper, books, or supplies.
Think about it. Failing to tell the SSA about the lifting you had to do at your past jobs, makes it easier for them to return you to your past jobs. In other words, you are making it easier for them to deny your case.
YOUR HEARING TESTIMONY IS ABOUT WHAT YOU CAN DO DURING THE WORK DAY
When you testify at your hearing you need to tell the judge what you can do during a work day. The judge knows you haven’t been working for the past few years. However, you need to be able to explain what you do at home during a normal day. But, you must realize the judge will use your answers to describe what you can do during an eight hour work day. That is why your testimony is so important.
Let’s use an example to make this clear. If you testify you can lift 20 pounds and walk for one mile, then the judge is going to believe you can do a job where you lift 20 pounds and stand all day. There are thousands of jobs you can do if you can walk, stand and lift for eight hours. For example, you could be a cashier. You could also do a job where you sit most of the day. For example, you could answer phones.
If your myasthenia gravis creates muscle weakness, then your ability to lift is limited. Likewise, your ability to stand and walk is limited. Your testimony must explain these limits. Think about your normal day. From nine to five, how often do you lie down? How many hours do you spend sitting? Are you sitting in a desk chair or reclining in a lounge chair? How many pounds can you truly lift if you had to do it over and over again? You need to be ready to answer these questions before you go to the hearing. If you cannot answer these questions, then you are not ready to testify about your MG.
THE MEDICAL EXPERT CAN TESTIFY ABOUT YOUR MYASTHENIA GRAVIS
Medical Experts (ME) often testify at Social Security hearings. They are called by the ALJ to review your medical records for myasthenia gravis. Also, they explain your medical conditions to the judge. Additionally, they testify as to whether or not your medical condition meets or equals an SSA listing, like 11.12. Similarly, an ME can be requested by your attorney. This is, however, mostly done in complex medical cases.
The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the medical expert is there to give testimony about your medical records and should not be for either side of the case.
Medical experts are doctors who the SSA calls to testify about your MG at the hearing. Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone.
It is also possible for an ME to answer written questions after the hearing. These written questions are sent to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of failing to prepare for the medical expert.
THE VOCATIONAL EXPERT AT YOUR HEARING
The vocational expert (VE) is also an expert witness, just like the medical expert. Normally, the Social Security Judge calls a VE to testify at the hearing. The Judge calls the expert to talk about jobs that are available to you based upon your ability. VEs have training in placing people in jobs. They also understand the numbers and types of jobs that exist in the nation. They are at the hearing in order to answer questions about jobs in the national economy.
Once the Judge asks you questions about your medical conditions, she will decide what you are capable of doing during an 8 hour work day. The SSA calls this your RFC. Your RFC what you can physically do throughout an 8 hour work day. Therefore, your answers to the questions at the hearing are very important. Just as the important as the medical records you submit.
The Judge listens to your hearing testimony and the takes the symptoms from your medical records to determine how your myasthenia gravis symptoms impact you on the job. At the end of your hearing, the Judge will ask the VE questions. Likewise, your attorney will also ask questions. Your attorney can also question the VE. It is often the VEs answers that determine whether you will win SSD benefits.
QUESTIONS FOR THE VOCATIONAL EXPERT
The Judge will ask questions to the VE about whether or not a person with your myasthenia gravis symptoms can work. Typically, the Judge will use three to four different questions. These questions can include many different symptoms from your MG.
For example, the Judge may ask if a person cannot concentrate on the job, could they work. Or, the Judge may ask what kind of work would be available to a person who cannot lift more than 20 pounds. The Judge’s questions will include your RFC. Learn about your RFC.
Once the Judge is done asking questions, your attorney has the right to question the VE. For those who do not hire an attorney, they are left to try to ask the VE questions on their own. Obviously, most people do not know what questions to ask because they have never been to a hearing. Nor do they have the training they need in order to understand what questions to ask.
VEs testify about what kinds of jobs are available to you. However, they also testify as to the number of jobs that exist in the national economy. For example, a VE may testify as to whether your work skills can be used in other work. They will also testify about the specific jobs in which they can be used.
A VE may also testify as to the effects of other medical conditions on the range of work you can do. Likewise, the VE can testify about the erosion of the job base caused by all of your medical conditions.
HIRE US TO WIN BENEFITS FOR MYASTHENIA GRAVIS
Unfortunately, if you do not hire an attorney with experience to help you, then you will probably lose your myasthenia gravis case. Most cases turn on the VE’s testimony at the hearing. If you are not capable of questioning the VE, you will not win. The judge relies on the VE’s testimony. So, you need to be able to prove, using VE testimony, that you cannot work. An attorney can make sure that all of your symptoms are taken into account in the VE’s testimony.
Also, your attorney should be familiar with jobs in the national economy. If the attorney has experience, then they also know what jobs the VE is likely to testify about. This part of the hearing is difficult. Trying to do it yourself will not work. If nothing else, you should hire an attorney to represent you if the Judge has called a VE to your hearing.
WHAT WE DO TO HELP YOU WIN SSDI AND SSI BENEFITS
If you have myasthenia gravis, then you need help to apply for Social Security benefits. You can always call our law firm and we will help you. We can help you file your application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSDI and SSI benefits
- Inform the SSA they should pay your benefits under the Compassionate Allowance Rules
- Appeal if you receive an initial denial
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge
- Prepare you to testify at your SSA hearing
- Represent you at your hearing and question the expert witnesses
- Read about job expert testimony at the SSA hearing
- Learn about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you don’t send it back, the SSA will not process your application. Sign it and send it back as soon as you can.
OUR EXPERT ATTORNEYS & LEGAL STAFF
If you need help winning your benefits for myasthenia gravis, then you have found the right law firm. You can learn about the attorneys at our law firm on our About Us page.
For example, you may want to know that Dianna Cannon has been helping her clients win Social Security cases for over thirty years. Additionally, Brett Bunkall and Andria Summers have won thousands of SSDI and SSI cases.
In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our experts can help you file for SSI benefits using the SSA’s website. However, we will need your help to apply for SSI benefits. Why? Because only you know your personal financial information. SSI benefits require you to have minimal assets and monthly income.
Likewise, if you need an appeal, we can help you do that too. There are also many forms that will need to be filled out. Don’t worry. If you have questions about these forms, we will answer them. You can learn about SSA’s appeal forms. Call us today for help winning your SSD benefits.
HIRE US FOR OUR YEARS OF LEGAL EXPERIENCE
If you have myasthenia gravis, then you should hire our law firm to help you win your benefits. We are one of the best Social Security law firms in the country. We are one of the best Social Security benefits firm in Las Vegas, Nevada. Also, we are the best Social Security law firm in Salt Lake City, Utah.
Learn about Utah SSDI benefits. Nevada SSI Information is also available. We also represent clients in Idaho. Learn about Idaho SSDI benefits. Find out about Colorado SSDI benefits. Likewise, if you are from California, then review California SSDI & SSI information.
Over the last 30 years, we have won thousands of SSDI and SSI claims. Additionally, we have won over $100 million in SSD and SSI benefits for our clients. It has become more difficult to win Social Security cases. Also, SSA’s listing rules are harder to meet. That is why you need an attorney who will help you win your case.
We recommend you do not go to your hearing without an attorney. Why? Because a lawyer can prepare you for your hearing. She can explain the judge’s questions. Preparation, like getting all of your medical records, will help win your case.
Those who come to the hearing without counsel are usually not successful in winning benefits. You should hire an attorney who has legal experience winning SSD and SSI benefits. Contact Cannon Disability Law today. We can help you win benefits for myasthenia gravis. Call us today and ask us for a free review of your case.
