UNDERSTANDING PRIMARY LATERAL SCLEROSIS (PLS)

If you have Primary Lateral Sclerosis (PLS), then you may be wondering whether you qualify for Social Security Disability benefits. The answer is yes. PLS is a serious and progressive neurological disorder, and it can form the basis for a successful SSD claim.

PLS causes stiff muscles, spasticity, and gradual weakness. It interferes with movement, speech, and even swallowing. Because it progresses slowly and affects the upper motor neurons in the brain, many people live with PLS for years. However, the condition can still be disabling—physically and emotionally. Not to mention what a serious disease can do to your finances.

The good news is that the Social Security Administration (SSA) recognizes Primary Lateral Sclerosis as a medical condition that qualifies for benefits. But even with this recognition, many people face denial of the claim for benefits. Usually, they are denied benefits due to a lack of proper medical records or misunderstanding of SSA rules. Below, we explain what PLS is and how the SSA evaluates it. We also explain what you need to do to qualify for Social Security Disability benefits.

WHAT IS PRIMARY LATERAL SCLEROSIS (PLS)?

Primary Lateral Sclerosis is a rare motor neuron disease that affects the nerve cells in the brain and spinal cord. These cells are responsible for muscle movement. Over time, PLS causes progressive muscle weakness, stiff joints, and tight or rigid muscles, especially in the legs, arms, and tongue.

PLS is often confused with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. However, PLS progresses more slowly and doesn’t usually affect the length of your life. That said, the symptoms of PLS can limit your ability to walk, speak, and perform daily activities. It can also make it impossible to work on a full-time basis.

Common symptoms of PLS include stiff legs and arms, muscle spasms, weakness, and difficulty with balance. As the disease progresses, it may cause slurred speech and emotional responses such as crying or laughing. Many people eventually require assistive devices like a cane or walker. Finally, as the disease progresses, it usually impacts your ability to work.

THE SYMPTOMS OF PRIMARY LATERAL SCLEROSIS

Primary lateral sclerosis causes problems with movement. People who have PLS may notice that their legs feel stiff or weak. They might trip more often or have trouble walking. As time goes on, the stiffness can spread to the arms, hands, and even the muscles used for speaking. The changes happen slowly, but they keep getting worse over the years.

Other symptoms include trouble with balance, clumsy movements, and feeling like your body just doesn’t respond the way it used to. Some people notice their speech becomes slower or harder to understand. Even though PLS makes movement harder, it usually doesn’t affect memory or thinking. It also doesn’t shorten your life, but it can make everyday tasks more difficult.

PLS is very rare. Doctors think fewer than 5,000 people in the United States have it. It usually starts between the ages of 40 and 60, but it can begin earlier or later. Because it’s so rare and the symptoms look like other diseases, it can take a long time to get the right diagnosis.

APPLY FOR SSDI & SSI BENEFITS IF YOU HAVE ASTHMA AND CAN’T WORK

In order to receive benefits for primary lateral sclerosis, you must first file an application. You can do this on Social Security’s website. Below is an explanation as to each type of benefit you can apply for if you have PLS that prevents you from working:

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 their medical condition. The monthly payment you will receive from SSDI benefits is based on the tax you paid during your work history. To qualify for SSDI, you must have enough “work credits.”

A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The number of 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 may only qualify for Supplemental Security Income benefits.

Supplemental Security Income (SSI):  

SSI is a needs based benefit. It is for people with little to no income, such as children and the elderly. Anyone who makes greater 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 $5000 a month, for example, then that income will prevent you from getting SSI benefits. You cannot qualify for SSI benefits, no matter how severe your primary lateral sclerosis, if you do not meet the income and asset rules for SSI

PRIMARY LATERAL SCLEROSIS UNDER LISTING 11.13 IN SSA’S BLUE BOOK

The Social Security Administration (SSA) evaluates PLS under Listing 11.13: Motor neuron disorders, other than ALS. This listing recognizes that motor neuron diseases can cause progressive symptoms.

To meet Listing 11.13 under step three of the SSD review process, you must provide medical evidence showing one of the following:

A. Disorganization of motor function in two extremities (such as both legs, both arms, or one arm and one leg), resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the arms effectively.

OR

B. Marked limitation in physical function and marked limitation in one of the following areas of mental function:

• Understand, remember, or apply information

• Interact with others

• Concentrate, persist, or maintain pace

• Adapt or manage oneself

If you meet the criteria in Section A or B, then you may qualify for benefits without the need to prove you can’t do any job.

MEDICAL EVIDENCE THAT PROVES YOU MEET LISTING 11.13

Meeting the listing for PLS requires medical records. First, your doctor must state that you have primary lateral sclerosis. In addition, you will need clinical records that describe your symptoms over time. These should include physical exams that note upper motor neuron signs such as weakness or a positive Babinski sign.

The SSA also looks for objective testing, including MRIs and EMG studies, to rule out other medical conditions. Also, a statement from your doctor is not enough evidence. That statement needs to agree with the progress notes from your doctor.

Progress and treatment notes should describe how your disease affects your ability to move, speak, walk, or use your limbs. In many cases, it is helpful to submit a Residual Functional Capacity (RFC) form completed by your doctor. The form outlines your physical and mental limits in detail. The RFC form helps the SSA understand what tasks you can or cannot perform during a normal day at work.

HOW PRIMARY LATERAL SCLEROSIS PREVENTS YOU FROM WORKING

People with PLS often reach a point where they can no longer maintain a job. The SSA will look at whether you can still perform your past work. They will also look at whether there is any other work you could do. Unfortunately, the symptoms of primary lateral sclerosis often eliminate the ability to do both physical and seated jobs.

PLS can make it difficult to walk without assistance, climb stairs, or stand for extended periods. Fatigue and muscle pain can limit your ability to use your hands and arms. Speech issues may interfere with communication. Some people experience cognitive issues or mood swings that further reduce their ability to work. The SSA will consider all of these limits when it evaluates your claim.

WHAT CAN YOU TO DO STRENGTHEN YOUR SSD CLAIM?

If you are filing an application for SSD benefits due to PLS, then there are several ways to improve your chances of success. First, make sure you see your doctor and follow all treatments. Ask your doctor to document your PLS symptoms over time. Also, make sure your doctor includes how PLS affects your ability to function at home and at work.

Submit an RFC form from your doctor that details your physical and mental limitations. This form should explain how long you can sit, stand, walk, or carry objects. It should discuss whether you can use your hands. The form should also include whether you require extra breaks and rest periods.

You can also submit personal statements or written observations from people who witness your daily struggles. These can provide valuable insight into your real limits. Also, during the application process you should not work. Any work attempt will simply make the SSA believe you can work 40 hours a week.

WHAT WE DO TO HELP YOU WIN SSD BENEFITS FOR PLS

You do not need to try to win SSD benefits on your own. Our law firm can help file your SSD application. Also, we can help you file an appeal after every SSA denial. That way, you can focus on your health. Our attorneys and staff can:

• Send you the paperwork you need to become our client
• Help you file your application for SSD and SSI benefits
• Inform the SSA to pay your benefits under the Compassionate Allowance Rules
• Request an appeal if you get an initial denial
• Help you confirm your free SSA doctor exam
• Request a Hearing with an Administrative Law Judge
• Prepare you to testify at your ALJ hearing
• Represent you at your hearing and question the expert witnesses
• Read about job expert testimony
• 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 on Social Security’s website, then you have 6 months to complete it. 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.

Additionally, once you receive a denial from the SSA, you have 60 days to file an appeal. You must meet the time limit set by the SSA. If you do not, then you will have to start the process over again. If you have to start over, then usually you lose any benefits you could receive on a prior application.

WHY YOU SHOULD HIRE THE BEST SSD LAW FIRM

If you need help filing for SSDI or SSI benefits, then hire us to help you. At our law firm, we help you apply and appeal any SSA denial you receive. You only have 60 days to appeal an SSA denial. So, don’t delay in calling our office. You do not want to miss the 60 day appeal time limit. When you call, then we can answer your questions over the phone. This doesn’t cost you anything. We will give you advice on how to appeal.

Navigating the five step Social Security review process is never easy. Especially if you have a rare disease like PLS. Even with a solid diagnosis, many claims are denied at the initial stage. That’s why it helps to have an experienced SSD attorney on your side. Our attorneys and staff have helped over 20,000 clients with complex medical conditions. We know how to present your case to the SSA.

We gather medical records and request statements from your doctors. Also, we prepare you for SSA hearing and advocate for you in court. Most importantly, we do it at no upfront cost to you. If we don’t win your case, then you don’t pay an attorney fee. Learn about attorney fees in SSD cases.

If we do win your benefits, then you pay 25% of your past due benefit as the attorney fee. However, there is a cap of $9200. You do not pay more than the cap and usually 25% is less than the cap. We also do not receive any money from your future benefits. Therefore, you have nothing to lose by hiring us. We are the best SSD attorneys.