Recently on our disability forum a user asked, “I have been diagnosed with narcolepsy. I have extreme drowsiness and fatigue during the day and fall asleep constantly. I have tried a variety of medications without relief. I have just been fired from my last job. I am wondering if I might qualify for Social Security Disability Insurance (SSDI)?”
Overview of Narcolepsy
According to WebMD, “Narcolepsy is neurological disorder that affects the control of sleep and wakefulness.” More specifically, it leads to “excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime.” Those between the ages of 15 and 25 are most commonly diagnosed with this condition.
Social Security Disability Insurance (SSDI) and Narcolepsy
Social Security Disability Insurance (SSDI) are benefits provided to workers who have a severe mental and physical health condition, who cannot work for at least 12 continuous months, who are not currently working and earning too much money, and who have sufficient work credits to be considered insured for benefits.
To win SSDI benefits claimants must either have a condition which meets or exceeds a listing on the SSA Listing of Impairments or they must have sufficient medical evidence to prove that they cannot work their current job or retrain for new work.
Is there a listing on the SSA Listing of Impairments for Narcolepsy?
There is not a specific listing for narcolepsy on the SSA Listing of Impairments. For this reason, you cannot “meet a listing.” Some claimant’s, however, have had some success in proving that their condition is as severe as a listed condition. Specifically, Section 11.03 of the Blue Book which addresses those suffering from epilepsy.
To prove that your condition is as severe as this listing you would need to have at least one episode per week, prove that your condition persists for at least 3 months despite treatment, and your episodes limit your ability to perform your daily activities.
Winning SSDI benefits by proving you cannot work
More than likely, however, your disability case for narcolepsy will be denied the first time you apply. It also might be tough to prove your condition is as severe as a listed condition. With that in mind, you will need to appeal the denial within 60 days of receiving the denial letter and submit sufficient medical evidence to prove you cannot work.
Evidence should include detailed medical records, clinical histories, treatment histories, lab reports, and written statements from your treating physicians. Additionally, it is helpful if your treating physician will provide information about your residual capacity to work (i.e. complete a Residual Functional Capacity Form (RFC).
Additional information on the RFC form can include detailed ways that your narcolepsy limits your ability to work. For example, do you need frequent breaks for treatment? Do you have to have scheduled naps to maintain your productive? Is your ability to walk, stand, lift or carry objects affected by your condition?
Winning benefits for narcolepsy can be very tough. Not only is it not a listed condition, but it might be difficult for a young claimant to prove they cannot perform any type of work with this condition.