There is no known
cause of Meniere's Disease, there is no known cure for Meniere's
Disease, and there is no cure on the horizon. That's not
"negative thinking"; that's simply the fact of the matter and there
is no point in denying it or offering false or gratuitous hope.
Click
here to see the latest research. The good news is that
Meniere's Disease is not fatal, that there are many possible
"symptomatic" treatments (treatments
for the symptoms) with which patients can try to lessen or at least
manage their symptoms, and that some patients experience temporary
spontaneous remissions of varying periods of time. However,
some patients are unresponsive to virtually all treatments,
including invasive surgery, and will become disabled. See the
other pages of this website for further information.
Meniere's Disease is recognized as
a potentially disabling condition by the U.S. Social Security
Administration.
The SSA "Blue Book"
(the cover is blue), "Disability Evaluation Under Social
Security," is the official SSA publication that lists diseases and
conditions for which SSA disability is available.
Meniere's Disease
is listed as a potentially disabling condition.
However, the fact
that one has Meniere's Disease does not by itself qualify one
for disability.
Many, many
patients have Meniere's Disease but they are not disabled.
Many patients are
disabled by Meniere's Disease.
To qualify for
disability benefits, one must demonstrate that one is
disabled.
We have specially
extracted the parts of the SSA "Blue Book" that pertain to
Meniere's Disease here.
For your SSA benefits to be
approved, your doctor MUST meet the "evidentiary requirements" in
Part II of the Blue Book that
demonstrate that you meet the Blue Book
criteria for disability! Your doctor must use the "magic
words" that will demonstrate that you qualify for SSA disability
(as opposed to merely stating that you are disabled).
SSA has two
disability programs: SSDI (Social Security Disability
Insurance) and SSI (Supplemental Security Income).
Generally, SSDI is the better of the two.
What's the
difference between SSDI and SSI? Click
herefor more information at the SSA website.
SSA disability
programs are for total disability. There is no SSA
disability program for partial disability. (Click
here and scroll
down to "Who can get Social Security disability benefits.")
Keep copies of
everything you send to SSA.
It's amazing how
often claimant's files get "lost" by SSA. Truly amazing.
If is happens to you, you'll want to be able to replace the
"lost" files immediately.
SSDI (Social
Security Disability Insurance) provides benefits for people
who have sufficient work credits under social security.
Official SSA
Publication No. 05-10029, "Social Security Disability Benefits."
Do not wait
for five or six months to pass. No benefits are
paid for the first five months after one becomes disabled.
Benefits start accruing at the beginning of the sixth month
after one becomes disabled. But one does not have to
wait either five or six months before applying for benefits.
Do not wait
for one year to pass. To qualify for disability,
one's disability must be expect to last at least one year
(or result in death), but one does not have to wait for a
year before applying.
One should apply as soon as one
is disabled (that very same day).
Benefits begin after five
months from the point in time at which one became disabled.
This is called the "five month waiting period." This
is a waiting period for benefits to begin to be paid.
It is not a waiting period to apply for benefits.
In other words, benefits
begin in the sixth month. There are no benefits paid for the
first five months from the point in time at which one became
disabled.
SSI (Supplemental
Security Income) provides benefits for people who are *not*
covered by social security but who are impoverished. Social
security work credits are NOT needed to qualify for SSI. The
requirements are different for adults and for children.
Official SSA
Publication No. 05-11000, "Supplemental Security Income" (for
adults).
a medically determinable
physical or mental impairment, which:
results in the
inability to engage in any "substantial gainful
activity" and
lasts or can expected to
last 12 months or longer
or result in death.
What is a "substantial
gainful activity"?
a level of work activity that is
both substantial and gainful.
Substantial work activity
involves performance of significant physical or
mental duties, or a combination of both, which are
productive in nature.
Gainful activity is work
performed for pay or profit; or work of a nature
generally performed for pay or profit, whether or
not a profit is realized. For activity to be
substantial, it need not necessarily be performed on
a full–time basis; work activity performed on a
part–time basis may also be substantial.
For SSI purposes, the
substantial gainful activity
provision does not apply to blind individuals.
If you hire a lawyer to
represent you in your disability claim, you don't have to pay
lawyer fees up front. Their fees are paid directly by the
Social Security Administration and are deducted from the back
benefits that you recover. There is no fee if you don't
recover back benefits.
Succeeding with a
claim for disability benefits is an uphill battle, especially
for a rare, little understood, "invisible" condition such as
Meniere's Disease. Most attorneys provide an initial
consultation at low or no cost. Legal practice before the
Social Security Administration is subject to a special federal
regulation that sets a maximum fee, and an attorney's fees must
be reasonable and approved by the Social Security
Administration. You pay the fee only if you win your claim
and recover back benefits. Our understanding is that the
maximum fee is 25% of the back benefits recovered, up to a set
maximum of $4,000 -- but you'll want to confirm the fees before
committing to hiring a lawyer. The fee will be paid
directly to your lawyer by the Social Security Administration
out of your back benefits, and you must first acknowledge that
the lawyer represented you and earned the fee. However,
one must pay out of pocket for expenses (as opposed to the
lawyer's fee), such as the price that one's doctor charges for
making photocopies of medical records.
We think that it is
unconscionable that one must usually obtain the services of a
lawyer to recover what one is due from the Social Security
Administration, and that one's recovered back benefits are
reduced by the attorney's fees. We believe that when SSA
denies a meritorious claim, that SSA should pay the lawyer's
fees. However, that's the system. The fact is that
patients are better off recovering 75% of their back benefits
than not.
One will want to
consult with an attorney early in the process so as to avoid
making an unrecoverable error.
Disability lawyer
links. Note: These links are provided for your
convenience. These links do NOT constitute an endorsement or
a recommendation. We receive no compensation for providing
these links.
NOTE: The
following websites request more personal information of you than
we feel comfortable in giving up to a website rather than to a
lawyer. We infer that whoever receives your information at
these websites are non-lawyers who then "shop" the information
to lawyers, but who knows? We think it is better to get
the name of a specific disability lawyer and then provide
personal information only to a specific lawyer under
circumstances that invoke the attorney-client legal privilege.
But the choice is yours.
When you tell the truth, you don't need a
long memory. -- Jesse Ventura
Beware the "Yes" or "No" question.
Beware the question that apparently calls
for a yes or no answer. When it comes to disability,
there are few questions that can be answered honestly and
completely with either a yes or a no. For example,
consider this question: "Do you have days when you can
work eight hours without having an attack?" Virtually
any Meniere's patient could answer this question "yes," but
consider whether that is an honest and complete answer.
To many people reading that answer, that answer would mean
that you can actually work a job most of the time without any
problem, and therefore you should not qualify for disability
benefits. If that is true, so be it. However, a
more accurate answer, if true, might be to say, "Once every
two or three weeks I have a day without an attack.
However, I suffer frequent acute 'drop' attacks that occur
without warning. When these attacks strike, I fall to
the floor due to acute vertigo and vomit because of the
vertigo. These attacks last from one to four hours,
during which time I am effectively immobilized. (Etc.,
etc., etc.)" Remember that most disability questions are
designed to *disqualify* you from receiving disability
benefits. Don't be tricked into a yes-or-no answer that
is incomplete and portrays a false impression by omission.
Don't volunteer any information.
Don't volunteer any information that is not
asked for. That nice person from Social Security (or
whatever) is NOT there to help you to get your benefits.
That person is there to disqualify you. Don't help that
person to disqualify you, especially if that person could
misinterpret whatever information you are "helpfully"
volunteering.
Don't be a comedian.
Your disability application, interviews,
and hearings aren't the Jay Leno show. Some people like
to joke around to cover up their nervousness. The
bureaucrats don't like it. You are wasting their time
and getting yourself into trouble. Be congenial, but
don't overdo it.
Never go alone.
Never go alone to a disability interview or
hearing. Always take a relative or a trusted friend.
Take your attorney if possible. There is strength in
numbers and bureaucrats are less likely to be unpleasant in
front of witnesses. It's human nature.
Afterwards, write up your notes as soon as
you get home -- or earlier. Write them together with
your witness. Sign them and date them and keep copies.
It is possible that the bureaucrat will claim that you said
something that you didn't -- or claim that you didn't say
something that you did -- through a misunderstanding.
Don't let their misunderstanding cost you your benefits.
State Rehabilitation Agencies
Each state has some sort of agency
for the purpose of assisting disabled people whose employment is
threatened by their disabilities to become rehabilitated, to become
employed or to retain employment, and to save the government the
expense of providing welfare benefits to those who, with assistance,
can be productive, taxpaying employees. Various states have
their own benefits and criteria for qualifying (possibly including
income or savings tests -- our speculation). Patients can be
expected to pay something toward the costs of services provided.
As little known and almost
secretive as these agencies may be in some cases, we have heard of
anecdotal successes in obtaining hearing aids and even cochlear
implants. We wonder whether vestibular rehabilitation is
available, and what other benefits might be available to "those
who know."
Although these agencies are created
to carry out state programs, in addition, the U.S. Social Security
Administration (SSA) provides funding to state rehabilitation
agencies to provide services to persons who are receiving Social
Security Disability (SSDI) and persons who are receiving
Supplemental Security Income (SSI) based upon disability or
blindness under certain conditions. The services must result
in return to work for at least nine continuous months at a
substantial earnings level, which is referred to as "substantial
gainful activity." See more
here.
Of course, navigating any government
benefit is much easier said than done. If you can find web
resources or rehabilitation counselors outside of the agencies to
consult and obtain information before you first make contact with
the agency itself, that might be the better approach. If you
can find a disability lawyer with whom to consult, so much the
better. If you do these things, you will know more than *some*
state employees, and you will have to *tactfully* help them out.
(Sad, but often true when dealing with any government agency.
No offense intended to dedicated government employees who practice
excellence in their work; they do the work of three for the salary
of one.)
The Social Security
Administration maintains this link, but the services provided are
primarily state agency programs. As mentioned above, SSA may
provided additional funding for SSDI and SSI rehabilitation
programs.
U.S. Americans with
Disabilities Act (ADA).
Note that the ADA does
not guarantee jobs to people who are disabled or who become
disabled. Rather, the ADA requires covered employers to
provide reasonable accommodations to those employees (or applicants)
who are disabled, or who are perceived to be disabled, to enable
them to perform jobs that they could not otherwise perform. An
employer is under no obligation under the ADA to employ a person in
a job that the person cannot perform with reasonable accommodations,
nor is an employer required to provide extraordinary accommodations
to a disabled employee.
Enforcement.
The ADA is enforced either by the U.S. Department of Justice (DOJ)
or by the U.S. Equal Employment Opportunity Commission (EEOC),
depending on the circumstances.
Govbenefits.gov
has general information on U.S. government
benefits of all kinds.
U.S. Department of
Labor (DOL).
Job
Accommodation Network (JAN). JAN is a U.S. Department
of Labor toll-free information and referral service on job
accommodations for people with disabilities; on the employment
provisions of the Americans with Disabilities Act; and on resources
for technical assistance, funding, education, and services related
to the employment of people with disabilities.
The DOE, through the
Rehabilitation Services Administration (RSA), Office of Program
Operations (OPO), is responsible for administering the
Rehabilitation Act through state vocational rehabilitation (VR)
agencies. There is a
specialized branch for deafness and communicative disorders.
Services offered under the Rehabilitation act are varied and range
from training to grants for the purchase of equipment. You
might inquire whether you qualify for exotic hearing aids or other
equipment to help to keep you employed. At least one,
unconfirmed, anecdotal report suggests that exotic hearing aids
are possible, without regard to income or wealth, if necessary and
appropriate to keep you employed. We suggest that you
contact your state vocational rehabilitation (VR) agency to get
the official word.
U.S. Merit Systems
Protection Board
A 2001
opinion by the U.S. Merit Systems Protection Board (MSPB)
supports a finding that a Meniere's patient, who was an employee of
the federal government, was disabled and entitled to a disability
retirement annuity under the Federal Employees Retirement System (FERS).(Many thanks to reader John
Dymond for bringing this great link to our attention.)
The opinion is full of
the usual legal gobbledygook, but the bottom line is that after
three separate denials of benefits by the Office of Personnel
Management (OPM), the patient finally prevailed on her fourth
attempt, an appeal which was heard by the MSPB. (In its
opinion, the MSPB noted that the Social Security Administration (SSA)
had awarded disability insurance benefits to the patient.)
Within the opinion, a couple of points stand out (at least to us).
(1) The conclusion of a physician needs to be supported by medical
records (tests, examination results, [results of] therapy, etc.,
as well as by clinical findings (hearing tests, sensory
organization [tests], and movement coordination [tests]).
(2) It is important to get all of the available information "on
the record" as early in the process as possible, because at a
later date it may not be possible to bring up additional
information "absent a showing that it was unavailable before the
record was closed despite the party's due diligence."
Although the patient in this case represented herself before the
MSPB quite successfully, there is a lot of technical ground
covered in the opinion, and given the perception of a culture of
adversity that one encounters in the pursuit of disability claims
(everywhere), one might want to seriously consider obtaining legal
counsel early in the process. (After all, patients
will certainly face legal counsel opposing their claims.)
U.S. Department of
Veterans Affairs
The U.S.
Department of Veterans Affairs recognizes Meniere's Disease as a
potentially "rated" disability in 38 C.F.R. § 4.87, Disability Code
(DC) 6205.
Hearing impairment with attacks of vertigo
and cerebellar gait occurring more than once weekly, with or
without tinnitus: 100
Hearing impairment with attacks of vertigo
and cerebellar gait occurring from one to four times a month,
with or without tinnitus: 60
Hearing impairment with vertigo less than
once a month, with or without tinnitus: 30
NOTE: Evaluate Meniere’s syndrome either
under these criteria or by separately evaluating vertigo (as a
peripheral vestibular disorder), hearing impairment, and
tinnitus, whichever method results in a higher overall
evaluation. But do not combine an evaluation for hearing
impairment, tinnitus, or vertigo with an evaluation under
diagnostic code 6205.
Note that in addition to monthly payments, a
disability rating provides access to medical care by the VA.
This could be even more important than the monthly payments.
Click
here to search for more information on this regulation as
it applies to Meniere's Disease.
Two problems with
obtaining veteran's benefits due to Meniere's Disease can be
causation and timing. Meniere's Disease is considered by most
authorities to be "idiopathic endolymphatic hydrops," with
"idiopathic" meaning "cause unknown," and it is difficult to
establish the time period during which Meniere's Disease began.
If the cause is unknown, it is hard to say that it was caused by
line-of-duty military service. If the cause is known, say from
military service, then perhaps the diagnosis should not be Meniere's
Disease. See more information on this subject on our Cause Page.
Tip to Service
Members: Be sure that symptoms of Meniere's Disease and
anything else are documented in your medical records, ESPECIALLY
in your separation physical.
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