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.
U.S. Government
Disability Website
The U.S. government has
a website for disability information at disability.gov.
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 $5,300 -- 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 not 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.
Lawyers with Internet links that
connects them with the disability representation of patients with Meniere's
Disease.
We don't
endorse, recommend, or refer to lawyers for the simple reason that we have
no particular competence to do so. The following lawyers are listed simply
because they have Internet links that connect them with the disability
representation of patients with Meniere's Disease.
U.S. lawyers: To be listed, simply provide us with the
Internet link that connects you with the disability representation of patients
with Meniere's
Disease. There is no charge. Click
here.
When you tell the truth, you don't need a long memory.
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 or otherwise. Don't let their misunderstanding
(or otherwise) 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 provide 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 a diagnosis of "Meniere's Disease"
can be causation and timing. "Meniere's Disease" caused by military
service is probably better diagnosed as a different form of
endolymphatic hydrops.
Remember that Meniere's
Disease is considered by most authorities to be "idiopathic
endolymphatic hydrops," with "idiopathic" meaning "cause unknown."
With the cause unknown, it is difficult to establish the time period
during which Meniere's Disease began. If the cause and therefore
the timing is unknown, it is hard to say that it was caused by
line-of-duty military service.
We have been contacted by
a veteran who anecdotally reports that he was awarded service-related
retirement based on service-related aggravation of his Meniere's
Disease, idiopathic or not (meaning whether the cause of the Meniere's
Disease was service-related or not). Thus, one approach might be
aggravation rather than causation.
If one has endolymphatic
hydrops caused by line-of-duty military service, then most authorities
would say that one does have not "idiopathic" endolymphatic hydrops
(Meniere's Disease), because the cause is known. In that case,
one might have "secondary endolymphatic hydrops" ("secondary" being
secondary to the known cause of line-of-duty military service) or
"delayed endolymphatic hydrops," where symptoms manifest subsequent
to, rather than coincident with line-of-duty military service.
See more information on this subject on our
Cause Page.
Tip to Service Members:
Be sure that symptoms of endolymphatic hydrops (whether Meniere's
Disease or any other form) and anything else are documented in your
medical records, ESPECIALLY in your separation physical.
Home Ownership Programs
for Persons With Disabilities
For many disabled
persons, home ownership may be a stretch, but there are some resources
available, and it is always good to know one's options.
