Winning Social Security Disability Benefits for Parkinson's Disease by Meeting a Listing

Listing 11.06

The Social Security Administration listing for Parkinsonian syndrome is 11.06. That listing is very brief and consists solely of the following sentence:

Parkinsonian Syndrome with the following signs: Significant rigidity bradykinesia, or tremor in two extremities, which, singly or in combination, result in sustained disturbance of gross and dexterous movements, or gait and station.

Similarity to Listing 11.04

The Social Security Administration listing for central nervous system vascular accident, listing 11.04, consists of two parts, one of which is "significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station."

This listing sets a consistent general standard for assessing the functional limitations resulting from all other neurological impairments.

As with the listing for Parkinson's disease, listing 11.04 focuses on limitations on two extremities as follows:

Upper extremity function:

  • Gross movements.
  • Dexterous movements.

Lower extremity function:

  • Gait (the manner of walking).
  • Station (the manner of standing, i.e., ability to maintain a posture).

Upper Extremity Function

The use of the arms and hands is evaluated by looking at gross and dexterous movements. Dexterous movements are those like writing, picking up small objects, or other types of fine movements. Gross movements involve larger motions with the arms and hands.

Movements can be influenced by weakness, or loss of control over the way an arm or hand moves, such as tremors or poor coordination. The ability to oppose fingertips to the thumb successively can give some idea as to the intactness of fine manipulatory (dexterous) ability. However, if finger-thumb opposition can only be done slowly and clumsily then you should not be considered capable of such activity.

Also, your activities of daily living can be helpful in assessing functional severity when they describe specific inabilities or abilities (e.g., turning doorknobs, dressing, climbing stairs, shaving, etc.).

Lower Extremity Function

In evaluating how well you stand and walk, the Social Security Administration requires a detailed description from a medical doctor. This involves factors such as how weak your legs are, how much difficulty you have in keeping balance, how fast you walk, how much help you need in walking, etc.

It is not necessary that you have to use a cane, crutch, brace, walker, or other assistive device to move about. Of course, if such devices were necessary, it would indicate a very severe limitation.

Meaningful functional data regarding strength can be obtained with some simple and routine maneuvers in physical examinations.

For example, there is the examining physician’s estimate of strength loss by comparing your strength of muscle contraction on the weak side to the normal side. Physicians frequently report subjective determination of strength by using a scale of 0–5 with 5 being normal. For example a physician might ask a patient to try to straighten out their leg while the doctor resists such movement. A weaker leg might be reported as 3/5 for the quadriceps muscle compared to an expected normal of 5/5. Zero means no movement. One means a trace of movement. Two means movement with the help of gravity. Three means movement is possible against gravity, but no resistance. Four means movement against gravity and resistance by the examining physician. Five means normal.

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