Vestibular balance disorders refers to disorders of the vestibular system, a complex structure in the inner ear that works with other body systems to maintain balance. The causes of vestibular balance disorders are myriad and include infection and head injuries, though occasionally the cause is unknown. The most common vestibular balance disorder is Ménière's disease. The symptoms of vestibular balance disorders include vertigo, nausea, vomiting, profound dizziness, disorientation and blurred vision.
The SSA will determine whether your vestibular balance disorder meets or equals one of the qualifying conditions in the SSA's Listing of Impairments (Listings).
The SSA discusses the criteria for automatic approval for vestibular balance disorders (including Ménière's disease) under Listing 2.07. To meet the criteria for Listing 2.07, you must prove that your labyrinthine-vestibular disorder or Ménière's disease has caused recurrent problems with your balance, tinnitus (ringing in the ears), and a gradual decrease in your ability to hear. In addition to these basic requirements, you must provide the SSA with the following:
If you can prove that your vestibular hearing disorder meets all of the criteria, your claim will be automatically approved. If you don't have problems with both balance and rining in the ears, but you do have hearing loss, you may be able to qualify under hearing loss alone.
Because symptoms of balance disorders such as vertigo can fluctuate over time and go into long periods of remission, it is important that you provide the SSA with medical records dating to when your symptoms first began. The medical records must include a detailed description of how long your attacks last, how severe they are and how often they happen. Also, although the SSA must accept evidence from most licensed doctors, it will give greater weight to the opinions and observations of doctors who specialize in your particular illness, such as neuro-otolaryngologists.
The SSA discusses in particular the symptoms related to Ménière's disease and the vertigo it produces. Vertigo symptoms include feelings of being in motion and positional disorientation; it is helpful to keep a log as to the frequency of the attacks and how they affect your ability to engage in your daily activities. You should also be able to demonstrate that you experience vertigo versus mere dizziness. If your doctor witnesses an episode of Ménière's related vertigo, he or she should describe whether you suffered from any observable symptoms like nausea, vomiting, incapacitation, or lack of muscle coordination.
You should provide the SSA with a complete list of all doctors you have seen to treat or diagnose your vestibular balance disorder and any hospital or clinics you have visited. The SSA must also be provided with test results from any x-rays, MRIs, speech or hearing tests and bone scans. Because of the complexity of the Listing requirements, it will be helpful to review the criteria and test requirements with your physician. Your physician can determine if you meet the Listing or if you need to undergo any additional tests the SSA may require.
Even if your vestibular balance disorder doesn’t meet the Listing requirement you may still be approved, but it will be significantly more difficult. At this step, the SSA must decide if you can still do your old job despite your vestibular balance disorder. If it believes you can do your past work your claim will be denied. If the SSA feels you cannot do your old job, then it will take into consideration your age, education, past work experience and work limitations caused by your vestibular balance disorder to see if there is any other work you can do. At this stage approval is easer for older less educated applicants.
You must also provide the SSA with a Residual Functional Capacity (RFC) assessment prepared by your treating doctor. The RFC should state any work limitations you have that result from your vestibular balance disorder. For example, because dizziness and vertigo are the primary symptoms of balance disorders, your RFC should state that you must avoid any work that involves heights or heavy machinery. Also, if your attacks are frequent you may miss more work that is acceptable; a decreased work productivity of 20% or more would prevent you from doing most jobs, according to the SSA. Some vestibular balance disorders, such as perilymph fistula, are triggered by physical exertion; therefore your RFC should state what limits you have on your ability to lift, carry, push and pull.