Those who suffer from TMJ disorders may find it impossible to maintain full- or part-time work. Some of the symptoms associated with TMJ disorders such as vertigo, light sensitivity, and pain in the neck, head and ears, can make it impossible to perform job responsibilities. The resulting lack of income can lead to significant financial stress. Fortunately, in some cases, obtaining Social Security Disability benefits can help to alleviate some of the financial strain.

Qualifying for Social Security Disability Benefits with TMJ Disorders

When you apply for Social Security Disability benefits, the Social Security Administration (SSA) will compare your condition to a list of conditions in the Social Security Blue Book. This publication lists all of the conditions that could possibly qualify an individual for disability benefits, as well as the criteria that must be met in order to be approved under each. While there is no specific listing for TMJ disorders, there are listings that are associated with some of the symptoms you may experience as a result of your TMJ disorder.

For example:

  • If you suffer from a speech impairment or have difficulty speaking due to jaw dysfunction or pain, you may be able to qualify for benefits under Section 2.08 of the Blue Book, which addresses loss of speech.
  • If you suffer from vertigo, you may be able to qualify for disability benefits under Section 2.07 of the Blue Book, which addresses disturbance of labyrinth-vestibular function.
  • If you suffer from hearing loss or severe tinnitus due to your condition, you may be able to qualify for benefits under Section 2.09 of the Blue Book, which covers hearing loss.
  • If you find it difficult to eat due to your limited jaw movement and have suffered weight loss because of this, you may be able to qualify for benefits under Section 5.08 of the Blue Book.

When applying for benefits based on a specific Blue Book listing, it is important to research the criteria that must be met under that listing and provide all of the medical documentation needed to prove to the SSA that you meet the established criteria for that particular listing. For example, if you are applying for benefits under Section 2.07 of the Blue Book, which addresses vertigo, you must provide the SSA with proof of the following:

  • You suffer from disturbance of labyrinthine-vestibular function that has been characterized by a history of frequent attacks of balance disturbance, tinnitus, and progressive loss of hearing; and
  • You suffer from a disturbed function of vestibular labyrinth demonstrated by caloric or other vestibular tests; and
  • You suffer from hearing loss established by audiometry.

By providing the proper medical evidence along with your application for benefits, you will have a better chance of being approved for benefits during the initial stage of the application process.

Conditions Coexisting with TMJ Disorders

TMJ disorders often coexist with other conditions such as chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, interstitial cystitis, irritable bowel syndrome, etc. While there is no specific listing for TMJ disorders in the Blue Book, the conditions previously mentioned are covered in the Blue Book here.

Qualifying for Benefits Without a Blue Book Listing

If your condition does not meet any of the listings contained in the Blue Book, you may still be able to qualify for disability benefits if you can prove that your condition prevents you from performing any type of work activity whatsoever. This is what is known as a “medical vocational allowance.”

For approval based on a medical vocational allowance, the SSA will conduct what is known as a residual functional capacity assessment or an RFC. A medical consultant will assess your functional restrictions and limitations, rate your ability to work and evaluate your residual functional capacity, which determines whether you can perform light, sedentary, medium, or heavy work. If it is determined that you are unable to perform any type of work activity, you will be awarded Social Security Disability benefits.

Financially Qualifying for Social Security Disability Benefits

There are two types of Social Security Disability programs including Social Security Disability Income (SSDI) and Supplemental Security Income (SSI). Each program has its own technical eligibility requirements.

If you are applying for SSDI benefits, you will need to have earned a certain number of work credits through previous work history. The exact number of work credits needed varies by age. If you have not earned any work credits or do not have enough work credits to qualify for SSDI benefits, you may still be able to qualify for SSI benefits.

The SSI program is a need-based program. No work credits are needed to qualify for SSI benefits. Instead, the SSA will look at your household income and assets. In order to qualify for SSI benefits, as of 2020, your household income cannot exceed $783 per month as an individual or $1,175 per month as a couple. Your household assets may also not exceed $2,000 as an individual or $3,000 as a couple.

For more information on SSDI and SSI, click here.

The Application Process

You can apply for benefits online from the SSA website or in person at your local Social Security office. When applying for disability benefits, you will be asked to fill out a number of forms. Be sure to fill in each form in its entirety and provide detailed answers to every question. The answers you offer will help the SSA understand how your condition prevents you from performing work activity. The more detail you can give on these forms, the easier it will be for the SSA to understand why you qualify for Social Security Disability benefits.

When applying, also make sure that you provide documentation of medical proof. If applying for SSI, you should also bring proof of financial eligibility, such as recent bank statements.

You will receive a decision regarding your claim approximately three to six months from the date of your initial application. If you are denied benefits, you have 60 days from the date of your denial to appeal the SSA’s decision. If you are denied, it is important that you do not give up. It is very common to be denied after your first application – approximately 60 percent of all initial applications are denied by the SSA. Many applicants go on to successfully appeal a denial of benefits. When dealing with an appeal, you may want to consider retaining the services of a Social Security Disability attorney. Statistics have shown that applicants who pursue the appeal process with the help of an attorney are more likely to be awarded benefits than those who try to represent themselves.

Article by Ram Meyyappan

Social Security Disability Help