What this listing covers
Muscular dystrophy is a group of genetic diseases that cause progressive weakness and loss of muscle mass. These conditions occur when abnormal genes interfere with the production of proteins needed to form healthy muscle. Over time, this leads to a decline in physical strength and mobility.
In daily life, this condition often makes simple tasks difficult. You may struggle to stand from a chair, maintain balance while walking, or use your hands for fine motor tasks like buttoning a shirt or writing. As the disease progresses, these limitations can make it impossible to sustain the physical demands of a full-time job.
How SSA evaluates a claim under this listing
Under Listing 11.13, the SSA evaluates the severity of your motor function loss. They look for evidence that your condition has caused extreme difficulty in standing, balancing, or using your arms and hands. This assessment focuses on how your muscle weakness prevents you from independently initiating or completing work-related tasks.
SSA also considers whether your condition causes marked limitations in both physical functioning and mental areas like concentration or managing yourself. To qualify, your medical records must show that these limitations have lasted or are expected to last for at least 12 months. An attorney can help you ensure your medical records clearly map to these specific criteria.
Evidence that strengthens a claim
Strong claims rely on detailed medical records that document the progression of your muscle weakness. This includes clinical examination findings, genetic testing results, and muscle biopsy reports. Imaging and nerve conduction studies are also helpful to show the extent of your neurological and muscular impairment.
Non-medical evidence is equally vital to your claim. Statements from your treating physician describing your specific physical restrictions are essential. Additionally, function reports from family members or former coworkers that detail your inability to perform daily activities or sustain work tasks provide context that medical records alone may miss.
How an attorney helps
An attorney can help you by ensuring your medical records clearly map to the specific criteria in Listing 11.13, coordinating with your doctors to obtain detailed functional capacity statements, and guiding you through the appeals process if your initial application is denied.
Frequently asked questions
Not every diagnosis of muscular dystrophy automatically qualifies. SSA evaluates your claim based on how the disease limits your physical and mental functioning. You must provide evidence that your symptoms meet the specific thresholds in Listing 11.13, such as extreme motor function loss or marked limitations in daily tasks. An attorney can help you review your medical records to see if they meet these requirements.
SSA measures motor function by observing your ability to stand from a seated position, maintain balance while walking, and use your upper extremities for tasks. They look for evidence that you cannot perform these actions independently without assistive devices like walkers or crutches. Your medical records must document these difficulties consistently over time.
A denial is not the end of your claim. You have the right to request a reconsideration, and if that is denied, you can request a hearing before an administrative law judge. You must file these appeals within specific timeframes. An attorney can help you identify why your claim was denied and gather the additional evidence needed to strengthen your case.
Yes, a statement from your treating physician is very helpful. SSA relies on medical evidence to understand how your condition affects your ability to work. A doctor who can explain your specific physical limitations and how they interfere with work-related activities provides the evidence needed to support your claim. An attorney can help you request the right documentation from your medical team.
