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Patient Resource Center

Social Security Disability and Spasmodic Torticollis



By Robert C. Angermeier

312 East Wisconsin Avenue, #210

Milwaukee, WI 53202

(414) 289-9200

Nearly 3 million applications for Social Security disability benefits are filed annually. Common disabling diseases such as cancer, heart disease, serious mental illnesses are typically processed in a very efficient manner. However, the Social Security system has considerable difficulty dealing with relatively rare conditions such as ST. The disability evaluators do not have much familiarity with ST.

Thus, the primary objective when applying for Social Security disability is to educate the Social Security personnel who initially evaluate the claim as well as the Social Security judge, the person most likely to ultimately decide the case.

My experience has been that once the Social Security judge is educated about ST and its pervasive impact on a person's ability to pursue gainful employment, these cases are very winnable.

You must not lose sight of the fact that ST is a disease, that once properly diagnosed, is a definitive diagnosis confirmed by objective clinical and diagnostic proof. This is a very important consideration. In other words, ST is not a vague "syndrome" which is diagnosed by ruling out other possible disease processes. Although rare, ST is a real disease process. The most obvious symptoms associated with ST are the manner in which the head is pulled, turned, or jerked toward the shoulder. However, the most disabling symptom associated with ST is the chronic pain. Although no one else can "feel" your pain, the law requires that the Social Security Administration consider the disabling impact of the pain which you experience. Thus, your description of your pain and how the pain affects your daily activities, and presumably how your pain would affect your ability to work, is usually the central feature of a successful disability claim.

Additionally, it is important that the Social Security Administration understand how stress affects the severity of your symptoms, and how your symptoms vary from day to day. For many individuals, if they are prevented from working two to three days per month because of disabling symptoms associated with ST, they are likely to be found disabled. This is because most employers are not in a position to tolerate 24 to 36 medical absences per year. This is a very important consideration, but it is often ignored. The Social Security Administration must also consider the disabling impact of depression caused by ST, and the impact of sleep deprivation on an individual's ability to work.

It is also important to understand that your physician plays a very critical role in a disability case. It is to your benefit that your physician is likely the only medical expert involved in your case that knows anything about ST. However, it is virtually useless for the physician to write a letter that


simply says this patient has ST and is "totally disabled". Such a letter fails in your overall efforts to educate the judge and explain the critical nexus between ST and the cluster of symptoms which prevent you from working.

A final issue is whether you should have legal representation. The statistics maintained by the

Social Security Administration clearly demonstrate that people who have legal representation are substantially more likely to be successful in their disability claims. The bottom line question is whether the money you would spend on an attorney in connection with your disability claim is a prudent investment. First, you must realize that disability claims are not insignificant. A 45 year old ST'r who obtains disability benefits, on average, will collect over $200,000 in disability benefits assuming they remain disabled until age 65. Thus, when put into context, paying $3,000 to $4,000 in attorney's fees is a prudent investment.

Most attorneys who represent individuals in connection with disability claims do so on a "contingent fee" basis. This means that the attorney agrees to represent the person and will only charge a fee if the case is successful. The fee is typically (but not always) 25% of accrued back benefits. The average fee is approximately $2,500, but this can vary depending upon the amount of accrued back benefits.

Unfortunately, only a few attorneys have the specialized knowledge and experience necessary to maximize your chances of success. If you hire an attorney with little or no experience in the field, you are probably not enhancing chances of success in connection with your claim. Thus, great care should be taken to find an attorney with the requisite skill and experience. An obvious starting point may be your local ST support group. You should be prepared to hire an attorney who has the requisite skill and experience.