Boston Social Security Disability Lawyer Guides SSDI Applicants With Genetic Conditions
At Keefe Disability Law, we understand the challenges of living with a genetic condition that affects your ability to work. When a hereditary disorder makes it impossible to maintain employment, you need experienced legal guidance to secure the Social Security Disability Insurance (SSDI) benefits you deserve.
Our Social Security disability lawyers help Massachusetts residents document their genetic conditions and build strong cases for SSDI approval. Explore how the Social Security Administration (SSA) uses genetic testing to evaluate SSDI applications for benefits.
How the Social Security Administration Evaluates Genetic Tests
According to the SSA's Program Operations Manual System (POMS), genetic tests use laboratory methods to detect genetic variations associated with diseases, conditions, or genetic disorders.More specifically, it accepts test results that analyze analyze chromosomes, deoxyribonucleic acid (DNA), or ribonucleic acid (RNA) anomalies linked to genetic conditions.
The 2016 Policy Interpretation Ruling SSR 16-4p established clear guidelines for how genetic test results factor into disability determinations. The SSA recognizes several types of genetic tests:
- Diagnostic tests that help confirm specific disorder diagnoses
- Predictive tests that assess future disorder risk
- Pharmacogenetic tests that guide medication choices
- Reproductive tests that identify inherited condition risks
Sources of Genetic Test Evidence
The SSA considers genetic test results from three primary sources:
- Clinical geneticists and physicians. These are acceptable medical sources (AMS) that can establish the existence of a medically determinable impairment through genetic testing.
- Genetic counselors. While not strictly considered AMS providers, genetic counselors often work closely with physicians. Their test interpretations can support disability claims when incorporated into medical records by an AMS.
- Direct-to-consumer (DTC) testing. The SSA can use DTC genetic test results to help corroborate other medical evidence, but DTC test results cannot establish a genetic condition on their own.
Disability Determination Process Stages and Genetic Testing
Genetic test results are considered objective medical evidence, similar to laboratory findings. However, the SSA evaluates this evidence differently at each stage of the disability determination process. The SSA pays particular attention to the severity of symptoms and how they impair your ability to perform past or other work, considering your age, education, and experience.
Establishing Medical Conditions
While genetic tests can help establish a medically determinable impairment, the SSA requires supporting clinical signs and symptoms. The sole exception is non-mosaic Down syndrome, which can be established through genetic testing alone.
Assessing Severity of Disability
Genetic test results generally don't determine impairment severity by themselves. The SSA needs to look at how your medical condition affects your ability to perform basic work activities. They use these results to evaluate the consistency of reported symptoms and limitations.
Meeting Medical Listings
Several SSA medical listings specifically reference genetic testing. For example, the listings for non-mosaic Down syndrome and xeroderma pigmentosum require specific genetic test documentation. Other conditions may use genetic test results as part of the overall medical evidence.
Functional Capacity
The SSA recognizes that many genetic disorders are multifactorial, with environmental influences affecting symptom development and limitation severity. They consider genetic test results alongside other evidence when assessing your residual functional capacity.
Required Medical Documentation for Social Security Disability Claims
With rare exceptions like non-mosaic Down syndrome, genetic test results alone cannot qualify someone for benefits. The SSA requires additional medical evidence showing the condition causes severe functional limitations, clinical signs and symptoms match the genetic diagnosis, and the impairment has lasted or will last at least 12 months.
The SSA will not order genetic testing as part of a consultative examination. Any genetic test results must come from your treating medical providers.
Medical Records
To support your disability claim involving a genetic condition, you'll need to provide such comprehensive medical records as:
- Genetic test results from an acceptable medical source
- Detailed clinical findings documenting symptoms
- Treatment records showing ongoing medical care
- Laboratory and imaging test results
- Evidence of how the condition impacts daily activities
Functional Assessments
Along with specific medical records, you should also provide documentation that details how your condition limits or impairs your ability to work or perform daily activities. These may include:
- Physician statements about work-related limitations
- Documentation of failed treatments or therapy attempts
- Records showing progressive impairment
- Evidence of assistance needed with daily activities
Genetic Conditions That May Qualify for Disability Benefits
Discussed below are examples of inherited disorders that may be approved for Social Security disability benefits when properly documented.
Aicardi-Goutières Syndrome
This rare genetic condition affects the brain and immune system, causing severe developmental problems, intellectual disability, and seizures. Aicardi-Goutières syndrome typically appears in infancy and leads to significant functional limitations.
Alport Syndrome
An inherited kidney disease, Alport syndrome often leads to hearing loss, vision problems, and eventual kidney failure requiring dialysis or transplant. The progressive nature of symptoms leading to end-stage renal disease often prevents sustained employment.
Fatal Familial Insomnia
This extremely rare genetic disorder progressively destroys sleep ability, causing hallucinations, chronic fever, accelerated heart rate, and death within months to years. The rapid progression of fatal familial insomnia typically meets the SSA’s disability criteria.
Duchenne Muscular Dystrophy
This genetic disease causes progressive muscle weakness, eventually affecting the heart and respiratory systems. The deteriorating nature of Duchenne Muscular Dystrophy (DMD) often qualifies for the SSA’s Compassionate Allowances program.
SCN8A-Related Epilepsy With Encephalopathy
This severe form of genetic epilepsy begins in infancy, causing frequent seizures and developmental delays. The ongoing seizure activity often prevents substantial gainful activity.
How Our Social Security Disability Law Firm Helps SSDI Applicants
When you work with the experienced Social Security disability lawyers from Keefe Disability Law, we will:
- Review your genetic test results and medical documentation
- Gather supporting evidence from treating physicians
- Ensure proper medical listing criteria are addressed
- File appeals if initially denied benefits
- Guide you through the entire SSDI application process
- Prepare you for disability hearings
- Advocate for your rights throughout the process
The Role of Medical Experts
Our Social Security disability law firm works closely with medical experts who provide crucial support for genetic condition disability claims. These specialists interpret complex genetic test results and explain how specific genetic variations affect a person's ability to function. They can document the progression of genetic conditions and provide detailed opinions about work-related limitations.
When necessary, these experts testify at disability hearings, offering professional insights about the severity and impact of genetic disorders. Their expertise helps establish the connection between genetic test results and functional limitations that affect employment.
Let Us Help With Your Disability Claim Today
Living with a genetic disorder is challenging enough without having to worry about getting approved for disability benefits. The caring legal team at Keefe Disability Law understands the interplay between genetic conditions and SSDI requirements. We've helped many Massachusetts residents secure the benefits they deserve.
