Erb’s palsy results from an injury to the brachial plexus, a network of nerves in the neck that controls movement and sensation in the shoulder, arm, and hand. Whether the condition is considered a disability depends entirely on the degree of functional impairment that persists after treatment. A diagnosis of Erb’s palsy does not automatically confer disability status; classification relies on the measurable, long-term impact on daily life activities.
Understanding Erb’s Palsy
The brachial plexus is composed of five nerve roots (C5 through T1) that supply the entire upper limb. Erb’s palsy typically involves damage to the upper nerves, C5 and C6, often occurring during a difficult delivery when the baby’s neck is stretched. This injury causes characteristic weakness or paralysis in the shoulder and elbow muscles, resulting in the “waiter’s tip” hand position.
The spectrum of injury severity dictates the long-term prognosis. The mildest form, neuropraxia, involves a temporary stretching that usually resolves spontaneously within three months. More serious injuries include a neuroma, where scar tissue partially blocks the nerve signal, or a complete tear (rupture). The most severe cases involve avulsion, where the nerve root tears directly from the spinal cord, resulting in permanent loss of function.
Rupture or avulsion leads to muscle atrophy, limited range of motion, and impaired bone growth due to the lack of nerve input. While most infants recover full function, approximately 20% of cases result in a persistent functional deficit. If this residual impairment significantly restricts arm use, it is considered a permanent physical impairment that may meet formal disability criteria.
Functional Criteria for Disability Classification
Disability classification for Erb’s palsy relies not on the diagnosis itself, but on a comprehensive functional assessment quantifying the impact on a person’s life. For programs like Social Security Disability, the standard is a severe impairment that significantly restricts the ability to perform basic work activities or major life functions. This impairment must be expected to last for at least 12 continuous months, requiring measurable restriction in range of motion, strength, and dexterity.
Specialized tools objectively measure these limitations. For infants, the Active Movement Scale (AMS) assesses the active range of motion for fifteen upper extremity movements using an eight-point scale. For older children and adults, the Modified Mallet Score (MMS) grades five specific shoulder and arm movements, such as hand-to-neck, on a five-point scale. These scores translate clinical findings into a quantifiable measure of functional restriction.
A “significant limitation” is established when scores demonstrate a substantial restriction in using the affected arm compared to the general population. This often involves a severe limitation in bimanual tasks, such as lifting or carrying. Documentation must include a physician’s diagnosis alongside objective findings, like muscle strength measurements, to establish the severity and permanency of the deficit. The classification process focuses on how the impairment limits participation in daily activities, self-care, and mobility.
Navigating Support and Accommodations
Once functional limitations are documented, various support systems help individuals manage daily life and achieve educational or vocational goals. For students, assistance in school is typically provided through a formal educational plan. A Section 504 plan provides accommodations to ensure equal access to the learning environment, such as extra time for assignments or modified physical education requirements.
A child with complex needs requiring specialized instruction may qualify for an Individualized Education Program (IEP). An IEP is a detailed, legally binding document that provides services like physical therapy, occupational therapy, assistive technology, and adapted learning materials. These plans are designed to address orthopedic impairments and other symptoms resulting from conditions like Erb’s palsy.
Adults with severe, permanent functional limitations may pursue financial assistance through the Social Security Administration (SSA). The Supplemental Security Income (SSI) program provides a monthly stipend for disabled individuals who meet specific income and resource limits. The application requires extensive medical documentation proving the impairment meets the SSA’s strict definition of disability, which includes a long-term inability to engage in substantial gainful activity. Workplace accommodations, often guided by laws promoting equal opportunity, also ensure that adults with persistent functional deficits can perform their jobs effectively.