Myasthenia gravis (MG) is a chronic, autoimmune neuromuscular disease that causes fluctuating weakness in the voluntary muscles of the body. This condition results from the body’s immune system mistakenly attacking the communication channels between nerves and muscles. Due to the unpredictable and often severe impact on a person’s ability to perform daily functions, myasthenia gravis is generally recognized as a potentially disabling condition, depending entirely on the severity of the individual’s symptoms and their functional limitations.
Functional Limitations of Myasthenia Gravis
The defining feature of MG is fatigable muscle weakness, meaning muscle strength declines with sustained activity and improves after periods of rest. This fluctuating weakness directly interferes with major life activities, forming the medical basis for a disability classification. Initial symptoms frequently manifest in the muscles controlling the eyes, leading to drooping eyelids (ptosis) and double vision (diplopia).
The condition often progresses to affect the bulbar muscles of the face and throat. Weakness in these muscles causes difficulty with speech (dysarthria) and problems chewing and swallowing (dysphagia). Swallowing difficulties can be particularly dangerous, raising the risk of aspiration and subsequent pneumonia.
Generalized MG can weaken the limb and neck muscles, making tasks like walking, climbing stairs, or lifting objects difficult or impossible. In the most severe cases, a myasthenic crisis can occur, involving respiratory muscle weakness that necessitates mechanical ventilation.
Formal Classification by Government Agencies
The Social Security Administration (SSA) formally recognizes myasthenia gravis as a potentially disabling condition within its medical guidelines. The condition is specifically listed in the SSA’s “Blue Book” under Section 11.12 for Neurological Disorders. A diagnosis of MG alone is not enough to automatically qualify for financial benefits; the individual must meet specific severity requirements outlined in the listing.
The listing provides criteria focusing on extreme functional limitations despite ongoing prescribed treatment. One way is to demonstrate a disorganization of motor function in two extremities (arms and legs). This must result in an extreme limitation in the ability to stand up from a seated position, balance while walking, or use the upper limbs.
Another path involves bulbar and neuromuscular dysfunction severe enough to have required mechanical ventilation due to a myasthenic crisis. Alternatively, the need for supplemental nutrition via a gastrostomy or central venous catheter can qualify. These criteria require comprehensive medical evidence to prove the level of severity and persistence of the functional limitations.
Protections Beyond Financial Benefits
Individuals with myasthenia gravis have legal protections that extend beyond financial assistance, primarily through the Americans with Disabilities Act (ADA). The ADA prohibits discrimination against qualified individuals with disabilities in employment, public services, and accommodations. MG is considered a disability under the ADA if it substantially limits one or more major life activities, such as walking, seeing, speaking, or working.
The law mandates that employers with 15 or more employees must provide “reasonable accommodations” to enable an employee with MG to perform the essential functions of their job, unless doing so would cause an undue hardship. Common accommodations are designed to mitigate the effects of muscle weakness and fatigue. These may include:
- Flexible scheduling, allowing for more frequent rest breaks.
- Providing a closer parking space.
- Adjusting the work environment for temperature control, as heat can worsen symptoms.
- Adjustments for vision issues, such as screen filters or reassigning tasks that require prolonged visual focus.
Securing Disability Benefits
The process of securing financial disability benefits, such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), is centered on proving the severity of the functional limitation. The application must demonstrate that the condition prevents the individual from engaging in Substantial Gainful Activity (SGA), which is the ability to earn above a certain income threshold set by the SSA. Since MG symptoms fluctuate, applicants must provide comprehensive medical documentation that clearly illustrates the long-term, disabling nature of the condition.
The SSA requires objective medical evidence, including detailed reports from neurologists, results from diagnostic tests like electromyography and nerve conduction studies, and a complete history of treatment. It is important to document how the symptoms affect the ability to perform work-related activities, such as lifting, walking, and sitting, over a sustained period. Insufficient medical evidence connecting the diagnosis to the inability to maintain a full-time work schedule is a common reason for initial denial.
The disability application process typically involves several stages, beginning with the initial application, followed by a request for reconsideration if denied. Many applicants must eventually proceed to a hearing before an Administrative Law Judge (ALJ). Medical records must establish that the condition has lasted or is expected to last for at least 12 continuous months, or result in death.