Myasthenia Gravis: a rare but potentially life-threatening chronic condition

December 7, 2021 in

Myasthenia gravis is a chronic, autoimmune, neuromuscular disease that is characterized by weakness and rapid fatigue of the muscles. Myasthenia gravis affects the voluntary muscles of the body, such as those which control the eyes, limbs, throat, and mouth. Myasthenia gravis is caused by an error in communication between nerves and muscles. Antibodies will block or destroy neurotransmitter receptors at the neuromuscular junction. As a result, the muscle is prevented from contracting. In addition, many adults with myasthenia gravis have an enlarged thymus gland. They may have clusters of immune cells in the thymus gland and can develop tumors known as thymomas. Thymomas can at times become cancerous.

Some of the most common symptoms of myasthenia gravis include visual problems like drooping eyelids and double vision, trouble swallowing, hoarseness, trouble pronouncing words, and weakness of the neck or limbs. Some symptoms first appear in the face and throat muscles. Weakness of the face and throat muscles may result in their speech sounding soft or nasal, problems with chewing and changing facial expressions. Muscle weakness worsens when the affected muscle is used more frequently. Often, the symptoms may improve with rest. When the muscles that control breathing become too weak to work, the person experiences a myasthenia crisis, which can require mechanical assistance with breathing.

Individuals with myasthenia gravis may undergo a thymectomy (removal of the thymus gland) to treat their condition. The thymus gland in many people with myasthenia gravis is often abnormal, and removal of the thymus gland can reduce symptoms. Myasthenia gravis may also be treated with medications. These medications may include anticholinesterase agents, like Mestinon. These types of medications improve neuromuscular transmission and increase muscular strength by slowing the breakdown of acetylcholine at the neuromuscular junction. These medications can cause side effects such as diarrhea, nausea, vomiting, increased urination, or abdominal cramps. Individuals with myasthenia gravis may also take immunosuppressant medications to suppress the production of abnormal antibodies. Other treatment options also include monoclonal antibodies, plasmapheresis, or IV immunoglobulin infusions.

If you have myasthenia gravis, you may have difficulty working due to your condition and may be eligible for Social Security Disability benefits. Individuals who have a medical condition that prevents them from working and has lasted or is expected to last for at least one year may be entitled to benefits.

The Social Security Administration follows a five-step process when evaluating an individual’s eligibility for benefits. First, the Social Security Administration will confirm that the claimant has not engaged in what is referred to as “substantial gainful activity” after his or her date of disability, also called the alleged onset date. The threshold for substantial gainful activity is updated on an annual basis and is currently limited to $1,310 per month in 2021. These are gross earnings – before taxes or any other deductions are applied. Once it is confirmed that the claimant has not engaged in substantial gainful activity, the Social Security Administration will confirm that the claimant has at least one severe impairment. Step 3 occurs when the Social Security Administration determines whether the claimant’s condition meets the criteria set forth under one of its listings of impairments. If the claimant does not have a condition that meets or equals a listing, the evaluator will then determine in Step 4 whether the person can perform the work that he or she used to do. If the claimant is unable to perform his or her past work, the Social Security Administration will then determine whether there is any other work that the person is able to do, in light of any limitations caused by his or her conditions.

Some persons with myasthenia gravis may meet the criteria under a “listing,” and if so, will be approved for Social Security Disability benefits, provided that they are also not engaging in substantial gainful activity after their date of the disability. In order to meet the criteria for a myasthenia gravis listing, the person must have adhered to prescribed treatment for at least three months, and have experienced one of these scenarios: disorganization of motor function in two extremities causing an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities; bulbar and neuromuscular dysfunction resulting in one myasthenia crisis requiring mechanical ventilation or need for a feeding tube or parenteral nutrition; or a marked limitation in understanding, remembering, or applying information, or interacting with others, or concentrating, persisting, or maintaining pace, or adapting or managing oneself. The standard for a “marked” limitation is very high, and most people who apply for disability benefits do not meet the threshold for a “marked” limitation. In addition, to meet the listing criteria for myasthenia gravis, you may not have earned income over the substantial gainful activity threshold after the events noted above have occurred. In other words, if you experienced a myasthenia crisis requiring mechanical ventilation, and then returned to work after you recovered, you would not meet the myasthenia gravis listing criteria.

However, even if you do not meet the criteria for a listing, you may still be eligible for benefits. Persons with myasthenia gravis often require long periods of rest so as to not fatigue their muscles and risk a myasthenia crisis. You may not be able to complete a full workday or work week due to needing extra breaks or days off. This may be especially true if you are an older individual and work in a profession that is physically demanding. Myasthenia gravis symptoms affecting the eyelids may interfere with your vision. Further, you may be experiencing side effects from the medications you are prescribed, which may result in even more time needed for breaks.

If you are suffering from myasthenia gravis and unable to work due to your condition, LaBovick Law Group is here for you. We have experience with myasthenia gravis Social Security Disability cases and can help you receive the benefits you deserve. Call us at (561) 625-8400 and our legal team would be happy to provide you with a free case evaluation.