Cushing Syndrome, also known as hypercortisolism, is a disorder which results in having too much cortisol in the body. Cortisol under normal circumstances is released into the body during times of stress and increases heart rate, increases blood sugar, manages blood glucose, managing respiration, and increases muscle tension. Cortisol levels are controlled by the adrenal glands, pituitary glands, and hypothalamus. Cushing syndrome only affects 10 to 15 people per million every year and occurs most often between the ages of 20 and 50.
What are the signs and symptoms of Cushing syndrome?
One very common sign of Cushing syndrome is weight gain and fatty tissue deposits. These occur particularly around the midsection and upper back, in the face (typically referred to as “moon face”), and between the shoulders. Other common signs include pink or purple stretch marks on the abdomen, breasts, thighs, and arms; thinning skin that bruises easily; cuts and insect bites that heal slowly; and acne. Women with Cushing syndrome may experience irregular or absent menstrual periods, as well as thicker or more visible body and facial hair. Other possible signs and symptoms of Cushing syndrome include headache, frequent infections, skin darkening, newly onset or worsening high blood pressure, severe fatigue, muscle weakness, depression, anxiety, cognitive difficulties, and loss of emotional control.
What causes Cushing syndrome?
The most common cause of Cushing syndrome is from taking oral corticosteroids in high doses over time. An example of an oral corticosteroid is prednisone. Oral corticosteroids are prescribed for conditions such as asthma, lupus, and rheumatoid arthritis. Typically, this type of Cushing syndrome stops when the person no longer takes corticosteroid medication.
Less often, Cushing syndrome can occur as a result of the body producing too much ACTH, which is the hormone responsible for cortisol production. Benign tumors in the pituitary gland can produce an excessive amount of ACTH, which then results in a higher production of cortisol. In rarer instances, the adrenal glands can produce too much cortisol, known as endogenous Cushing syndrome.
How is Cushing syndrome diagnosed?
To diagnose Cushing syndrome, doctors will order urine and blood tests which measure hormone levels and determine whether the body is producing too much cortisol. The urine tests are typically collected over a 24-hour period. Additionally, doctors may order saliva tests to measure cortisol levels. One test measures cortisol levels in saliva between 11 pm and 12 am, as people with Cushing syndrome typically have high cortisol levels during this time. In another type of test, people with suspected Cushing syndrome will receive a late night dose of dexamethasone and have their cortisol levels measured the next morning. Typically, dexamethasone causes cortisol to decrease to a very low level, but this decrease in cortisol levels does not occur in people with Cushing disease. Additionally, doctors may order CT scans or MRIs of the pituitary and adrenal gland to determine whether a tumor is present which may be causing excess ACTH production.
How is Cushing syndrome treated?
If the person has a tumor in the pituitary gland causing Cushing syndrome, the tumor may be surgically removed. After the surgery, the person may need to take cortisol replacement medications until the body returns to normal adrenal hormone production. The doctor will monitor cortisol levels using blood tests to determine whether cortisol replacement is still needed and whether it can be stopped. This process can take up to a year or longer. In some individuals, normal adrenal function never returns, and lifelong cortisol replacement therapy is required.
Am I eligible for Social Security Disability benefits if I have Cushing syndrome?
Social Security Disability Insurance benefits are available for people who have worked and paid taxes on their income for at least five of the past ten years and who are unable to work due to a medical condition which lasts or is expected to last for at least one year or result in death. If symptoms and treatment related to Cushing syndrome have caused you to stop working, you may be eligible for Social Security Disability benefits.
How does Social Security evaluate my disability claim?
Social Security follows a five step process when evaluating Social Security Disability applications. First, the person cannot be performing substantial work activity after their date of disability, referred to as the Alleged Onset Date. “Substantial activity” refers to work that earns more than $1350 pre-tax per month in 2022.
Next, Social Security will confirm that you have a severe impairment. This is established through all of the medical documentation in your file, including doctor visit notes, hospital records, imaging reports such as MRIs or CT scans, lab work, and any other treatment you have received. Social Security evaluates the totality of your conditions. Therefore, if you have another condition such as lupus for which you take steroid medications which have caused Cushing disease, Social Security will evaluate both lupus and Cushing disease. If you are experiencing mental symptoms from Cushing disease such as depression or cognitive difficulties, it is important to seek mental health treatment to ensure that your mental health symptoms are properly considered in your case. Receiving a medical source statement from your treating provider is helpful as well; however, it is important that the doctor include information in the statement that specifically applies to disability.
Social Security will then determine your ability to do common work activities such as sit, stand, walk, lift and carry objects, and use your hands. Social Security will also evaluate your ability to perform mental tasks such as maintaining attention and concentration for extended periods or interacting with others. This assessment is known as your Residual Functional Capacity. Social Security will determine whether you are able to perform your previous jobs in light of your Residual Functional Capacity. If you cannot do your previous work, Social Security will evaluate whether there are other jobs you can do with your limitations. If not, you will be found disabled.
LaBovick Law Group is here to help.
Applying for Social Security Disability benefits is a daunting task, and the process is not straightforward or easy. Your best chance of success is with an experienced attorney handling your case. Give us a call at (561) 625-8400. We are ready to help you get the benefits you deserve.