Cerebral palsy is an umbrella term for describing a group of chronic disorders that impair a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of the brain. Cerebral palsy affects two to six infants out of every 1,000 births, and is the most common disability among children in the U.S. The problem causing cerebral palsy may occur while the infant is still in the womb or after birth, and the problem is not always detectable during a child’s first year of life. Children with mild cerebral palsy may only have a minor limp or an uncoordinated walk, while patients with severe cases will require care and supervision throughout their lives. Many of the infants born with cerebral palsy also experience some degree of mental retardation and/or have seizures.
Patients with cerebral palsy can have a variety of symptoms. These symptoms usually do not worsen over time and include:
- Difficulty with fine motor skills, such as writing and using scissors
- Involuntary muscle movements
- Difficulty maintaining balance and walking
- Learning problems
- Vision defects, such as crossed eyes
- Speech difficulty
- Sucking and swallowing problems
Cerebral palsy may affect one arm or leg, an arm and leg on the same side, only the legs, all four limbs, or any combination of arms and legs. Whatever the affected areas may be, the muscle types involved are often the same. Muscles that enable people to bend their arms and legs are called flexor muscles. Extensor muscles are the opposite of flexors and enable a person to straighten these limbs back out. It is the inability to control these and other muscles that defines the most common cerebral palsy syndromes.
Social Security reviews Cerebral Palsy claims under a special definition of disability called a listing. The listing number for Cerebral Palsy is 11.07. To qualify as disabled under this listing, you must meet the following four requirements: An IQ of 70 or less, abnormal behavior patterns, such as destructiveness or emotional instability, significant interference in communication due to speech, hearing, or visual defect; OR significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station.
The requirements for children are slightly more complicated. The first way to meet the listing is if the child has motor dysfunction, including one of the following two:
1. Persistent disorganization or deficit of motor function for age involving two extremities, which (despite prescribed therapy) interferes with age-appropriate major daily activities and results in disruption of:
a. Fine and gross movements; or
b. Gait and station.
Major dysfunction of a joint characterized by gross anatomical deformityand chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint ,with:
a. Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively; OR
b. Involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively.
Another way that a child can meet the listing is if he or she has less severe motor dysfunction (but more than slight), AND urinary or fecal incontinence when inappropriate for age; OR an IQ of 70 or less. A third way to meet the listing is if the disorder affects all four extremity. Lastly, a child can meet the listing if there is hydrocephalus (an abnormal accumulation of cerebrospinal fluid in the cavities, of the brain) producing interference with mental or motor developmental progression.
To effectively argue disability based on cerebral palsy at a hearing, the claimant must raise the issue of Listing 11.07 (111.07 for children) and provide medical evidence showing the diagnosis of Cerebral Palsy and why it prevents the claimant from engaging in full time work.