PARKINSON’S DISEASE

Definition

Parkinson’s disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.
Alternative Names
Paralysis agitans; Shaking palsy

Causes

Parkinson’s disease was first described in England in 1817 by Dr. James Parkinson. The disease affects approximately 2 of every 1,000 people and most often develops after age 50. It is one of the most common neurologic disorders of the elderly. Sometimes Parkinson’s disease occurs in younger adults, but is rarely seen in children. It affects both men and women.
In some cases, Parkinson’s disease occurs within families, especially when it affects young people. Most of the cases that occur at an older age have no known cause.
Parkinson’s disease occurs when the nerve cells in the part of the brain that controls muscle movement are gradually destroyed. The damage gets worse with time. The exact reason that the cells of the brain waste away is unknown. The disorder may affect one or both sides of the body, with varying degrees of loss of function.
Nerve cells use a brain chemical called dopamine to help send signals back and forth. Damage in the area of the brain that controls muscle movement causes a decrease in dopamine production. Too little dopamine disturbs the balance between nerve-signalling substances (transmitters). Without dopamine, the nerve cells cannot properly send messages. This results in the loss of muscle function.

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Parkinson’s Disease and Social Security Disability Insurance (SSDI)

Here is an explanation of Social Security’s five-step process to determine if a Parkinson’s disease patient qualifies for Social Security Disability Insurance:STEP ONE simply determines if an individual is “working (engaging in substantial gainful activity)” according to the SSA definition. Earning more than $940 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

STEP TWO implies that the Parkinson’s disease disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

• walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
• seeing, hearing and speaking
• understanding/carrying out and remembering simple instructions use of judgment
• responding appropriately to supervision, co-workers and usual work situations
• dealing with changes in a routine work setting

STEP THREE lists Parkinsonian syndrome under the category of impairments known as neurological. If the following criteria are met, an individual is found to be disabled under the Social Security Act as meeting a medical listing: Significant rigidity, bradykinesia, or tremor in two extremities, which, singly or in combination, result in disturbance of gross and dexterous movements, or gait and station. An individual who has the preceding clinical findings and has a diagnosis of Parkinson’s will be found to meet medical listing 11.06. An individual who has similar findings with a diagnosis of Parkinson’s may be found to “medically equate” the aforementioned medical listing.

STEP FOUR explores the ability of an individual to perform work they have done in the past despite their Parkinson’s disease. If SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

STEP FIVE looks at age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine Parkinson’s disease disability, SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of Parkinson’s disease, unable to perform what SSA calls sedentary work, then SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to his disability, limited to performing sedentary work but has no work-related skills that allow him to do so, SSA will reach a determination of disabled.

Age 55 or older and, due to his disability, limited to performing light work but has no work-related skills that allow him to do so, SSA will reach a determination of disabled.

Over age 60 and, due to his disability, unable to perform any of the jobs he performed in the last 15 years, SSA will likely reach a determination of disabled.

Any age and, because of Parkinson’s disease, has a psychological impairment that prevents even simple, unskilled work, SSA will reach a determination of disabled.

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OTHER PROBLEMS OF PARKINSON’S

Some people with Parkinson’s disease become severely depressed. This may be due to loss of dopamine in certain brain areas involved with pleasure and mood. Lack of dopamine can also affect motivation and the ability to make voluntary movements.
Early loss of mental capacities is uncommon. However, persons with severe Parkinson‘s may have overall mental deterioration (including dementia and hallucinations). Dementia can also be a side effect of some of the medications used to treat the disorder.
Parkinson’s in children appears to occur when nerves are not as sensitive to dopamine, rather than damage to the area of brain that produces dopamine. Parkinson’s in children is rare.
The term “parkinsonism” refers to any condition that involves a combination of the types of changes in movement seen in Parkinson’s disease. Parkinsonism may be caused by other disorders (such as secondary parkinsonism) or certain medications used to treat schizophrenia.

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