Is Acoustic Neuroma A Disability?

dAcoustic neuroma also known as vestibular schwannoma is a rare benign slowly growing tumor of the vestibular branch of the eighth cranial nerve (vestibulocochlear nerve) that arises from the Schwann cells of the peripheral nerve sheath. The vestibulocochlear nerve runs from the inner ear to the brain and is responsible for hearing and balance of the body. Acoustic neuroma is mostly seen in 1 out of every 100,000 individuals aged between 30-60 years. The incidence of acoustic neuroma is rising with approximately 2500 new cases diagnosed per year. It is also more common in women than in men. Although the cause of acoustic neuroma is yet unknown, prior exposure to ionizing radiation is a potential risk factor along with exposure to prolonged loud noises. It is also associated with a genetic disorder, type 2 neurofibromatosis.⁽¹⁾

Acoustic neuroma patients may qualify for disability benefits. Although the Social Security Administration does not specifically list acoustic neuroma in its Blue Book, it mentions ‘disturbance of labyrinthine-vestibular function’ under Section 2.07 of the Blue Book. As per the criteria of Section 2.07, if a person qualifies after the provision of evidence by a medical practitioner, then he can qualify for Social Security Disability benefits. The Section 2.07 criteria that need to be met include a disturbance of the labyrinthine-vestibular function that is characterized by a history of frequent balance disturbance, tinnitus, and progressive hearing loss; disturbed function of the vestibular labyrinth that is evidenced by caloric or other vestibular tests; and the hearing loss is detected by audiometry.⁽²⁾

If the above mentioned Blue Book criteria cannot be met by a person then that person needs to prove that their condition prevents them from performing any type of gainful activity by using SSA’s Residual Functional Capacity form. Based on a vocational allowance, the application may be accepted if it is proved a person is unable to perform their work activities. Extensive medical evidence will have to be provided that a person will be unable to carry out their work for a period of 12 months. Since the process of social security disability claim can be very complex, it is best to have an attorney who helps in the entire process of filing the application and helping in claiming the disability benefits.⁽²⁾

Presenting Symptoms Of Acoustic Neuroma

Acoustic neuroma may be asymptomatic in a few patients, especially those with the smaller size of the tumor. However, even smaller tumors can present with symptoms depending on the location of the tumor along the nerve. The symptoms of acoustic neuroma may occur due to compression of the vestibulocochlear nerve and its disability to transmit nerve signals to the brain or compression of the adjoining structures such as the nerves or the brainstem.⁽¹⁾

The most common presenting symptom that is present in approximately 90% of all patients is unilateral hearing loss, except in type 2 neurofibromatosis patients in whom the hearing loss is bilateral. The hearing loss is mostly progressive; however, in some cases, it may even be sudden or fluctuant. The second most common presenting symptom is tinnitus (ringing in ears) or a feeling of fullness of the affected ear. In some patients, speech discrimination may also be reduced. Acoustic neuroma may also be associated with dizziness and balancing problems such as unsteadiness. Other rare symptoms include facial numbness, tingling, weakness, paralysis, and difficulty swallowing when other cranial nerves are compressed. Acoustic neuroma may also lead to hydrocephalus that may cause headache, ataxia (inability to coordinate voluntary movements) and mental confusion. On very rare occasions, an untreated large acoustic neuroma may lead to life-threatening complications.⁽¹⁾

The diagnosis of acoustic neuroma is based on clinical evaluation, patient history, specialized tests including hearing tests, contrast-enhanced MRI, CT scan, electronystagmography and brainstem auditory evoked response (BAER). However, contrast-enhanced MRI is the most sensitive method for the confirmatory diagnosis of acoustic neuroma.⁽¹⁾

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Is Acoustic Neuroma A Disability?