Is Hashimoto's Disease A Disability?

Many people have Hashimoto's disease, an autoimmune condition that affects the thyroid gland. Because your thyroid gland regulates so many of your body’s functions, an underactive thyroid results in a variety of symptoms, some of which can be debilitating.

So, if you have Hashimoto's disease, can you get disability benefits?

What is Hashimoto's disease?

Hashimoto's thyroiditis is an incurable (but eminently treatable) autoimmune disease in which your immune system attacks cells within your thyroid gland. This results in progressive damage to the gland that eventually leads to it producing too little thyroid hormone (hypothyroidism).

Hashimoto's disease is diagnosed based on a variety of symptoms combined with blood test results. The blood tests help to make a definitive diagnosis because many of the symptoms are shared with other causes of hypothyroidism or thyroid dysfunction. 

People with Hashimoto's disease typically have to take thyroid hormone replacement therapy (levothyroxine) for life. If properly treated, patients can lead a perfectly normal life. However, some people have lingering symptoms.

Hashimoto's disease is also frequently associated with other autoimmune conditions, such as:

• Type 1 diabetes

• Celiac disease

• Rheumatoid arthritis

• Vitiligo (a disorder that causes the skin to lose pigment)

Untreated Hashimoto's thyroiditis can cause symptoms such as:

• Swelling of the face

• Joint pain

• Intolerance to cold

• Fatigue

• Depression

It can result in complications from an enlarged thyroid gland, as well as cardiovascular and neurologic abnormalities. This can make you unable to work, but appropriate treatment usually resolves the situation.

How common is Hashimoto's thyroiditis?

Hashimoto's thyroiditis affects between 1% and 2% of adults in the US and is by far the most common cause of hypothyroidism. It is more often seen in women than men.

The exact number of people who have the condition is unknown. Early diagnosis is difficult due to the lack of symptoms until the disease has progressed to clinical hypothyroidism. 

People with Hashimoto's disease may also be misdiagnosed. Because Hashimoto's thyroiditis shows so many different symptoms, it can easily be mistaken initially for:

• Chronic fatigue syndrome

• Premenstrual syndrome (PMS)

• Depression

• Anxiety

• Fibromyalgia

• A form of bipolar disorder called cyclothymia

In most cases, once a formal diagnosis is obtained and levothyroxine treatment is started, many of the symptoms improve or resolve within a few weeks.

Is Hashimoto's disease a disability?

Hashimoto's disease is not listed specifically as a disability. However, thyroid gland disorders are listed under section 9.00 Endocrine Disorders — Adult of the Social Security Act. Unfortunately, it does not give any specific criteria but refers to other impairments to determine whether a person is disabled.

The issue with claiming disability benefits for Hashimoto's disease is that most people can lead a normal life with treatment. While this is good news for people living with the condition, for the small number who find they still have symptoms after attempting to control them with medication, it can be an uphill struggle to get help. Qualifying for a disability depends on your medical records and symptoms but can also be influenced by the judge assigned to your case.

A judge is unlikely to award disability for Hashimoto's thyroiditis alone. Qualifying for a disability requires that the impairment be severe and long-lasting (at least 12 months). While uncontrolled hypothyroidism can be debilitating, controlled hypothyroidism is a treatable condition that typically does not affect someone's ability to work or live.

It generally takes far less than 12 months to get Hashimoto's thyroiditis under control. Most people taking medication for the disease only have occasional symptoms when their dosage drifts off, which can quickly be resolved with a medication adjustment.

Therefore, despite being a permanent endocrine disorder, the actual period of impairment is not life-long. Because of this, disability applications from people with Hashimoto's disease frequently do not meet the required qualifications. 

However, it is reasonable to ask your employer for accommodations to manage your condition. For example, you may need time off for doctor's appointments and blood tests. 

Can you get disability benefits for Hashimoto's disease?

In some cases, people aren't diagnosed with Hashimoto's thyroiditis until they experience significant symptoms. Some of these, such as fatigue, depression, and anxiety¹, may reverse once treatment is started. However, in rare cases, someone might develop long-term complications like damage to their heart and blood vessels, leading to heart failure.

In other words, complications from Hashimoto's disease may result in a disability that would qualify for benefits. You may also be able to get temporary benefits for the few months it takes to properly stabilize your thyroid levels. The VA will typically give a 30% rating for hypothyroidism, including Hashimoto's disease. The rating for one case was increased to 60%² because of the associated long-term depression and weight gain.

Hashimoto’s disease alongside other conditions

Also, Hashimoto's disease is frequently comorbid (existing in the same person) with a variety of other autoimmune disorders. If you have multiple autoimmune disorders, you are much more likely to be awarded benefits.

In this case, Hashimoto's thyroiditis may be included in your application, even if it is not the primary cause of your disability. It can be used as supporting evidence to demonstrate that you have more than one medical condition contributing to your inability to work.

Two common disorders that can result in disability are rheumatoid arthritis and is myasthenia gravis (an autoimmune, neuromuscular disease).

Hashimoto’s disease alone

If you only have Hashimoto's disease, you will have to demonstrate that your symptoms, despite treatment, remain severe enough to interfere with your ability to work. This is generally quite rare. In fact, you would probably be in conversation with your doctor about other possible causes.

Ultimately, getting approved for disability is not based on what condition you have but on whether and how much it interferes with your ability to work. If you have not yet been diagnosed or do not adhere to your treatment plan, Hashimoto's disease can prevent you from working and even handling daily life.

However, there are precedents for treatable conditions not being considered disabilities. A judge is likely to argue that as you can take medication to get better, there is no reason to award you disability benefits.

Thankfully, levothyroxine is an inexpensive medication, so most people with Hashimoto's disease don't end up being told they are not disabled because there is treatment available but then are unable to access or afford the medicine.

The lowdown

Hashimoto's thyroiditis, once diagnosed, is usually easy to treat and manage. Therefore, the vast majority of people with the condition do not qualify for long-term disability support.

However, it may be possible to receive a temporary disability while you get your condition under control. Also, Hashimoto's disease is often comorbid with other autoimmune diseases, some of which might be more likely to interfere with your ability to work and thus be considered disabilities by a judge.

Remember that treated Hashimoto's disease should have few, if any, manifestations. But if you continue to have debilitating symptoms, talk to your doctor about other possible diagnoses rather than apply for disability with a limited chance of approval for Hashimoto’s disease alone.

Once your physician has investigated other possible diagnoses, the full extent of your medical condition will be clarified. You can then receive treatment that will, hopefully, facilitate your return to health and a regular work schedule.