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Some physical conditions do not outwardly manifest themselves. So while you may not “look disabled” or be suffering from obvious pain, you may be suffering from symptoms that would prevent you from returning to your past work at step 4 or holding any full-time job at step 5 of the sequential evaluation (see #7 of What can I expect to happen at my hearing?). Vertigo is an excellent example where disability case can be proven at step 5. 

Vertigo is a symptom, caused by a variety of underlying medical conditions. Commonly, vertigo results from a disorder of the inner ear (vestibular labyrinth), caused by inflammation or viral infection. Meniere’s disease is an example of an inner ear problem that can produce vertigo. In other cases, vertigo may result from problems within the brain, including tumors. For this reason, it is important to consult with a medical provider to determine what medically determinable impairment may be causing your symptoms. 

Vertigo is the sensation that either you or your environment is moving (and often spinning). Vertigo may also be associated with: difficulty walking (balance disturbance); abnormal eye movement; impaired concentration; sweating; nausea; vomiting; hearing loss or ringing in the ears. Symptoms may be aggravated by: change of position (i.e. sitting to standing, or stooping); certain head movements; and visual stimuli. 

Symptoms may come on without warning; last minutes to hours; and be episodic or constant. Often, individuals will need to rest or lie down to relieve symptoms. Serious symptoms are highly disruptive to even simple daily activities of living. 

In determining whether you can return to your past work at step 4 or other work at step 5, Social Security must determine your residual functional capacity (RFC). According to Social Security Ruling 96-8p,  RFC is the individual's maximum remaining ability to do sustained work activities in an ordinary work setting on a regular and continuing basis. A "regular and continuing basis" means 8 hours a day, for 5 days a week, or an equivalent work schedule.

If vertigo is affecting you on a regular basis, it’s likely to seriously or markedly interfere with your ability to compete a normal workday and workweek without interruption. If the judge determines that an individual is unable to compete a normal workday and workweek without interruption, a finding of disability should follow at step 5 of the sequential evaluation. Sometimes it can be helpful to track the frequency and severity of your vertigo attacks by keeping a journal.

By talking and meeting with our clients well before the hearing, we are able to determine not only what medical records are needed to prove your underlying impairment, but also request a vertigo-based medical source statement from your doctor in order to develop a winning theory for your case.