Social Security Disability for Lambert-Eaton Myasthenic Syndrome: A Case Study
We recently represented a 48-year-old client in a Social Security Disability (SSD) hearing before an Administrative Law Judge (ALJ). The client suffers from a rare and debilitating condition known as Lambert-Eaton Myasthenic Syndrome (LEMS)—an autoimmune neuromuscular disorder named after the two Mayo Clinic doctors who first studied it.
Understanding Lambert-Eaton Myasthenic Syndrome
LEMS is a rare disease with two known potential causes. In some cases, it develops as a paraneoplastic syndrome, often associated with small cell lung cancer. In others, it occurs independently of cancer, with no clear cause identified. The condition is similar in presentation to myasthenia gravis and, like it, involves the immune system mistakenly attacking the body’s own tissues.
Specifically, LEMS disrupts the communication between nerves and muscles. The body’s immune system targets the voltage-gated calcium channels at the nerve endings, impairing the release of neurotransmitters and causing muscle weakness. In cancer-related cases, doctors believe the immune system is attempting to attack malignant cells but misfires, damaging healthy tissues in the process.
A Rare Symptom in a Rare Disease
Our client presented with an especially uncommon and severe manifestation of LEMS—bilateral vision loss due to nerve dysfunction affecting the eye muscles. His condition was first identified by an ophthalmologist after he experienced sudden vision loss and swelling that left both eyelids swollen shut. Despite having intact retinas and optic nerves, his eyelids could no longer respond to neural signals, effectively leaving him legally blind.
This dramatic symptom was just one of many. He also experienced muscle weakness, instability while walking (requiring the use of a cane), difficulty lifting or standing for extended periods, and widespread fatigue—all consistent with a progressive neuromuscular disorder
A Case That Shouldn’t Have Been Denied
Despite these profound limitations, our client’s initial SSD application and request for reconsideration were both denied. This was puzzling—not only had his treating physician declared him legally blind and unable to work, but even the Social Security Administration’s own consulting physician confirmed significant functional impairments.
This man had worked as a stockbroker—a position that clearly requires visual acuity and sustained cognitive and physical stamina. The suggestion that he could return to this role, or pivot to another line of work, was completely unrealistic.
The Appeal and the ALJ’s Ruling
Once we were retained, we submitted comprehensive medical documentation, including detailed notes from the treating specialist. The record was overwhelming. After reviewing the evidence, the ALJ had no difficulty awarding benefits. But even the judge openly questioned why the case had ever reached this point—why the State Agency denied SSD when both the treating and consulting doctors had concluded the claimant was disabled.
Unfortunately, this is not uncommon. Cases involving rare diseases are often misunderstood—or overlooked—by analysts unfamiliar with their implications. That’s where experienced legal representation can make a significant difference.
Final Thoughts
This case illustrates a fundamental flaw in the system: even when the facts clearly establish disability, deserving claimants can still be denied due to bureaucratic gaps or lack of awareness. While we’re grateful that our client finally received a favorable ruling, he should never have had to fight this hard for something so clearly justified.
When dealing with rare conditions like Lambert-Eaton Myasthenic Syndrome, experience and advocacy matter. It’s our job—and our commitment—to ensure that those facing complex medical challenges receive the benefits they deserve.
