L thru O

Leukemia - a disorderly, diffuse, cancer-like growth of a particular white blood cell in the hematopoietic organs, with infiltration of the liver, spleen, kidneys, skin and other tissues.
A. Acute leukemia-a disease of early life that is rapidly fatal, lasting from a few days to a few weeks.
B. Chronic leukemia-often shows remissions.
1. Chronic myelogenous leukemia-affects males more than females and is most common between the ages of 20-40. It is characterized by abnormal granular leukocytes in the blood.
2. Chronic lymphatic leukemia-more often in males between 45-60. Lymphocytes are greatly increased. The first sign is generalized enlargement of lymph nodes.
Acute leukemia may be considered under a disability for 2-1/2 years from the time of initial diagnosis. The diagnosis must be based upon definitive bone marrow findings.
Chronic leukemia may be documented by peripheral blood bone marrow, or cerebrospinal fluid pathological findings. In addition: the patient must require one or more blood transfusions on an average of once every 2 months or at least one spontaneous hemorrhage, requiring transfusion, within 5 months prior to adjudication; or documented recurrent systemic bacterial infections occurring at least 3 times in the 5 months prior to adjudication; or non-Hodgkin's lymphoma with progressive disease not controlled by prescribed therapy.

Liver Disease -
A. Chronic liver disease-any long term disease or disorder of the liver.
B. Portal system-pertaining to the portal vein which brings blood to the liver along with the hepatic artery.
C. Postnecrotic cirrhosis-usually follows hepatitis or other inflammation and is characterized by nodules of varying sizes in the liver .
D. Biliary cirrhosis-scar tissue which has developed around the bile ducts. The disease may last 1-2 years and may terminate at any time with convulsions and coma.
E. Hepatitis-injury to liver cells as a result of a viral infection or toxin.
1. Acute-onset is rapid and may last from 6-8 weeks but the patient will recover if treated.
2. Chronic-long term; noninfectious with cirrhosis developing in varying degrees.
See the entry on Cirrhosis for criteria for disability which covers all of these liver disorders.

Lordosis - curvature of the spine in the lumbar region. Lordosis is not cause for disability unless it can be documented that there is loss of function.

Lumbar Disc Disease - refers to disease of the discs ("cushions" of cartilage between vertebrae} in the lumbar region of the spine. A ruptured disc (herniated nucleus pulposus} is characterized by motor weakness, loss of reflex, loss of sensation, localized tenderness over the injured disc, pain, and the onset is usually 2-24 hours after the injury. See Herniated Nucleus Pulposus for disability criteria.

Lung Cancer (Pulmonary Neoplasm or Malignancy) - may be either:
A. Primary-arising in the lung.
B. Secondary-metastasis from other organs.
Three main tissue types of lung cancer predominate:
1. Squamous cell carcinoma-made up of flat, epithelial cells (strongly linked to cigarette smoking).
2. Adenocarcinoma-a metastasis spread through the blood stream.
3. Undifferentiated forms-oat cell carcinoma.

The treatment of choice is surgical resection when possible, then radiation or chemotherapy. Cancer of the lungs qualifies for a disability when it is unresectable; or with metastasis, or recurrent after resection; or incomplete incision; or oat cell carcinoma (fast spreading and difficult even to slow its progression, and is impossible to cure).

Lung Infection (Mycotic) - a lung infection caused by a microorganism. There is disability when there is a culture of specific organisms, x-ray evidence, evidence of the condition persisting for 3 months despite prescribed therapy; or a culture of specific organisms from sputa and current x-ray evidence of a lesion and episodes of hemoptysis occurring at least once every 2 months; or impairment of pulmonary func- tion due to extensive disease.

Lupus - a skin disease.
A. Lupus erythematosus-inflammation of the skin with scaly patches.
B. Scleroderma-a condition characterized by hardening and thickening of the skin; occasionally pigmented and stiff.
C. Disseminated lupus-lupus affecting the whole system.
Disseminated lupus erythematosus is cause for disability when it is established by a positive LE preparation or a biopsy or a positive ANA test with frequent symptoms demonstrating involvement of the renal or the cardiac or the pulmonary or the gastrointestinal or the central nervous systems.
There is a disability with scleroderma or progressive systemic sclerosis (the diffuse or generalized form) with advanced limitation of use of the hands due to sclerodactylia (affecting the fingers) or limitation in other joints; or significant visceral manifestations of digestive, cardiac, or pulmonary impairment.

Malabsorption - a disorder wherein nutrients are not absorbed by the blood from the villi of the small intestines in the volume needed for good health. In itself malabsorption is not a disability unless there is significant weight loss or some deficiency disease. Then it would be evaluated under the specific problem for disability.
Malabsorption of fats leads to a deficiency of Vitamins A, D and K which may result in tetany, muscle cramps, bone pain, pathological fractures of ribs and vertebrae, osteoporosis, hypoalbuminuria, peripheral edema, anemia or coagulation defects. Malabsorption of iron, folic acid, or Vitamin Bl2 may produce fatigue, dyspnea, weakness, low blood pressure, abdominal distention with hypeFactive bowel sounds.

Malassimilation - a disorder wherein the body cannot assimilate certain substances from the food eaten. Disability would be evaluated according to the specific resulting disorder. The range of symptoms and impairments are very similar to those listed for Malabsorption.

Malignancy of the Abdomen - cancer affecting any part of the abdomen. There is cau~e for disability when there is generalized carcinoma; or retroperitoneal cellular sarcoma not controlled by prescribed therapy; or ascites with demonstrated malignant cells.

Malignancy of the Brain or Spinal Cord - cancer. There is disability when there is metastatic carcinoma to the brain or spinal cord; or they are malignant gliomas; or there is disorganization of motor function.

Malignancy of the Esophagus or Stomach - cancer. Criteria for disability are carcinoma or sarcoma of the upper two-thirds of the esophagus; or carcinoma or sarcoma of the distal one-third of the esophagus with metastasis to the regional lymph nodes or extension to surrounding structures; or carcinoma of the stomach with metastasis to the regional lymph nodes or extension to surrounding structures; or sarcoma of the stomach not controlled by prescribed therapy; or inoperable carcinoma; or recurrence or metastasis after resection.

Malignancy of the Kidneys, Adrenal Glands, or Ureters - cancer. Criteria for disability are carcinoma that is unresectable; or with metastasis.

Malignancy of the Large Intestine (from ileocecal valve to and including anal canal) - Criteria for disability are carcinoma or sarcoma that is unresectable; or metastasis beyond the regional lymph nodes; or recurrence or metastasis after resection.

Malignancy of the Liver or Gallbladder - cancer. Criteria for disability are primary or metastatic malignant tumors of the liver, or carcinoma of the gallbladder; or carcinoma of the bile ducts, unresectable or with metastasis.

Malignancy of Lymph Nodes - cancer. There is a disability when there is Hodgkin's disease or non-Hodgkin's lymphoma with progressive disease not controlled by prescribed therapy; or metastatic carcinoma in a lymph node (except for epidermoid carcinoma in a lymph node in the neck) where the primary site is not determined after adequate search; or epidermoid carcinoma in a lymph node in the neck that is not responding to prescribed therapy.

Malignancy of the Mandible, Maxilla, Orbit or Temporal Fossa A. Mandible-the lower jawbone.
B. Maxilla-the upper jawbone.
C. Orbit-the bony cavity in the skull that holds the eyeballs.
D. Temporal fossa-the shallow depressions on the sides of the skull at the temples.
The criteria for disability are sarcoma of any type with metastasis; or carcinoma of the antrum (inner part of skull) with extension into the orbit or ethmoid or sphenoid sinus, or with regional or distant metastasis; or orbital tumors with intracranial extension; or tumors of the temporal fossa with perforation of skull and meningeal involvement; or adamantinoma with orbital or intracranial infiltration; or tumors ofRathke's pouch with infiltration of the base of the skull or metastasis.

Malignancy of Pleura or Mediastinum - cancer .
A. Pleura-the serous membrane that enfolds the lungs.
B. Mediastinum-the space between the left and right lung. There is cause for disability when there is malignant mesothelioma of the pleura; or malignant tumors, metastatic to the pleura; or malignant primary tumor of the mediastinum not controlled by prescribed therapy.

Malignancy of Prostate Gland - cancer of prostate gland. Prostate gland is defined as a gland found in males that produces a seminal fluid. It often stops functioning in the elderly. There may be cause for disability when the carcinoma is inoperable and is not controlled by prescribed therapy.

Malignancy of Salivary Glands - cancer of the salivary glands. The salivary glands are four pairs of glands that produce saliva.
A. Parotid glands-located on each side of the face below the ear which secrete ptyalin, an enzyme that begins breaking down starch while food is being chewed.
B. Submaxillary glands-in the floor of the mouth. C. Sublingual glands-in the floor of the mouth and under the tongue.
D. Buccal glands-scattered beneath the mucous membrane of the lips and cheek.
Criteria for disability is carcinoma or sarcoma with metastasis beyond the regional lymph nodes.

Malignancy of the Skeletal System (exclusive of the jaw) or Cancer of the Bone - any persistent or progressive pain involving the trunk or the extremities, especially if associated with a mass, must be considered a bone tumor until proved otherwise.
Criteria for disability is a malignant primary tumor with evidence of metastasis and not controlled by prescribed therapy; or metastatic carcinoma to bone where the primary site is not determined after adequate search.

Malignancy of the Small Intestine - cancer of the small intestine. It is most common in the ileum producing pain, obstruction, bleeding, and rapid weight loss. Most carcinoid tumors are not invasive; therefore, the prognosis is good in most cases. The criteria for disability is carcinoma, sarcoma, or carcinoid tumor with metastasis beyond the regional lymph nodes; or recurrence of carcinoma, sarcoma or carcinoid tumor after resection; or sarcoma, not controlled by prescribed therapy.

Malignancy of the Thyroid Gland - cancer of the thyroid glands. Thyroid glands are endocrine glands located in the neck which produce hormones that control growth and metabolism. The patient usually becomes aware of a mass or "lump" in the neck that is not painful or tender. Disability may exist when there is carcinoma with metastasis beyond the regional lymph nodes not controlled by prescribed therapy.

Malignant Glioma - cancer of nervous tissue.
A. Astrocytoma-tumor formed of star-shaped cells in the nervous system.
B. Glioblastoma-cancer of the central nervous system, especially the cerebellum (part of the brain).
C. Medulloblastoma-a malignant tumor of nerve tissue in bone marrow.
D. Ependymoblastoma-a cancer of the membrane lining the central canal of the spinal cord.
See Brain Tumors, Tumors of the Back, Malignancy of the Brain or Spinal Cord.

Malignant Melanoma - a malignant tumor that may arise anywhere the color pigment melanin (skin, mucous membranes, eye) is found. There are three major types, but all have one factor in common; they spread rapidly and death occurs within months.
1. Lentigo Maligna Melanoma-arises from a large freckle on the face or other sun-exposed parts in elderly people. It is a flat, tan or brown spot with darker brown or black spots scattered irregularly over the surface.
2. Superficial Spreading Melanoma-usually occurs on the legs in women and on the torso of men. This is the most common type. It appears as an enlarged, discolored, lesion with raised edges and it may have red, white, blue, or blue-black nodules.
3. Nodular Melanoma-may occur anywhere on the body and at almost any age. It is a dark, elevated area that rapidly enlarges.
The criteria for disability is that the disease is widespread after wide excision; or with metastasis to adjacent tissue or elsewhere.

Malnutrition/Weight Loss - a diagnosed primary disorder of the digestive tract that interferes with nutrition and results in weight loss. These disorders are: enterocolitis, chronic pancreatitis, postgastrointestinal resection, or esophageal stricture, stenosis or obstruction.
A disability exists when the weight corresponds to certain established values and a serum albumin of 3.0 gm per 100 cc or less; or a hematocrit of 30% or less, or serum calcium of 8.0 mg per 100 cc or less; or uncontrolled diabetes mellitus; or fat in stool of 7 gm or greater per 24 hour specimen; or persistent or recurrent ascites or edema not attributable to other causes.

Meniere's Disease - a combination of tinnitus, vertigo, and deafness. These disturbances of balance may be constant or intermittent attacks with nausea, vomiting, ataxia, and incapacitation. Prognosis is variable because remission in chronic cases varies. Surgical treatment has good results, while streptomycin therapy may cause injury to the cochlea.
There may be a disability when there is a history of frequent attacks of balance disturbance, tinnitus, and a progressive loss of hearing with disturbed function of the vestibular labyrinth demonstrated by caloric or other vestibular tests; and hearing loss established by audiometry.

Mental Retardation - IQ of 69 or less marked by severe mental and social incapacity and a dependence on others for personal needs. There is a disability when manifested by severe mental and social incapacity as evidenced by marked dependence upon others for personal needs (e.g., bathing, washing, dressing, etc.) and the inability to understand spoken words and the inability to follow simple direction and the inability to read, write, and perform simple calculations; or IQ of 59 or less; or IQ of 60-69 inclusive with a physical or other mental impairment imposing additional and significant work-related limitation of function.

Multiform Bullosum - a skin disease with multiple lesions. It may be a cause for disability if accompanied by extensive lesions that do not respond to prescribed treatment.

Multiple Sclerosis (MS) - a progressive, chronic hardening of the nervous system and a chronic thickening of the arteries. There may be a disability with disorganization of motor function (sig- nificant and persistent disorganization of motor function in 2 extremities, resulting in sustained disturbances of gross and dexterous movements, or gait and station); or visual or mental impairment.

Myasthenia Gravis - generalized muscular weakness without atrophy. The end fibers of nerve tissue fail to transform impulse into action. The disease is usually improved with cholinesterase-inhibiting drugs. The onset may be sudden or gradual. The first symptom is usually a drooping eyelid, followed by difficulty in swallowing, difficulty in moving joints, limb weakness and respiratory difficulty which is potentially life threatening. Thyroid disorders are frequently concurrent with myasthenia gravis. The criteria for disability is significant difficulty with speaking, swallowing, or breathing while on prescribed therapy; or significant motor weakness of the muscles of the extremities or repetitive activity against resistance while on prescribed therapy.

Myelofibrosis (Myeloproliferative Syndrome) - a progressive disease in which bone marrow is replaced by fibrous tissue causing anemia, hepatomegaly and splenomegaly.
There is a disability with chronic anemia (see the entry on anemia); or documented recurrent systemic bacterial infections occurring at least 3 times during the 5 months prior to adjudication; or intractable bone pain with radiologic evidence of osteosclerosis.

Myocardial Infarction (Acute) (also known as "heart attack") - injury and death of heart muscle due to an insufficient blood supply when one or more of the coronary arteries are obstructed. The patient usually complains of crushing chest pain which radiates to the upper stomach, neck, jaw, and arms. Other symptoms may be sweating, nausea, weakness, and anxiety.

With appropriate medical care the overall prognosis is good. Prognosis is dependent upon the length of time between the onset ofpain and treatment, the extent and location of myocardial damage and the development of complications. Some important complications are congestive heart failure, ventricular aneurysm and ventricular fibrillation.
Myocardial infarction (acute) is classified as ischemic heart disease by the Social Security Administration. The criteria for disability is:
A. Treadmill exercise demonstrating one of the following at an exercise level of 5 METS or less:
1. Horizontal or down-sloping ischemic depression of the ST segment to 1.0 mm or greater, clearly discernible in at least 2 consecutive complexes which are on a level baseline in any lead; or
2. Premature ventricular systoles which are multiform or bidirectional or are sequentially inscribed (3 or more); or
3. ST segment elevation to 3 mm or greater; or
4. Development of second- or third-degree heart block; or
B. In the absence of a report of an acceptable treadmill exercise test, one of the following:
1. Transmural myocardial infarction exhibiting a QS pattern or a Q wave with amplitude at least 1/3 ofR wave and with a duration of 0.04 second or more. (If these are present in leads III and a VF only, the requisite Q wave findings must be shown, by labelled tracing, to persist on deep inspiration; or
2. Resting ECG findings showing ischemic-type (original copy) depression of ST segment to more than 0.5 mm in either leads land a VL and V, or leads II and III and a VF or leads V3 through V6; or
3. Resting EKG findings showing an ischemic configuration or current of injury with ST segment elevation to 2 mm or more in either leads I and a VL and V6 or leads II and III and a VF or leads V3 through V6; or
4. Resting EKG findings showing symmetrical inversion of T waves to 5.0 mm or more in any two leads except III or a VR or V, or V2; or
5. Inversion of T waves to 1.0 mm or more in any of leads I, II, a VL, V2 to V4 and R waves greater than S wave in lead a VF; or
6. "Double" Master two-step test demonstrating one of the following:
(a) Ischemic depression ST segment to more than 0.5 mm lasting for at least 0.08 second beyond the J junction and clearly discernible in at least 2 consecutive complexes which are on a level baseline in any lead; or
(b) Development of a second- or third-degree heart block; or
7. Angiographic evidence (obtained independent of the Social Security disability evaluation) showing one of the following:
(a) 50% or more narrowing of the left main coronary artery; or
(b) 70% or more narrowing of a proximal coronary artery (excluding the left main coronary artery); or
(c) 50% or more narrowing involving a long (greater than 1 cm) segment ofa proximal coronary artery or multiple proximal coronary arteries; or
C. Resting E KG findings showing left bundle branch block as evidenced by QRS duration of 0.12 second or more in leads I, II, or III and R peak duration of 0.06 second or more in leads I, a VL, V 5 or V 6, unless there is a coronary angiogram of record which is negative; or
D. Left ventricular ejection fraction of30% or less measured at cardiac catheterization or by echocardiography.

Myocardial Ischemia and Angina Pectoris -
A. Myocardial ischemia is the condition caused by an imbalance between myocardial oxygen supply and demand.
B. Angina pectoris is the pain, fullness and heaviness caused by myocardial ischemia, brought on by exertion or excitement, and usually relieved by nitroglycerine.
For those patients with 80% obstruction in at least 2 main arteries; aortocoronary bypass surgery is indicated. Bypass surgery most often relieves all symptoms of angina. In other cases, prognosis depends upon the patient's general health. For disability criteria see the entry on Myocardial Infarction and Chest Pain of Cardiac Origin.

Myocardiopathies (Cardiomyopathies) - a disease that affects the heart muscle. It may be primary or secondary. Primary myocardiopathies are those characterized by changes in the myocardial structure and function which cannot be attributed to a specific cause. Secondary myocardiopathies are dysfunctions associated with other diseases. Disability is based upon the particular disease or condition and the degree of impairment associated with it.

Myotonic Dystrophy - a hereditary weakness of many of the major muscles of the body. There is a progression of muscle-wasting with death in the early 60's in the majority of cases. There is a disability when there is a loss of major function due to degenerative changes in association with loss of muscle mass in both hands; or both feet; or one hand and one foot; or disorganization of motor function. Cardiac arrhythmia may develop with myotonic dystrophy, and if it does, disability may be based upon that evidence as well.

Nephrotic Syndrome - a set of symptoms such as excessive excretion of protein in the urine, less albumin than is normal, and edema. The symptoms are anorexia, weakness, fatigue, edema, and sometimes hypertension.
There is a disability for nephrotic syndrome when there is anasarca, persistent for at least 3 months despite prescribed therapy with a serum albumin of 3.0 gm per 100 cc or less and a proteinuria of 3.5 gm per 24 hours or greater ; or proteinuria of 10.0 gm per 24 hours or greater.

Neurohypophyseal Insufficiency (Diabetes Insipidus) (also known as Polyuria) - an enormous urine output that is very often the result of a tumor of the pituitary gland or ahead injury or it may be a congenital, inherited condition. There are two kinds recognized:
A. Nephrogenic diabetes insipidus-an inherited recessive trait affecting males. There is polyuria and extreme thirst.
B. Vasopressin-sensitive diabetes insipidus-usually the result of a tumor of or an injury to the pituitary gland which causes the gland to discontinue its production of vasopressin (ADH) hormone that concentrates the urine.
Dehydration is a very real and dangerous complication to both kinds. Both usually respond to medical treatment except in the case of operable tumors of the pituitary. There may be a disability with a urine specific gravity of 1.005 or below, persistent for at least 3 months and recurrent dehydration.

Neurosis (Functional Non psychotic Disorders) - defects in the personality most often involving the perception of and reaction to stressful situations. The main types are:
A. Anxiety-a functional mental disturbance caused by fear.
B. Depressive neurosis-bouts of self-doubt, self-criticism, hopelessness, and lack of mental and physical energy.
C. Obsessive-compulsive-an uncontrolled desire to do something or to dwell on a thought or idea.
D. Phobia-unusual fears of situations or objects.
E. Hysteria-an attitude of indifference toward involuntary muscular movements or paralysis.
F. Hypochondria-an unusual preoccupation with imagined diseases or disorders of one's body.
These are considered under functional non psychotic disorders. For disability, the neurosis must demonstrate findings from both A and B:
A. Manifested persistence of one or more of the following clinical signs:
1. Demonstrable and persistent structural changes mediated through psychophysiological channels (e.g., duodenal ulcer); or
2. Recurrent and persistent periods of anxiety, with tension, apprehension and interference with concentration and memory; or
3. Persistent depressive affect with insomnia, loss of weight and suicidal thoughts; or
4. Persistent phobic or obsessive ruminations with inappro- priate, bizarre or disruptive behavior; or
5. Persistent, compulsive, ritualistic behavior; or
6. Persistent functional disturbance of vision, speech, hearing or use of a limb with demonstrable structural or trophic changes; or
7. Persistent, deeply ingrained, maladaptive patterns ofbe- havior manifested by either:
(a) Seclusiveness or autistic thinking; or
(b) Pathologically inappropriate suspiciousness or hostility; or
B. Resulting persistence of marked restriction of daily activ- ities and constriction of interests and deterioration in personal habits and seriously impaired ability to relate to other people.

Obesity - overweight. Obesity in itself is not a disability unless it is equal to or greater than the values specified by the Social Security Administration and one of the following: a history of pain and limitation of motion in every weight-bearing joint or spine (or physical exam) associated with x-ray evidence of arthritis in weight-bearing joints or the spine; or hypertension with diastolic blood pressure persistently in excess of 100 mm of mercury (Hg) measured with appropriate size cuff; or history of CHF manifested by past evidence of vascular congestion such as hepatomegaly, peripheral or pulmonary edema; or chronic venous insufficiency with superficial varicose veins in a lower extremity with pain on weight-bearing ana persistent edema; or respiratory disease with total forced vital capacity equal to or less than 2.0 Lor a level of hypoxemia at rest equal to or less than values specified by the Social Security Administration.

Obsessive-Compulsive - involves an uncontrolled desire to do something or to dwell on an idea or thought. For disability criteria, see Neurosis.

Optic Atrophy - damage to the optic nerve resulting from different causes.
1. Primary-no evidence of previous inflammation, edema, a reduced number of living optic nerve fibers, and reduced blood supply to the optic disc.
2. Secondary-disc margins are blurred and glial overgrowth are observed.
There is decreased central or peripheral vision, as this is an end stage and the damage is permanent. There is a disability for impairment of central visual acuity when remaining vision in the better eye after best correction is 20/200 or less; or contraction of peripheral visual field in the better eye to 10¡ or less from the point of fixation; or so the widest diameter subtends an angle no greater than 20¡; or to 20% or less visual field efficiency.

Osteitis Fibrosa - a disease in which fibrous tissue replaces bony tissue. This is usually associated with a disorder of the parathyroid in which calcium is extracted from the bones and is deposited in the kidneys causing them to harden (hyperparathyroidism). See Hyperparathyroidism.

Osteomyelitis - an infection of the bone or bone marrow most frequently caused by Staphylococcus aureus. The prognosis is excellent if treatment is begun in time. There may be cause for disability if it persists with at least 2 episodes within a 5-month period and x-ray shows that it exists in the pelvis, vertebrae, femur, tibia, or a major joint of an upper or lower extremity. There also should be laboratory findings of leukocytosis and an elevated sedimentation rate.

Osteoporosis - softening of bones due to calcium phosphate being withdrawn. This is particularly significant among menopausal and postmenopausal women. There is a disability if generalized osteoporosis is established by x-ray, manifested by pain and limitation of back motion and paravertebral muscle spasms with x-ray evidence of either compression fractures of vertebrae; or other disorders (e.g., herniated nucleus pulposus or spinal stenosis) and with pain, muscle spasm, significant limitation of motion in the spine; weakness and sensory and reflex loss persisting for at least 3 months and expected to last 12 months in spite of pre- scribed therapy.

Osteosclerosis - a progressive disease wherein the bones become harder and heavier. Other names are Albers-Schonberg disease, marble bones, osteitis, osteopetrosis, osteopoikilosis, and Paget's disease. This disease develops slowly and usually without symptoms. It is discovered when x-rays or an elevated alkaline phosphatase (blood test) is done for some other purpose. The most commonly affected bones are, in order, the pelvis, femur, skull, tibia, vertebrae, clavicle (collar bone), and humerus (upper arm).
The course of the disease is slowly progressive causing deformity, joint immobility and spinal compression. A disability would be evaluated by the criteria for the impairment of the body system most affected.

Otosclerosis - a hereditary disease of the bones of the middle ear. It is more common in females. Surgical repair restores some degree of hearing. A late postoperative complication is perilymph fistula (sudden decrease in hearing) and should be treated as an emergency.
A disability may exist when hearing impairment is properly documented and hearing is not restorable by a hearing aid and manifested by: average hearing threshold sensitivity for air conduction of 90 decibels or greater, and for bone conduction to corresponding maximal levels, in the better ear, determined by the simple average of hearing threshold levels at 500, 1000 and 200 hz.; or speech discrimination scores of 40% or less in the better ear .

Ovarian Tumors - 30-40% of ovarian tumors are malignant and are rarely detected until late in the course of the disease. Treatment depends on the pathological diagnosis and the degree of invasion into the surrounding tissue. For malignant tumors, surgery, radiation therapy and/ or chemotherapy are the advised treatment. When the tumors are benign, the prognosis is excellent; but malignant tumors of the ovary have a poor prognosis. They are the fourth leading cause of death in American females. There is no disability unless it is malignant, and inoperable; or recurrent and with metastasis.