Epilepsy and filing SS Disability Claims

If you have Epilepsy you may qualify for SS Disability.
The Social Security Administration has two listings for epilepsy- Convulsive and Non-convulsive.
Call 512-454-4000 for help.

Social Security specifically recognizes epilepsy as an impairment under Section 11.02 of its Blue Book. However, epilepsy is not always disabling. In cases where it is well-controlled by medications, an applicant must prove that epilepsy limits their daily activities even though they are taking anti-seizure medications.

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Each year 150,000 Americans are diagnosed with epilepsy, the fourth most common neurological disease after migraines, stroke and Alzheimer’s.

Epilepsy is a disorder of the central nervous system in which brain activity is abnormal, causing seizures, periods of unusual behaviors and sensations, and sometimes loss of consciousness. Epilepsy affects both men and women and people of all ages, races and ethnic backgrounds.

Seizures are disruptions of the electrical communications between neurons and affect any process the brain coordinates.

Symptoms vary and can manifest in a number of different ways:

•    Loss of consciousness or awareness
•   Staring blankly into space
•   Uncontrollable movement of arms and legs
•   Temporary confusion
•   Feelings of fear, anxiety or déjà vu

A single seizure does not mean a person has epilepsy; an individual must experience at least two unprovoked seizures to confirm epilepsy.

Seizures are classified according to what part of the brain the seizure originates from and what symptoms they cause such as whether or not loss of consciousness or awareness occurs.

Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from Epilepsy. If you have been denied disability don’t give up!

There are two main types of seizures: focal and generalized.

A focal seizure, also known as a partial seizure, begins in one particular area of the brain. This type of seizure can cause physical and emotional effects, changing how things look, smell, feel, taste or sound. Focal seizures can also cause involuntary jerking or twitching and symptoms which may be confused with mental illness. Complex focal seizures (or complex partial seizures) may cause an individual to lose consciousness but still look like they are awake. These seizures begin in the part of the brain controlling emotions and memory; the person may stare into space, gag, laugh or cry.

Generalized seizures involve all areas of the brain. They can cause muscle spasms, loss of consciousness and falls. There are six types of generalized seizures.

•    Tonic-clonic or grand mal seizures are the most noticeable seizures. They cause an abrupt loss of consciousness and the body stiffens and shakes.
•   Absence or petit mal seizures. During these seizures the affected person stares blankly into space and does not respond to others. Since absence seizures last only a few seconds, the person may not remember having one.
•   Tonic seizures cause muscles in the arms, legs, and trunk to stiffen and the affected person may fall. These seizures often occur while the person is sleeping and last less than 20 seconds.
•   Clonic seizures. These seizures result in repeated, rhythmic muscle spasms that last several minutes.
•   Atonic seizures cause a loss of muscle control. A person may drop something they are holding or fall.
•   Myoclonic seizures cause sudden, brief jerks, as if a person has been shocked. Some individuals have both myoclonic and atonic seizures.

For many people there is no identifiable cause of epilepsy; however, most cases involve injury to the brain.

The main factors contributing to epilepsy include:

•    Infections such as meningitis and viral encephalitis
•   Genetic influences
•   Brain tumors or strokes
•   Head injury
•   Prenatal injury
•   Developmental disorders such as autism

Seizures affect an individual’s safety, relationships and work life.

Even mild seizures can be dangerous if they occur at certain times, like when a person is driving. Additionally, symptoms that precede a seizure, such as fatigue or aphasia (loss of ability to understand or express speech), can prevent a person from maintaining employment.

Social Security specifically recognizes epilepsy as an impairment under Section 11.02 of its Blue Book.

However, epilepsy is not always disabling. In cases where it is well-controlled by medications, an applicant must prove that epilepsy limits their daily activities even though they are taking anti-seizure medications. A claimant must also show that drug or alcohol use is not contributing to their condition or inhibiting a medication’s effectiveness.

When a Social Security claims examiner reviews a claim for disability they will look for:

•    A detailed report from at least one medical provider describing the applicant’s seizures
•   A diagnosis of epilepsy
•   Description of typical seizure and pre-seizure and post-seizure symptoms
•   Physicians’ statements of types and frequency of seizures
•   History of applicant’s medications, treatments and responses to treatments
•   EEG results (Social Security does not require an applicant with epilepsy to submit an EEG report; however, the EEG results will be evaluated and it is an important part of an applicant’s medical evidence)

Eligibility for Social Security disability benefits depends on the type and frequency of seizures.

It is important to note that Social Security describes seizures that qualify as disabling a little differently than common medical sources:

In adults, the most common potentially disabling seizure types are generalized tonic-clonic seizures and dyscognitive seizures (formerly complex partial seizures).
a. Generalized tonic-clonic seizures are characterized by loss of consciousness accompanied by a tonic phase (sudden muscle tensing causing the person to lose postural control) followed by a clonic phase (rapid cycles of muscle contraction and relaxation, also called convulsions). Tongue biting and incontinence may occur during generalized tonic-clonic seizures, and injuries may result from falling.

Dyscognitive seizures are characterized by alteration of consciousness without convulsions or loss of muscle control.

During the seizure, blank staring, change of facial expression, and automatisms (such as lip smacking, chewing or swallowing, or repetitive simple actions, such as gestures or verbal utterances) may occur. During its course, a dyscognitive seizure may progress into a generalized tonic-clonic seizure.

In order to meet the Social Security’s listing criteria an applicant must be able to show they suffer from the following, even while following treatment:

•    generalized tonic-clonic or grand mal seizures occurring at least once a month for three consecutive months;

OR

•   dyscognitive seizures occurring at least once a week for three consecutive months;

OR

•   generalized tonic-clonic seizures occurring at least once every 2 months for at least 4 consecutive months AND a marked limitation in one of the following:
1.    physical functioning
2.   understanding, remembering, applying information
3.   interacting with others
4.   concentrating, persisting, maintaining pace
5.   adapting and managing oneself in a workplace setting

OR

•   dyscognitive seizures occurring at least once every 2 weeks for at least 3 consecutive months AND a marked limitation in one of the following:
1.   physical functioning
2.    understanding, remembering, applying information
3.   interacting with others
4.   concentrating, persisting, maintaining pace
5.   adapting and managing oneself in a workplace setting

If you have epilepsy, yet your disability does not match Social Security’s listing, you may still be eligible for Social Security Disability benefits if you have another impairment; for example, arthritis.

Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical vocational assessment), taking into account whether or not you are able to drive, your age, and level of education. If you can show that you cannot do any work on a full-time basis, you may be approved for a medical vocational allowance.

If you have epilepsy and it has prevented you from working, you may be eligible for Social Security Disability Income.

An experienced Social Security Disability attorney can review your case and help you file your claim, saving valuable time and improving your chances of approval.

In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

1.   Are you working?   Your disability must be “total”.
2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.

More details can be found on our Qualifying for Disability page.