Traumatic Brain Injury and SSA Disability Benefits

Traumatic Brain Injury and SSA Disability Insurance
By Kimberly BishopSeptember 17, 2013

This post discusses how the Social Security Administration evaluates your claim for disability if you have experienced a traumatic brain Injury (TBI). If you or someone you know has suffered a TBI and are considering filing for disability, read on for how the Social Security Administration will evaluate your claim.

SSA Disability Benefits

The Social Security Administration offers two types of benefits, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is based on the work that you have done in the last 10 years while SSI is a need based program that takes your income and resources into consideration. You must be found disabled under SSA's Five Step Evaluation before you are entitled to either benefit. Also, in order for you to be found disabled by the Social Security Administration, you have to show that your disability is going to last for at least a year OR result in death (duration requirement).

Traumatic Brain Injury

According to the CDC, there are at least 1.7 million TBIs that occur in the U.S. every year and an estimated 5.3 million Americans are living with a disability due to a traumatic brain injury. TBIs can result from a blow, bump, jolt or penetration that interrupts the normal function of the brain. This disruption can be mild or severe.  A mild TBI can still cause confusion, headaches, mood changes, fatigue, problems sleeping and depression. A moderate to severe TBI can cause severe confusion, agitation, slurred speech or weakness/numbness in toes and fingers (via the Mayo Clinic). In addition, studies have shown that major depression usually occurs after a traumatic brain injury.

Treatment for a TBI can range from rest to emergency surgery to remove the cause of the TBI. The more intrusive the injury to your brain, the longer and more complicated the recovery process will be. It is possible that with the right therapy and medications, your disability from your TBI might not last a year.

In the alternative, even with the best medical treatment, some recover from a TBI very slowly. Following your doctor's advice is important for your recovery and your disability case. If you are following your doctor's advice but still have cognitive or other symptoms that are preventing you from returning to work filing for Social Security Disability may be the right choice for you.

Also see Hydrocephalus

Traumatic Brain Injury and SSA Disability Benefits

The Social Security Administration can evaluate traumatic brain injuries in different ways: The Listings, the Medical Vocational Guidelines (a.k.a. The Grids) and the combination of your impairments.

The brain makes up the majority of the Central Nervous System (CNS) so damaging the brain can lead to various complications throughout the body.

SSA covers Traumatic Brain Injury directly at 11.18. This listing requires extreme limitations in standing from a seated position, balance while standing/walking or in using the upper extremities for at least 3 consecutive months OR marked physical limitations with mental limitations as well.

This first part of this listing (as with most listings) is difficult to meet. It essentially requires you to be unable to stand or walk or use your hands. The marked physical with mental limitations would be slightly easier to meet but is still a strict standard.

If your TBI causes seizures that prevent you from working, the SSA can use Listing 11.02 Epilepsy . Psychiatric impairments are discussed in Listing 12.02 Organic Mental Disorders. In addition you can be evaluated under Listing 11.04 Central Nervous System Vascular Accident (CVA or stroke).

The Grids may help those that are 50 years and older who have difficulty with standing, walking or using their hands to lift. In addition, if you have been diagnosed with multiple impairments, SSA may find you disabled based on the combination of your symptoms.

In the case of a severe TBI (usually caused by trauma), an individual may never fully recover their pre-trauma functioning. It is important to know that SSA will not find you disabled simply because you are different than before. They may find that there is less skilled or less physically demanding work that you may still be able to do even after your trauma. As discussed above, the severity of your symptoms is key.

Are you experiencing seizures that medication will not control? Are you three months post TBI and still experiencing speech/motor function problems? Do you have difficulties performing routine daily tasks? Has your family described you as "a totally different person" than you were before your TBI? If you answer yes to any of these questions, you may be found disabled based on your TBI.

If you are following your doctor's advice regarding your Traumatic Brain Injury but are still unable to work due to your symptoms, file a claim for disability benefits as soon as possible.  The Bishop Law Firm represents clients in Raleigh, NC and surrounding areas. Call us, (919) 615-3095 or start your free case review now!

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