The term “brain injury” may make you think of a person who has been permanently physically and cognitively disabled by a severe closed head injury. That image accurately portrays some, but not all, brain injury victims. The extent of the injury depends on the part of the brain that was damaged and how bad the damage was. Some brain injury victims will recover within a few months while others will never fully recover. Some brain injury victims will be able to go back to work while others will never work again.
Social Security Disability May Help Those Who Are Seriously Hurt and Can’t Work
The Social Security Administration’s Listing of Impairments (Blue Book) does not include traumatic brain injury (TBI) as an acceptable impairment in and of itself. Instead, the SSA determines disability based on the specific conditions experienced by the applicant, as described in Section 11.18: Cerebral trauma. Unlike other listings, Section 11.18 does not describe the specific eligibility criteria for someone with a traumatic brain injury, but, instead, states that disability is to be evaluated under the following sections:
- Section 11.02: Convulsive epilepsy. Typically, in order to qualify pursuant to this listing you must have convulsive epilepsy documented by a detailed description of a typical seizure pattern that occurs more frequently than once a month in spite of at least three months of treatment and you must have either: (a) daytime episodes; or (b) nighttime episodes with residuals that significantly interfere with your daytime activities. Other specific requirements must also be met.
- Section 11.03: Non-convulsive epilepsy. Generally, in order to qualify pursuant to this listing you must have episodes documented by a detailed description of a typical seizure pattern that occurs more frequently than once a week in spite of at least three months of treatment. Other specific requirements must also be met.
- Section 11.04: Central nervous system vascular accident. More than three months after the accident you must still be experiencing either: (a) sensory or motor aphasia that results in ineffective speech or communication; or (b) significant and persistent disorganization of motor function in two extremities that results in a sustained disturbance of gross and dexterous movement or gait and station.
- Section 12.02: Organic mental disorders. This listing covers psychological and behavioral abnormalities associated with a dysfunction in the brain. Very specific requirements must be met and accompanying documentation must be provided.
If your TBI meets the eligibility criteria of one of these listings, then your Social Security disability application should be automatically approved.
What to Do if You Think You Qualify
The SSI Blue Book is confusing to say the least. All you know for sure is that you are unable to work due to the TBI you suffered in an accident. You may be confident that you meet the eligibility requirements as described above and you may think your application for benefits is undeniable. However, your confidence is not enough. You need an experienced disability attorney to ensure that you complete the application accurately. We encourage you to learn more about the application process by watching our free videos and by browsing our online resources. If you still have questions, give us a call. We’re here to help!
by Paul B. Burkhalter Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.