If you suffer from seizures that impact your ability to work, you may be eligible to get Social Security disability. The Social Security Administration (SSA) offers Social Security Disability Insurance (SSDI) for individuals who have worked enough to earn sufficient credits and who have paid enough in Social Security taxes. If an individual is unable to work for 12 months or longer, and is considered fully disabled during that time, he or she may be eligible for SSDI.
Seizure disorders are caused by uncontrolled electrical activity in the brain. In order for an individual to have normal brain functioning, there needs to be an orderly, coordinated discharge of electrical impulses. When the electrical activity disturbances occur, the individual suffers temporary brain dysfunction. Seizures can cause uncontrollable movements, unconsciousness, or result in the individual stopping movement all together.
Those with seizure disorders are not aware of what is happening during a seizure, but some people experience unusual symptoms before having a seizure. There are some seizure disorders that are the result of birth defects or environmental hazards, but some can be caused by low blood sugar levels, low oxygen levels in the blood, abnormal heart rhythm, fever, medications, or infection. Some people have seizures that are triggered by flashing lights, repetitive sounds, or even video games.
Those who suffer from recurring seizures suffer from what is called seizure disorder. Those who suffer from seizure disorder are much more likely to experience seizures when they are sleep deprived or experiencing stress or if there are additional neurological disorders, immune system problems, or psychiatric conditions. There are some seizures that cause serious problems, impact intelligence, or cause brain damage.
The Cost of Treating Seizure Disorders
According to Web MD, the cost of treating seizure disorders is much more expensive than initially believed. If you have insurance, you will have co-pays or deductibles for doctor visits, prescription co-pays, and the costs for tests and any hospitalizations. Patients who have controlled seizure disorders can expect to spend about $2,000 per year while those with uncontrolled disorders can pay out as much as $10,000 annually.
Those who have poor control of their seizures represent about a fourth of all those who have seizure disorders, but they also account for as much as 86% of all costs. About 30% of the direct medical costs go toward the costs of anti-seizure drugs. As the population in the U.S. continues to age, the cost of treatment and diagnosis are expected to climb as well.
The SSA Evaluation and Medical Qualifications
The SSA uses a medical guide called the Blue Book to determine whether or not an individual is disabled. There is no specific listing for seizure disorders for adults in the medical guide, but the disability evaluation process focuses on any effects or limitations you experience from your seizure disorder. You will have to provide the SSA with the evidence they need to show that your seizure disorder negatively affects you and how it has limited your activities.
There are two different epilepsy impairment listings in the Blue Book for seizure disorders. These include listing 11.02, which is for convulsive epilepsy, and Listing 11.03, which is for non-convulsive epilepsy. Each listing has different qualification requirements that apply to that particular condition.
To qualify for SSDI under 11.02 you will have to show you suffer:
AND
- At least one seizure each month after having taken medication for three months
- Your seizures occur during the day and either involve loss of consciousness or convulsions OR occur at night causing symptoms that impact your daytime activities.
Listing 11.03 requires you prove:
AND
- You have at least one seizure each week in spite of having undergone taking three months of prescription medications
- Your seizures either interfere with your daily activities or they cause you have post-seizure behavior that is abnormal.
Meeting Disability Criteria with an RFC and Medical - Vocational Guidelines
If you are disabled because of your seizure disorder but don’t exactly meet the Blue Book listings, you could be eligible for SSDI using the medical-vocational guidelines. Using this approach, you are saying your seizure disorder has symptoms that interfere with your daily life and activities to an extent that no jobs are available for you to regularly perform.
While your medical conditions and symptoms are given utmost consideration, Disability Determination Services also consider your age, your educational background, any transferable work skills, any other psychiatric or medical conditions that impact your ability to work, and any restrictions that your doctor has given you.
During this approach, your physician will complete a residual functioning capacity (RFC) form in detail. He or she will clearly indicate your symptoms and your limitations. As an example, if you cannot regularly bend or lift, that must be indicated. If your seizure disorder results in you suffering from severe fatigue and loss of concentration, that should be noted along with how that impacts your work day.
If you are unable to drive because of your seizures, that also needs to be indicated in the RFC. Using this approach, you can show that you are not able to work because of the limitations you face because of your conditions. The disability process is lengthy and can be complicated, but the more documentation you can provide, the stronger your case.
Applying Specific Medical Tests to Your Case for Disability
There are several tests used to diagnose seizure disorders, including an EEG, CT scan, MRI, PET scan, and other neuropsychological tests. These tests should be included with your medical records that are supplied to the SSA when you apply for Social Security disability benefits.
The SSA may order a medical evaluation and/or mental evaluation with the physicians they choose at their expense. These evaluations are not for treatment purposes but to provide the additional information they need to help make a decision regarding your disability claim. These evaluations can confirm your symptoms and your limitations.
The disability process can take several months. Your claim may be denied twice and then you can appeal it each of those times. The final step would to be request a hearing before an administrative law judge for a ruling on your case.
