Will I be Entitled to Social Security Disability Benefits with Epilepsy?
Epilepsy is a brain disorder that happens when certain nerve cells in your brain misfire, which can cause seizures. There are different types of epilepsy. All types of epilepsy have seizures in common.
There are two types of seizures. Focal seizures, which start in a particular part of your brain, can cause both physical and emotional effects. 60% of people with epilepsy have this type of seizure, which is sometimes called a partial seizure. The second type are generalized seizures, which happen when nerve cells on both sides of your brain misfire and can make you have muscle spasms, blackout or fall.
Sometimes people have seizures that start out as one kind and then become the other. The most noticeable kind of seizures are called grand mal seizures which cause your body to stiffen, jerk and shake, and you lose consciousness. They usually last one to three minutes. Most common treatments are medications called anti-seizure or anticonvulsant medications that change the way your brain cells work and send messages to each other.
Epilepsy and Social Security Disability
If you suffer from epilepsy, you may be entitled to Social Security Disability Benefits, depending on whether you meet the definition of “disability” under the Social Security Administration’s (“SSA”) rules and regulations. There is a five step process or analysis that the SSA uses to evaluate each claim and determine if you are disabled. In general, to meet the definition of disability you must be unable to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
Social Security Administration’s 5 Step Analyses
- In the first step, SSA looks at whether or not you are working. If you are working, you must not be engaging in substantial gainful activity. In the year 2020, substantial gainful activity is defined as earning over $1,260 a month. If you have no earnings or are earning under that amount, then you move on to step two.
- In step two of the process, you must show that your impairment or impairments are severe. To be severe, your impairment(s) must have more than a minimal impact on your ability to engage in basic work activity.
- In step three of the process, it is determined whether your condition meets the criteria of a listing. Social Security created a list of conditions referred to as the “listings”. If you meet the criteria of a listed condition, you will be considered disabled automatically. Epilepsy is a listed condition. Thus, if you meet the criteria of listing 11.02 for epilepsy, then you will be automatically considered disabled at step three.
There are many variations to meeting the criteria. Although there are various types of seizures, SSA only considers generalized tonic-clonic (grand mal) seizures or dyscognitive focal seizures to be disabling enough to meet the listing for epilepsy. Generalized tonic-clonic seizures involve loss of consciousness and violent muscle contractions. Whereas, dyscognitive seizures do not involve convulsions, but they impair awareness and consciousness. During its course, a dyscognitive seizure may turn into a generalized tonic-clonic seizure.
If you have generalized tonic-clonic seizures occurring at least once a month for at least three consecutive months despite taking prescribed treatment, then you will have met the listing. Alternatively, if you have dyscognitive seizures occurring at least once a week for at least three consecutive months despite taking prescribed treatment, you will have met the listing.
If you have generalized tonic-clonic seizures occurring at least once every two months for at least four consecutive months despite taking prescribed treatment, and a marked limitation with either: 1. physical functioning; 2. understanding, remembering or applying information; 3. interacting with others; 4. concentrating, persisting or maintaining pace; or 5. adapting or managing oneself; then you will have met the listing.
Or, if you have dyscognitive seizures occurring at least once every two weeks for at least three consecutive months despite taking prescribed treatment, and a marked limitation with either: 1. physical functioning; 2. understanding, remembering or applying information; 3. interacting with others; 4. concentrating, persisting or maintaining pace; or 5. adapting or managing oneself, then you will have met the listing.
Notably, SSA does not count seizures that occur during a period when you are not adhering to prescribed treatment without good reason. SSA will consider you to have good reason for not following prescribed treatment if, for example, the treatment is very risky due to its consequences or unusual nature; or if you are unable to afford prescribed treatment and no free community resources are available.
Also, SSA will not begin to count your seizures until after your first month of prescribed treatment. Further, multiple seizures that occur in one 24-hour period will count as one seizure. Seizures that occur one after the other without a return to consciousness will also count as one seizure.
If the criteria of listing 11.02 is not met, then you move on to step four of the evaluation process.
- At step 4 in the process, your residual functional capacity is determined. This is an evaluation of your level of disability as measured by your functional ability to engage in basic work activity considering your impairment of epilepsy and any other impairments. The first question that must be answered is whether you are able to do any of your past relevant work considering your residual functional capacity. If you are not deemed able to return to your past relevant work, then you move on to step five.
- At step 5 in the process, the last and final step, it is determined whether you can return to any other work within your residual functional capacity, considering your age, education and work experience. If there are no other jobs that you can do within your residual functional capacity, then you will be considered disabled. Notably, compliance with prescribed medications is a significant factor that is taken into account. Thus, if you experience seizures because you are not following your doctor’s orders, then this can negatively impact a determination of disability.
Applying for Social Security Disability Benefits due to Epilepsy
If you believe your epilepsy prevents you from working, applying for social security disability is likely the right choice for you. At the LaBovick Law Group, we provide free consultations where we will review the facts of your case to determine if this is the right program for you. Call us today at (561) 625-8400 for your free evaluation.