Do I Qualify For Social Security Disability Benefits If I Have Epilepsy?
The Social Security Administration (SSA) doesn’t always make it easy for those with epilepsy to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve. SSA evaluates epilepsy based on the type of epilepsy, frequency, duration and nature of the seizures. Many claims are denied because SSA says:
(1) Your epilepsy won’t prevent you from working at least 12 months,
(2) Your epilepsy isn’t severe,
(3) Your epilepsy is uncontrolled because you haven’t followed your physician’s prescribed treatment,
(4) Your epilepsy or its complications don’t meet the requirements of, or is the equivalent of, a Medical Listing,
(5) You can return to the lightest job you held in the 15 years before you became disabled, or
(6) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
Not all cases of epilepsy are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with epilepsy.
Well controlled epilepsy is not necessarily disabling; you have to prove that your epilepsy interferes with your daily activities even though you have taken your medication.
Ms. Cavey works to overcome the claims denial by working closely with you and your physician by showing that you:
- Meet the requirements for a disability listing, or
- Proving that your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.
She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
What Is Epilepsy?
Epilepsy is a brain disorder that causes seizures that occur when nerve cells or neurons in your brain send out the wrong signals. There is no known cause of epilepsy, though seizures can be triggered by brain injury, brain tumor, stroke and abuse of drugs or alcohol..
Epileptic seizures can range from brief to long periods of shaking. Seizures are controlled by medication in about 70% of cases. It is not uncommon for disability carriers to deny payment of benefits on the basis that the seizure disorder is well controlled or that the seizures don’t occur often enough to be disabling. Carriers even will ignore the cognitive complications caused by seizures.
What Are The Types of Seizures and Common Symptoms?
60% of seizures are convulsive, which include generalized, partial and non-convulsive seizures. It is not uncommon for epilepsy also to result in depression, anxiety disorder and migraines.
The common symptoms include:
- Staring spells,
- Temporary confusion,
- Uncontrolled jerking movements, and
- Loss of consciousness.
What Are The Complications Of Epilepsy?
More often than not, the complications of epilepsy can be key to winning your claim. These complications can include injuries caused during seizure, brain injury and even psychological problems.
What SSA Wants to See in Your Medical Records
SSA will review your medical records and look for the following:
- A diagnosis of epilepsy,
- Detailed description of your typical seizure, including symptoms before and after a seizure,
- Statement from your physician corroborating your account of the nature and frequency of your seizures,
- A description of your seizures from a third party,
- A record indicating the frequency of your past seizures,
- Results of an EEG,
- Detailed treatment history, including medication, and your response, and
- Evidence that you have complied with treatment, including blood work that proves at least a three-month compliance with medication.
Epilepsy and Its Complications and The Listing Of Impairments
There is a listing for convulsive epilepsy in Listing 11.02 and for non-convulsive epilepsy in Listing 11.03 of the SSA’s “Listing of Impairments.” If your complications from Epilepsy fall under or are equal to a listing, you might be approved for benefits at Step 3 of the Five-Step Sequential Evaluation.
Listing 11.02 requires that you show the following:
- At least one seizure a month, following at least three months of medication treatment, and
- The seizures are daytime seizures that involve convulsion or loss of consciousness, OR nighttime episodes that result in symptoms that interfere with your daytime activities.
Listing 11.03 requires that you show the following:
- At least one seizure a week, despite at least three months of compliance with prescription medication, and
- The seizures significantly interfere with your daily activities, OR cause you to display abnormal post-seizure behavior.
Your medical records must establish that you meet every element of the Listing considered disabling.
If you have Epilepsy and another medical impairment, SSA is required to consider the combined effects of your impairments when determining if your condition is equal to a listing or when doing your RFC analysis at Steps 4 and 5.
If you don’t meet or equal a listing, then SSA will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5. Because the listing requirements are difficult to meet, SSA finds that most disability applicants don’t meet a Listing.
When Your Epilepsy Makes It Impossible to Work
If your epilepsy and its complication don’t meet a listing, you will have to prove that you:
- Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
- There isn’t any other work you can do in the mythical national economy you can do based on your age, education, transferable skills and your residual functional capacity (RFC).
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your epilepsy.
Residual Functional Capacity For Epilepsy
The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that explain:
- How far you can walk,
- How long you can stand and sit at one time and for an eight-hour work day,
- How much and how often you can lift, stoop, squat, bend during an eight-hour work day,
- Whether you have to alternate sitting and standing,
- Whether you have difficulty concentrating for long periods of time,
- Whether you have chronic pain from any injuries you have sustained while having a seizure,
- Whether you have good days and bad days and how many days per month you would miss from work, and
- Whether you have psychological problems, including depression or anxiety, that would interfere with your ability to work.
This is not an exhaustive list of all of the questions on an epilepsy or other applicable RFC forms. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form. Their treating physician may not have completed the RFC form properly. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.
How Your Residual Functional Capacity Is Used At A Social Security Hearing
Many claims for epilepsy are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
- Whether you can return to the lightest job you held in the last 15 years,
- Whether there is other work you can do or could learn to do.
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
How Do I Get The Social Security Disability Benefits I Deserve For Epilepsy?
Epilepsy and its complications can interfere not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:
- file your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits;
- challenge a wrongful denial of your Social Security disability application or Request for Reconsideration;
- file a Request for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.
The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by experienced Social Security Disability attorney Nancy Cavey.
Contact Social Security Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live in Florida
Epilepsy and its complications can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits. Call today for a free consultation at 727-894-3188.