Epilepsy is a brain disorder that is responsible for causing seizures and nervous system disorders. Symptoms of epilepsy can vary from minor lapses of attention to violent convulsions and loss of consciousness. While medication has successfully treated some patient’s epilepsy, the main benefit is reducing the frequency of seizures, not curing the disease altogether. Therefore, many ordinary tasks, such as driving a car or carrying heavy objects, can be dangerous for people with epilepsy. If you are diagnosed with epilepsy or have experienced multiple seizures that prevent you from working, Jon Sipes, Attorney at Law, may be able to assist you in obtaining Social Security Disability benefits. Attorney Sipes has decades of experience helping South Texans with disabling conditions get Social Security Disability benefits.
What Are Social Security Benefits?
There are two types of Social Security benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Generally, both types of Social Security benefits require an individual to suffer from a long-term condition that prevents him or her from working.
Whether you qualify for SSDI or SSI depends on the number of years you have worked and paid Social Security taxes. Eligibility for SSDI is based on a formula analyzing age, the number of years worked, and payroll taxes paid. Generally, you must have worked for some portion of the last ten years to meet SSDI eligibility.
SSDI payments are based on the amount of Social Security payroll taxes you paid during your employment history. The amount of SSI payments are based on an amount set by Congress. As a result, monthly SSDI payments are usually higher than SSI payments.
If you are ineligible for SSDI, you may still qualify for SSI. SSI is a need-based program that benefits the elderly, the blind, and those with other disabilities.
Am I Eligible for Social Security Disability Benefits with Epilepsy and Seizures?
Eligibility for either SSDI or SSI benefits requires applying with the Social Security Administration. The Social Security Administration is a government agency that is responsible for administering disability benefits. The Social Security Administration examines applications for disability benefits. It determines whether an applicant has a long-term disability expected to last at least 1 year or result in death.
A disability is a long-term medical condition expected to continue for at least 1 year or result in death. Disability can result from physical injuries, chronic medical conditions, or mental illness. The Social Security Administration applies several tests to determine whether a disability prevents an applicant from performing any type of work when considering an application.
In addition to being long-term and severe, an applicant’s medical condition must also prevent him or her from performing any substantial gainful activity (SGA). SGA is an activity that results in earning income over an established amount. As of 2020, Congress set the amount recognized as SGA at $1,260 per month or more. This amount is subject to yearly revision.
What Is Epilepsy?
Epilepsy is a neurological disorder that results in or is characterized by recurring seizures. Epilepsy may be brought on by several underlying conditions, such as a stroke, head trauma, brain tumors, birth defects, or infections of the brain.
Doctors often diagnose epilepsy through brain scans and blood tests. A special test called an electroencephalogram (EEG) is often helpful in diagnosing epilepsy, but a normal result may still not rule out epilepsy.
The seizures caused by epilepsy are often controlled by medication. In other cases, surgery or neurostimulation may help. However, treatments generally do not cure epilepsy; they only reduce the frequency of seizures. Despite this, many people with epilepsy can still improve to the point that treatment is no longer necessary.
Is Epilepsy a Disability?
Depending on the severity of the condition, epilepsy may qualify as a disability under the Social Security Administration’s guidelines. Because epilepsy can be controlled in some cases, the Social Security Administration will evaluate the type of epilepsy and the frequency, duration, and nature of the seizures experienced when reviewing an application.
What Does the Social Security Administration Look for When Evaluating Epilepsy and Seizures?
When you apply for Social Security benefits and claim epilepsy as a disability, the claim examiner will review your application to determine if your epilepsy is a significant, long-term disability.
The Social Security Administration recognizes two types of epilepsy: convulsive and non-convulsive. To qualify for benefits based on convulsive epilepsy, you must show you experience daytime seizures that cause you to convulse or lose consciousness or nighttime seizures that cause complications during the day, such as inability to stay awake, concentrate, or perform physical tasks. You must also show that you continue to have seizures at least once a month after you have been on anti-seizure medications for at least 3 months.
To qualify for benefits based on non-convulsive epilepsy, you must experience seizures during the day or night and cause you to have pronounced symptoms, such as unusual behavior, lack of coordination, lack of mental focus, lack of energy, or trouble staying awake. You must also show you continue to experience seizures at least once a week, even after you have been on anti-seizure medications for at least 3 months.
Can I Still Qualify for Disability Benefits if I Don’t Meet the Social Security Administration’s Criteria for Someone with Epilepsy or Seizures?
The short answer to this question is yes. If you do not meet the Social Security Administration’s definition of someone with disabling epilepsy, you may still qualify for disability benefits if you can show that your condition prevents you from working.
In this case, the Social Security Administration evaluates an applicant’s ability to work through a tool called a Residual Functional Capacity (RFC) assessment. The RFC measures the most an applicant can do despite physical or mental impairments. To assess RFC, the Social Security Administration considers evidence, including medical records, a medical exam, and your statements regarding your pain or other limitations caused by CTS.
The RFC examines an applicant’s physical abilities, mental abilities, and other abilities such as senses affected by impairment. Epilepsy often causes mental and physical problems for people experiencing seizures. You may have trouble thinking clearly or feel tired, or you may lack coordination or be unable to stand for long periods. Details like these allow a claims examiner to understand how your condition impacts your ability to work, and the more descriptive you can be, the better.
In many cases, you will need to submit medical records, including a doctor’s evaluation, to substantiate your application for disability benefits. In addition to these records, you will need to describe how your epilepsy impacts your daily life and ability to work. You will also need to describe your seizures and any other symptoms or side effects caused by them.
What Happens if a Disability Claim with Epilepsy or Seizures is Denied?
If the Social Security Administration denies a claim of epilepsy based disability, you have the option to appeal that decision to an Administrative Law Judge. You will then need to make a case on appeal that explains why your epilepsy should be considered a disability. Consulting with an experienced disability attorney can assist applicants in winning appeals from an initial SSDI or SSI denial.
Discuss Your Claim for Epilepsy or Seizures-Based Disability with an El Paso Social Security Disability Benefits Attorney
Epilepsy and seizures caused by epilepsy severely limit your ability to hold a job. If you experience frequent seizures that prevent you from working, you may qualify for disability benefits. However, to obtain benefits, you must include information in your application that allows the Social Security Administration to find that you suffer from a long term medical condition that impacts your ability to work. Jon Sipes, Attorney at Law, has worked with hundreds of El Paso area clients applying for and appealing denials of disability benefits and understands the information the Social Security Administration needs to award you benefits. If you are considering applying for Social Security disability benefits, reach out to Attorney Jon Sipes to help you through the process.