Is Epilepsy Considered a Disability? Qualify for Disability Benefits with Epilepsy?
Epilepsy is a common disorder of the brain that causes seizures. If you are one of the more than three million adults with epilepsy, according to the Centers for Disease Control and Prevention, you may wonder: Is epilepsy a disability?
Many people with epilepsy successfully control their seizures and other symptoms with medication that allows them to continue to work and earn a living. However, seizures may still occur even with medication, making it difficult or impossible to work on a full-time basis, if at all.
You may qualify for disability benefits with epilepsy through two federal programs managed by the Social Security Administration: Social Security Disability Insurance and Supplemental Security Income. The disability lawyers at the Clauson Law Firm want you to know about the disability benefits available to you when you cannot work because of seizures and other symptoms of epilepsy.
They put together this guide explaining how epilepsy qualifies for disability benefits. Read through it and contact Clauson Law to learn more about how our disability lawyers can help you qualify for benefits through SSDI and SSI during a free initial consultation and claim evaluation.
What Is Epilepsy?
Epilepsy is a brain condition causing a person to have unprovoked and recurring seizures. There are several types of epilepsy, just as there are different forms of seizure activity.
Seizures are generally the result of sudden and abnormal electrical activity in the brain. A seizure does not necessarily mean that you have epilepsy, so you must undergo a medical examination to determine the cause of the seizure.
A diagnosis that a person has epilepsy is not made after a single seizure. Doctors typically look for at least two seizures that are at least 24 hours apart before making a diagnosis that a person has epilepsy.
Seizures caused by epilepsy may be controlled with medication or, in some cases, through surgical procedures. Although medication or surgery controls seizure activity in some people, others continue to have seizure activity even with treatment.
Types Of Seizures And Their Symptoms
Symptoms experienced by a person diagnosed with epilepsy can vary because there are different types of seizures. Seizures that originate in only one area of the brain are focal seizures. There are two types of focal seizures:
- Focal seizures with awareness impairment: Sometimes called complex partial seizures, focal seizures with impaired awareness may cause a person to experience a change or loss of consciousness. A person may be unresponsive and staring into space or engage in hand rubbing, walking in circles, or other repetitive movements.
- Focal seizures without loss of consciousness: At one time called simple partial seizures, these types of seizures may cause a person to experience a change in emotions or alteration of their senses of smell, taste, touch, or sound. A person may exhibit involuntary jerking motions of arms or legs and experience tingling or dizziness.
Focal seizures originate from abnormal electrical activity in the brain’s temporal, frontal, and occipital lobes, but they do not cause convulsive symptoms. The symptoms differ depending on the lobe of the brain where they originate. For example, temporal lobe seizures may cause a person to experience an aura, a sensory reaction that may include losing awareness of surroundings or staring blankly into space. Occipital lobe seizures typically cause symptoms affecting vision, such as an inability to see, blinking, uncontrolled eye movements, or hallucinations.
Generalized seizures involve abnormal activity in multiple areas of the brain. Types of generalized seizure activities include:
- Tonic seizures: These seizures typically affect muscles and may cause stiffening that could lead to loss of consciousness and falling to the ground.
- Atonic seizures: These types of seizures are also called “drop” seizures because they cause a person to lose muscle control, which can cause a person to drop to the ground.
- Absence seizures: You may know these types of seizures as petit mal seizures. Typical symptoms include a lack of body movements while staring into space. Absence seizures may occur more frequently in children than adults and cause a loss of awareness.
- Tonic-clonic seizures: These types of seizures were previously labeled as “grand mal seizures.” A person having a tonic-clonic seizure may experience a sudden loss of consciousness with stiffening of the body and shaking or twitching movements.
- Clonic seizures: A person experiencing a clonic seizure may exhibit rhythmic, jerking muscle movement typically affecting the face, neck, and arms.
If you experience symptoms of a seizure, you need to be seen by a physician as soon as possible to have your symptoms evaluated to determine the cause.
Does Epilepsy Qualify For Disability Benefits?
Medication prescribed by physicians has proven effective in controlling seizure activity in individuals diagnosed with epilepsy. An epilepsy diagnosis on its own may not be enough to qualify for disability benefits through SSI and SSDI.
The Disability Determination Services, state agencies that review applications for disability benefits, determine whether you are disabled. The DDS follows the definition of disabled contained in federal regulations to determine if the medical evidence proves that you have a medically determinable physical or mental impairment that meets the criteria of the definition of disabled.
Determining whether you qualify for disability benefits with epilepsy usually comes down to whether the medical evidence shows that you have a condition that is not successfully controlled. If you take the medication prescribed by your doctor and frequently have seizures, you have a stronger claim for disability benefits than an applicant whose seizure activity is well controlled.
Federal regulations define “disabled” for purposes of adults qualifying for disability benefits through SSDI and SSI as being unable to engage in substantial gainful activity, or SGA, because of a medically determinable mental or physical impairment or combination of impairments that is expected to result in death or to last for a continuous period of at least one year.
To assist its claims examiners in determining whether a medical condition is severe enough to be disabling and eligible for disability benefits, the Social Security Administration created a listing of impairments otherwise known as the “Blue Book.” Section 11.02 of the Blue Book contains a listing for epilepsy.
Is Epilepsy A Disability, According To The Blue Book?
Section 11.02 of the Blue Book refers to generalized tonic-clonic epilepsy and dyscognitive, or focal seizure, epilepsy as those most likely to cause disabling seizure activity. The epilepsy listing of Section 11.02 requires medical documentation of at least one of the following to qualify for SSI or SSDI disability benefits:
- Generalized tonic-clonic seizures occurring for at least three consecutive months with at least one seizure a month while taking prescribed medication.
- Focal seizures occurring at least one time per week for at least three consecutive months while taking prescribed medication.
If you can document with medical evidence the occurrence of generalized tonic-clonic seizures at least once every two months for four consecutive months or focal seizures once every two weeks for at least three consecutive months while taking medication, you meet the listing criteria provided you document a marked limitation in at least one of the following areas:
- Physical functioning
- Remembering, understanding, or applying information
- Concentrating, persisting, or maintaining pace
- Interacting with others
- Managing or adapting yourself
It’s important to note that your medical records must document not only an epilepsy diagnosis but also must include the medication prescribed by your doctor and that you continued having seizure activity while taking the medication.
Your medical records will document the diagnosis, a description of seizure activity and its frequency, results of EEGs and other diagnostic testing, and medications or other treatments prescribed by your physician. You should document your seizure activity by keeping a diary and recording the date, time, and length of seizures that you experience. Include in the diary entries a description of the symptoms you experience during and immediately before and after a seizure. Statements from your family, friends, and co-workers who are present when you have a seizure can be valuable evidence to prove the seizure activity.
Qualifying For Disability Benefits Without Meeting Blue Book Criteria
If your seizure activity does not meet the listing requirements of Section 11.05 of the Blue Book, the Disability Determination Services reviews the medical evidence and other documentation submitted in support of your application. This review is to decide whether the limitations imposed by your medical condition combined with your age, education, skills and other factors prevent you from working at a previous job or another type of work. If they do, you could be considered disabled and eligible for SSI, SSDI, or both.
Consult A Disability Lawyer At Clauson Law
The disability lawyers at the Clauson Law Firm understand how frustrating it can be to have a claim denied because the Social Security Administration determines that you do not qualify for disability benefits with epilepsy. Instead of giving up, turn to the disability lawyers at Clauson Law to challenge the denial of benefits through the Social Security appeal process.
You have the right to appeal a denial of benefits, but you must act quickly because your time to file an appeal is limited. Learn more during a free consultation and claim evaluation by contacting the Clauson Law Firm now.
