Epilepsy Social Security Benefits

What is Epilepsy?

Epilepsy occurs when the brain or certain areas of the brain become excessively active and transmit an excessive number of messages. As a result, seizures, sometimes known as epileptic fits, occur. Seizures can be mild, causing only a few muscles to twitch ā€“ or they can be severe, causing your entire body to spasm (shake uncontrollably) and lead you to lose consciousness.

Epilepsy can strike people of any age. Some people experience their first seizure as children, while others experience their first seizure as adults. Between seizures, there are typically no physical signs. However, many people fear having another seizure.

Medication can aid in the prevention of seizures and the maintenance of a high quality of life. Unfortunately, it is not always effective: approximately three out of every ten patients continue to experience regular seizures. This makes living with epilepsy all the more difficult for them.

Epileptic seizures can vary significantly across individuals. Some last only a few seconds and may even go unnoticed; some affect only one arm or leg, while others affect the entire body. At times, individuals become unconscious, at other times, they are only mentally absent for a little while, and at still other times, they stay completely cognizant.

Epileptic seizures are often brief. The term “status epilepticus” refers to a seizure that lasts longer than five minutes. This is a medical emergency that requires prompt pharmaceutical therapy. Additionally, individuals may experience many seizures in a short period of time.

Epileptic seizures are classified into two broad categories:

  • Seizures on a broad scale
  • Seizures that are partial (focal) in nature

Medically Eligible for Benefits via the Blue Book

The Social Security Administration maintains a guidebook titled the Blue Book, which provides disability designations. This guidebook covers both convulsive and non-convulsive epilepsy. When you make a claim for benefits, the SSA staff will check your medical records and other paperwork to the applicable listing to determine if you are eligible for benefits.

To qualify for the Blue Book classification, your epilepsy must be severe and uncontrollable with drugs, notwithstanding your adherence to your doctor’s treatment orders, AND the evidence in your medical records must match or closely match the description for the type of epileptic seizures you have.

The SSA requires evidence of the following for convulsive seizures (listing 11.02):
Seizures that occur during the day that force you to convulse or lose consciousness

OR

Seizures that occur at night can have serious consequences throughout the day, such as difficulty staying awake, thinking properly, or coordinating your physical motions.
Along with having seizures that satisfy this criteria, you must continue to have seizures at least once a month after three months on anti-seizure medication(s).

For non-convulsive epilepsy (listing 11.03), the SSA must observe you exhibiting the following symptoms:
Seizures that occur at any time of the day or night

Cause you to have significant post-seizure symptoms, which may include strange behaviors, problems thinking, a lack of energy, difficulty staying awake, or other post-seizure symptoms that interfere with daily activities.
To qualify for this ranking, you must not only match the aforementioned criteria, but also continue to have at least one seizure per week while taking anti-seizure medication(s) consistently for at least three months.

It can be difficult to decipher the technical and medical jargon contained in the Blue Book. The book is geared toward medical professionals. Consult your physician meticulously to comprehend the listings and determine whether or not you are likely to meet or closely match one of them as well.

How to Apply for Benefits While Suffering from Epilepsy

Epileptics can apply for disability benefits in one of two ways: online or in person at their local Social Security Administration office. If you’re applying online, keep in mind that you can only submit an application for SSDI or Social Security Disability Insurance through the SSA’s website. SSDI and Social Security Disability Insurance are benefits available to disabled workers who meet all program conditions.

Applying at a local location in person means you can finish your SSDI application and also apply for Supplemental Security Income, or SSI. SSI is a need-based program with rigorous criteria regarding income and financial assets.

Whether you are applying for SSI, SSDI, or both, you must ensure that all SSA-specific information is included in your application. These include accurate records of your employment history, schooling, medical care, as well as your income and other financial information. Before you begin your application(s), gather as many records as possible and be sure to complete all forms regularly and thoroughly. Additionally, you can obtain additional information about your situation by completing this brief and completely free evaluation form.

Additionally, the SSA will require contact information for your main care physician, any hospitals where you had emergency department or in-patient care, and any other healthcare provider you’ve seen. This will enable them to get your medical documents, which are necessary for benefit approval.

A critical piece of evidence is a comprehensive report from at least one medical doctor describing a seizure that he or she witnessed personally. While descriptions of your seizures from you, your family, or friends may be helpful, the majority of epileptics who receive benefits have a written medical report documenting the physical and mental effects of their seizures. With any hope, you’ll receive approval swiftly and be able to concentrate on your health. Please read our post about applying for Social Security Benefits.