Social Security Disability Benefits For Epilepsy

SSDI Epilepsy Eligibility Guidelines

1. Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,470 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

2. Conclude the epilepsy disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

• Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling.
• Seeing, hearing and speaking.
• Understanding/carrying out and remembering simple instructions.
• Responding appropriately to supervision, co-workers and usual work situations.
• Dealing with changes in a routine work setting.

3. In epilepsy, regardless of etiology, degree of impairment will be determined according to type, frequency, duration and sequel of seizures. At least one detailed description of a typical seizure is required. Testimony of persons other than the claimant is essential for description of type and frequency of seizures if professional observation is not available. Epilepsy is evaluated under the neurological body system – medical listing 11.02.

11.02 Epilepsy, documented by a detailed description of a typical seizure and characterized by A, B, C, or D:

A. Generalized tonic-clonic seizures (see 11.00H1a), occurring at least once a month for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C).

OR

B. Dyscognitive seizures (see 11.00H1b), occurring at least once a week for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C).

OR
C. Generalized tonic-clonic seizures (see 11.00H1a), occurring at least once every 2 months for at least 4 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C); and a marked limitation in one of the following:

1. Physical functioning (see 11.00G3a); or
2. Understanding, remembering, or applying information (see 11.00G3b(i)); or
3. Interacting with others (see 11.00G3b(ii)); or
4. Concentrating, persisting, or maintaining pace (see 11.00G3b(iii)); or
5. Adapting or managing oneself (see 11.00G3b(iv)).

OR
D. Dyscognitive seizures (see 11.00H1b), occurring at least once every 2 weeks for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C); and a marked limitation in one of the following:

1. Physical functioning (see 11.00G3a); or
2. Understanding, remembering, or applying information (see 11.00G3b(i)); or
3. Interacting with others (see 11.00G3b(ii)); or
4. Concentrating, persisting, or maintaining pace (see 11.00G3b(iii)); or
5. Adapting or managing oneself (see 11.00G3b(iv)).

4. Explore the ability of an individual to perform work they have done in the past despite their epilepsy. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine epilepsy disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of epilepsy, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to the epilepsy disability, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to the epilepsy disability unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.

Any age and, because of epilepsy, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.