Social Security Disability Benefits For Traumatic Brain Injury (TBI)

SSDI Traumatic Brain Injury (TBI) 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 traumatic brain injury 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. Ask if the traumatic brain injury disability meets or equals a medical listing. Traumatic brain injury is listed under neurological disorders.
The guidelines for evaluating impairments caused by cerebral trauma are contained in 11.18, which states:

11.18 Traumatic brain injury, characterized by A or B:

A. Disorganization of motor function in two extremities resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities, persisting for at least 3 consecutive months after the injury.

OR

B. Marked limitation in physical functioning in one of the following areas of mental functioning, persisting for at least 3 consecutive months after the injury:

1. Understanding, remembering, or applying information; or
2. Interacting with others; or
3. Concentrating, persisting, or maintaining pace; or
4. Adapting or managing oneself.

4. Explore the ability of an individual to perform work they have done in the past despite their traumatic brain injury. 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 traumatic brain injury disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person with a traumatic brain injury would warrant a finding of disabled at any age. The inability to meet any of the basic mental demands of work would entitle a claimant to disability benefits.

Social Security Rulings 85-15 and SSR 96-9p both describe how an individual must, on a sustained basis, be able to understand, remember and carry out simple instructions; make simple work-related decisions; respond appropriately to supervision, co-workers, usual work situations and to deal with changes in a routine work setting.

A substantial loss of ability to meet any one of these basic work-related activities would severely limit the potential occupational base for all age groups and justify a finding of disabled. A person who has a medically determinable severe impairment of traumatic brain injury and is unable to understand, remember or carry out simple instructions would be found disabled based on his/her mental residual function capacity.