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SUMMARY
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The short answer is yes, epilepsy is a disability. It is listed in section 11.02 of the Social Security Administration (SSA) Blue Book under neurological disorders. An individual must meet the eligibility criteria of the Blue Book listing to qualify for disability benefits for epilepsy. Epilepsy is a disability recognized under the Americans with Disabilities Act (ADA) and protected from employment discrimination under the Equality Act.
Epilepsy is a chronic disorder of the brain characterized by recurring, unprovoked seizures. The disorder can have many causes due to genetic abnormalities, brain injury, stroke, or traumatic brain injury, but often the source remains unknown. Seizure symptoms can range from simple staring spells to complete loss of consciousness and convulsions.
Seizures vary widely in frequency among people with epilepsy. Many people greatly reduce the frequency with which seizures occur through medication and treatment, with some becoming completely seizure-free within a few years. However, others continue to experience frequent, uncontrollable seizures despite treatment. Adults with uncontrolled epilepsy may apply for disability benefits from the SSA.
Common Types and Symptoms of Epilepsy
In the United States, the Centers for Disease Control and Prevention (CDC) reports that approximately 3.4 million Americans currently live with active epilepsy, including about 470,000 children and 3 million adults.
Fundamentally, seizure-type disorders have two groups: Generalized and Partial (also called Focal or Localized). Before learning the process of getting disability for epilepsy, it is helpful to understand the different types of seizure disorders and their symptoms.
Generalized Epilepsy Classifications
Generalized seizures are characterized by abnormal electrical impulses distributed broadly throughout the brain, affecting both hemispheres simultaneously.
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Generalized Tonic-Clonic Seizures
- First, the patient may lose consciousness and could collapse
- They experience body stiffening, called the “tonic” phase
- The patient experiences uncontrollable and violent jerking, known as the “clonic” phase
- Finally, there is a recovery stage called the “postictal” or “after-seizure” phase
It is important to note that anyone suffering generalized tonic-clonic seizures (formerly called grand mal seizures) can experience serious accidents and injuries such as tongue biting, head trauma, urinary incontinence, and falls that cause fractures or concussions.
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Other Generalized Seizure Types
- Absence Seizures: More common in children, characterized by momentary loss of consciousness, where the person stares blankly and stops activity. Frequent seizures may occur, sometimes several per day, and the person is often unaware the seizure happened.
- Myoclonic Seizures: Involve sporadic and brief jerking movements, typically on both sides of the body, described as feeling like electrical shocks. Movements may become dangerous, such as involuntarily throwing or dropping objects.
- Clonic Seizures: Characterized by repetitive and rhythmic jerking movements involving both sides of the body simultaneously.
- Tonic Seizures: Involve muscle stiffness and rigidity without the jerking component.
- Atonic Seizures: Result in sudden, generalized loss of muscle tone, commonly affecting the legs and arms, which can result in falls and serious injuries.
Partial (Focal) Epilepsy Classifications
Partial seizures are characterized by electrical impulses localized to a specific part of the brain, which may spread to other regions.
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Simple Partial Seizures
Simple partial seizures may include four different types of symptoms:
- Motor symptoms: Can include jerking, muscle rigidity, stiffening, head-turning, and spasms.
- Sensory symptoms: Including unusual sensations that may affect any of the five senses.
- Autonomic symptoms: Including a rising sensation in the stomach termed “gastric uprising.”
- Psychological symptoms: Include memory phenomena similar to déjà vu, and specific emotions like pleasure, fear, or depression.
Complex Partial Seizures (Dyscognitive Seizures)
Also called dyscognitive seizures, complex partial seizures involve a temporary alteration of consciousness. Symptoms may include:
- Impairment of awareness and feeling “out of touch”
- Staring into space or blank stare
- Automatisms (involuntary, coordinated, repetitive, and purposeless movements such as chewing, lip-smacking, picking at clothes, or walking around aimlessly)
Partial Seizures with Secondary Generalization
With these types of seizures, a partial seizure evolves into a generalized seizure, often becoming a generalized tonic-clonic seizure. Research shows that around 70% of patients with partial seizures can have seizures controlled with proper antiepileptic medication, though seizures uncontrolled after medication use may require surgery.
Can You Get Disability for Epilepsy?
The Social Security Administration (SSA) considers epilepsy a recognized disability under the Blue Book. An individual who qualifies for disability for epilepsy and whose disability is preventing them from working for an extended time can receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
It is important to note that epilepsy may not be disabling if it can be controlled with medication. To establish disability, patients will have to prove that epilepsy interferes with daily activities despite taking prescribed antiepileptic medications for at least three months. In some cases, patients may have to prove that alcohol or drug use are not contributing to the medication’s lack of effectiveness.
Epilepsy qualifies for disability only under specific circumstances. The Social Security Administration (SSA) evaluates epilepsy according to its type, duration, frequency, and nature of seizures. The specific criteria to qualify for SSDI benefits for epilepsy are complex and detailed in the Blue Book Section 11.02.
SSA Blue Book Section 11.02: Epilepsy Listing Criteria
What Are the Medical-Vocational Guidelines to Qualify for Epilepsy?
While claiming SSDI or SSI for epilepsy, your application may be reviewed by a medical examiner and adjudicator. When evaluating your claim, they will want to review several pieces of information, including:
- Diagnosis of epilepsy from medical records
- Detailed description of the seizure (pre-seizure symptoms, during seizure, and post-seizure symptoms)
- Complete medical records and imaging results (EEGs, MRIs, CT scans)
- Witness statements describing your seizures
- Detailed record mentioning the frequency and severity of past seizures
- EEG (electroencephalogram) results showing abnormal brain activity
- History of treatment, including all medications tried and their effectiveness
- Side effects experienced from medications
To qualify under medical-vocational guidelines, you would also be required to provide documentation of:
- Age at the time of diagnosis and current age
- Education level and work history
- Transferable work skills or lack thereof
- Any other medical conditions or comorbidities
- Any physical or mental restrictions ordered by your medical professional
- Impact of seizures on your ability to work safely in any environment
Generally, the chances to obtain SSDI epilepsy benefits increase if the applicant is older, has less education, or lacks specialized job skills. The SSA recognizes that individuals with unpredictable seizures may be unable to work in any job due to safety concerns and workplace restrictions.
How to Apply for Disability Benefits for Epilepsy
If you have a disability that has lasted or is expected to last for 12 months or more, you may be able to receive benefits. To apply for disability benefits for epilepsy, you can visit the SSA’s website at www.ssa.gov or call 1-800-772-1213 to schedule an appointment at your local SSA office.
The SSA offers two types of disability benefits:
- SSDI (Social Security Disability Insurance): Available to those with a qualifying work history who have paid Social Security taxes.
- SSI (Supplemental Security Income): A needs-based program for those with limited income and resources, regardless of work history.
Generally, there is a 3 to 5 month waiting period after you submit your application before you hear back from the SSA regarding your claim.
You will need to provide the following documentation to support your claim:
- Written notes and referral letters from healthcare professionals and neurologists
- Prescription history and treatment records showing all medications tried
- Hospital admission records and discharge summaries
- Chest imaging reports and test results
- EEG (electroencephalogram) results and brain imaging (MRI or CT scans)
- Medical source statements from your treating physician
- Documentation showing you have been on medication for at least 3 consecutive months
- Records showing seizure frequency and severity
Contact a Disability Attorney to Seek Legal Assistance
At Nationwide Disability Representatives, we specialize in Social Security Disability claims, including those involving complex neurological conditions like epilepsy. We handle every stage of your claim from initial application through appeals and hearings. We work on a contingency fee basis, which means you pay nothing unless we win your case.
Call us today at 800-572-3753 or fill out our online contact form to schedule a free consultation. We promise we can help you secure the disability benefits you deserve.
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