Epilepsy is a disorder of the brain in which abnormal electrical activity in the brain causes recurrent and unprovoked seizures. It affects about 3.4 million people in the United States. Anyone can develop epilepsy. Genetics, stroke, brain tumor, traumatic brain injury, or infection of the central nervous system are a few of the events that can trigger epilepsy.
In adults, generalized tonic-clonic seizures and dyscognitive seizures (formerly complex partial seizures) are the most common types of potentially disabling seizures.
Characteristics of generalized tonic-clonic seizures include loss of consciousness accompanied by a tonic phase (sudden muscle tensing causing the person to lose postural control) followed by a clonic phase (rapid cycles of muscle contraction and relaxation, also called convulsions). Tongue biting, incontinence and injuries as a result of falling may occur during generalized tonic-clonic seizures.
Characteristics of Dyscognitive seizures include alteration of consciousness without convulsions or loss of muscle control. Behaviors such as blank staring, change of facial expression, and automatisms (such as lip-smacking, chewing or swallowing, or repetitive simple actions, such as gestures or verbal utterances) may occur during the seizure. Dyscognitive seizures can sometimes progress into generalized tonic-clonic seizures.
Although there is currently no cure for epilepsy, it can be successfully treated. Most people with epilepsy live perfectly normal lives. However, not everyone with epilepsy responds to treatment. At least one million people in the U.S. have uncontrolled epilepsy. For these individuals, the symptoms of their epilepsy may make it impossible for them to work.
If the symptoms of your epilepsy make it impossible for you to work, your condition may qualify you for disability benefits from the Social Security Administration, Veterans Affairs, or an ERISA LTD Insurance policy.
The Houston disability attorneys at Marc Whitehead & Associates have helped individuals all over the U.S. obtain the disability benefits they need when they become unable to work because of their epilepsy. Below, we answer some common questions about disability benefits for epilepsy.
When Does Epilepsy Qualify As a Disability?
According to Chapter 11 (Neurological – Adult), Section 2 (Epilepsy) of the Social Security Bluebook of Disabilities, in order to qualify for disability benefits for epilepsy, you must be able to show that you experience:
Generalized tonic-clonic seizures, occurring at least once a month for at least 3 consecutive months despite adherence to prescribed treatment;
or
Dyscognitive seizures, occurring at least once a week for at least 3 consecutive months despite adherence to prescribed treatment;
or
Generalized tonic-clonic seizures, occurring at least once every 2 months for at least 4 consecutive months, despite adherence to prescribed treatment, with a marked limitation in one of the following:
- Physical functioning
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself;
or
Dyscognitive seizures, occurring at least once every 2 weeks for at least 3 consecutive months despite adherence to prescribed treatment, with a marked limitation in one of the following:
- Physical functioning
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself.
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What does “Despite adherence to prescribed treatment” mean when applying for Social Security disability benefits for epilepsy?
The SSA requires that the limitations from your epilepsy exist despite adherence to prescribed treatment. What this means is that your impairment continues to meet the listing requirements even though you’ve taken your prescribed medication(s) or followed other treatment procedures for your neurological disorder(s) as prescribed by a physician for at least three consecutive months.
What evidence do you need to submit to support your claim for disability benefits for epilepsy?
Social Security requires both medical and non-medical evidence (signs, symptoms and laboratory findings) to assess the effects of your epilepsy.
Medical evidence should include your medical history, examination findings, relevant laboratory tests, and the results of imaging, such as x-ray, computerized tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG). It can also include descriptions of any prescribed treatment and your response to it.
Non-medical evidence can include statements you or others make about your impairments, your restrictions, your daily activities, or your efforts to work.
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Can You Appeal A Denial of Disability Benefits for Epilepsy?
It’s not uncommon for applicants to have their claim for disability benefits denied by the Social Security Administration. One of the most common reasons a claim is rejected is simply that the applicant failed to provide the necessary information the SSA requires to make a decision.
Fortunately, you can appeal an SSA denial of disability benefits for epilepsy. ERISA gives you the right to appeal a denial of epilepsy LTD benefits by an insurance company. If you have an individual LTD policy, federal and state laws could apply in a denial of benefits case.
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We Are Here To Help You Get the Epilepsy Disability Benefits You Deserve
Having your claim represented by an experienced disability attorney greatly improves your chances of success. Marc Whitehead & Associates are Houston, TX, based disability benefits lawyers who serve clients all over the U.S. We have helped many individuals with epilepsy and other severe medical conditions get the benefits they deserve, even after their claims were rejected by the SSA, VA, or private insurance company.
Contact the law offices of Marc Whitehead & Associates to discuss your claim. We are here to answer all your questions and provide honest legal advice on the best way to proceed with your disability claim.
Call or text 800-562-9830 or complete a Free Case Evaluation form
