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Epilepsy and Social Security Disability Insurance

If you have epilepsy or a seizure disorder you may not be able to work. Did you know the Social Security Administration offers cash assistance to certain individuals who are severely disabled with a mental or physical condition and this condition causes severe functional limitations which are expected to last for at least twelve months? Did you know these benefits may also be available to children who have a severe functional limitation? These benefits are called Supplement Security Income (SSI) benefits and are only awarded to families with VERY limited income and resources.

Did you know that if you are unable to work you and you have paid employment taxes and are considered insured by the SSA you may be entitled to wage replacement benefits through the Social Security Disability Insurance program (SSDI)?

So does the Social Security Administration consider epilepsy a severe medical condition? First, it is important to understand what it means to be “epileptic.” Epilepsy generally refers to seizures which are divided into two types: partial seizures and generalized seizures. Children and adults need to have at least 2 or more seizures to be considered epileptic.

Types of Seizures

All seizures are caused by disturbances in the electrical signals in the brain. If the electrical activity is disturbed in one part of the brain this is considered a partial or focal seizure. If the seizure affects the entire brain it is called a generalized seizure.

The medical community further divides partial seizures into two categories: simple seizures, which do not affect awareness or memory, and complex seizures, which affect awareness or memory before and after the seizure. Complex seizures can cause other involuntary movements.

Generalized seizures are also caused from disturbances in the electrical activity of the brain and are divided into four categories

• Petit Mal seizures which can cause a loss of consciousness, staring and subtle body movements
• Grand Mal which are the most severe and can cause loss of consciousness, shaking of the body along, body stiffening, and loss of bladder control.
• Myoclonic seizures which can cause uncontrollable movements in the arms and legs.
• Atonic seizures which cause a person’s muscles to give way and the person falls.

Does the Social Security Administration consider epilepsy a condition which is severe enough to receive SSDI (for adults) or SSI (for children and adults)? The SSA categorizes epilepsy into two groups. First they consider whether a seizure is convulsive or non-convulsive.

Convulsive Epilepsy

This grouping includes psychomotor (complex partial seizures) or grand mal seizures. SSDI or SSI may be awarded if the claimant’s condition meets the listing outlined in the SSA Listing of Impairments (Blue Book).

The SSA listing states the claimant must have medical documentation to prove they have had at least 2 or more seizures per month (a detailed description of a typical seizure pattern with associated symptoms must be present). The claimant must also have been following the prescribed treatment plan for their epileptic condition for at least 3 months and they must also have experienced one of the following two symptoms:

• If daytime episodes, a loss of consciousness and convulsions or
• If nighttime episodes, having lingering and lasting effects which significantly interfere with activity during the day

Nonconvulsive Epilepsy

Nonconvulsive epilepsy includes psychomotor (complex partial), petit mal and focal type seizures. Claimants may meet the SSA Listing of Impairments for these types of seizures if they have medical evidence to prove that they have had at least 2 or more seizures per week while they have been following their medical treatment plan for at least 3 months and one of the symptoms from the following two categories.

• Altered awareness or a loss of consciousness
• Transient postictal manifestations of unconventional behavior (this occurs immediately post seizure and can include drowsiness, nausea, confusion, headaches, or other disorienting symptoms) or
• A significant interference with activity during the day

What if your seizure condition or epilepsy does not meet the above listing? If you are a child you must prove that your condition severely affects your ability to function. Adults must prove that their seizure disorder or epilepsy is so severe that it will not allow them to perform substantial gainful activity.

Hiring a Disability Lawyer

If your seizure conditions or epilepsy does not meet the Social Security Administration’s Listing of Impairments you may want to contact a disability lawyer to determine if you have sufficient medical evidence in your medical file to prove your disability, and if you are an adult, to prove you are unable to work or perform substantial gainful activity for at least 12 continuous months.