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Traumatic Brain Injuries and Disability benefits from the SSA

Traumatic brain injuries can be caused by car or bicycle accidents, blows to the head, assaults or falls. Any strong blow to the head can cause swelling of the brain, intracranial pressure and permanent brain damage. Delicate brain tissues and nerve cells are destroyed, leaving an individual with a variety of symptoms ranging from the minor to the severe.

Concussions are one of the most common types of brain injuries. They are generally mild but can leave the injured with headaches, dizziness, vomiting, slurred speech, ringing in the ears, and nauseous.

Claimants who have a severe traumatic brain injury have much more severe symptoms which can include nerve damage, seizures, communication difficulties, changes in perceptions, post concussion syndrome, coma, personality changes and cognitive difficulties.

If you have suffered a traumatic brain injury and you feel like you are no longer able to work, you may have considered applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits (SSI), but you are probably wondering what you have to prove to win SSA disability benefits.

Proving disability after a traumatic brain injury

The SSA has two methods they use to determine whether or not a claimant with a traumatic brain injury is disabled. The first is by “meeting a listing.” The second is to win benefits through a medical vocational allowance.

Meeting a Listing for a traumatic brain injury

The SSA maintains a listing called the SSA Listing of Impairments or the SSA Blue Book that identifies all of the diseases and mental and physical health conditions that they consider automatically disabling.

If you can prove that your traumatic brain injury “meets or equals” a listing in the SSA Blue Book, the Social Security Administration will automatically award you either SSI or SSDI, assuming you meet the nonmedical requirements for one of the programs.

There are a number of Social Security Listings that may apply in a closed head injury case for instance 11.18 - Cerebral Trauma. It reads “Evaluate under the provisions of 11.02, 11.03, 11.04 or 12.02 as applicable.”

So what do these listings describe? Several of them talk about seizures and how they interfere with everyday life (Listing 11.02 and 11.03), others describe the types of limitations that can be caused by a stroke, including loss of communication or functional limitations of a claimant’s arms and legs (Listing 11.04). Finally, others describe what the SSA terms “organic” brain damage which can cause the claimant to experience loss of cognitive function, memory loss, personality changes and disorientation (Listing 12.02).

Winning disability for traumatic brain injury through a medical vocational allowance

Most disability claimants who have suffered a traumatic brain injury will not meet a listing, but they may have a strong chance to prove they are disabled through a medical vocational allowance.

If your condition does not meet a listing the SSA will evaluate whether or not you have enough residual capacity to perform your current job and if not, could you retrain for new work given your age, work history, education level and residual functional capacities.

So, what do you need to prove? You will need solid medical evidence from a medical professional that you do not have the residual capacity left after your injury to perform simple, unskilled, entry-level work due to your severe symptoms (dizziness, headaches, memory loss, medication side effects, vision problems, etc.).

What types of medical evidence do you need to support your claim?

1. Documentation that you have been diagnosed with a traumatic brain injury. Evidence can include a MRI report, CT scans, X-rays, therapy notes, etc.

2. Evidence that your head injury has caused severe symptoms such as fatigue, anger management, vision issues, etc.

3. Evidence of seizures that cannot be controlled by medication, if present.

4. Evidence that you can no longer perform work 8 hours per day for 5 days per week. This could include extreme fatigue, requiring frequent naps throughout the day, the inability to complete simple job tasks, personality changes which have affected your ability to work with others.

5. Evidence of migraines or blurred vision which could also interfere with your ability to focus on tasks for extended period of times.

6. Statements from your doctor providing a detailed list of reasons why you are disabled. This statement can include functional limitations which make it difficult for you to work.

Claimants whose condition does not meet or equal a listing generally benefit from help from a disability lawyer who understands how to evaluate medical records and determine what information may be needed to prove they are disabled.