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Social Security Disability Benefits For Head Injuries/Cerebral Trauma/Traumatic Brain Injuries

I have been diagnosed with a head injury. Can I apply for Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

Do you have a diagnosis of a head injury or a traumatic brain injury (TBI)? This can be the start of your Social Security disability claim. However, the main focus is usually on the symptoms you experience from your head injury and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week.

There is a wide range of head injuries that may qualify for disability benefits. These injuries may result from accidents, an assault, falls, repeated blows, and the like. What they have in common is that they involve forceful strikes to the head, resulting in traumatic brain injury (TBI) or cerebral trauma.

Is having a brain injury a disability?

Some symptoms of TBI occur immediately, such as dizziness, disorientation, and loss of consciousness. But there are victims who do not experience signs until days or weeks after obtaining their injury. These symptoms can be wide-ranging, including headaches, sensory issues, sleeping difficulties, speech problems, memory and/or concentration problems, and mood swings. Severe cases may also involve seizures, unusual behavior, amnesia, and coma.

A head injury can have a real impact on your life, but its symptoms are often dismissed as harmless. To confirm that a head injury is disabling you, the Social Security Administration (SSA) uses a five-step evaluation process.

Step 1. Do you work gainfully?

At the first step, the SSA considers your work activity. If you are engaged in Substantial Gainful Activity (SGA), you will not be found disabled. The amount you must earn to be working at SGA changes each year. For 2018, it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your head injury/TBI and any other physical or mental conditions are considered.

Step 2. Can your condition be considered “severe”?

For the SSA to determine that you are disabled, your medical condition must significantly limit your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.

To be found disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits.  If your condition is that severe, the SSA goes on to Step 3.

Step 3. Does your injury match an SSA listing?

The Social Security Administration maintains a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them. The Adult Listing for head injury/cerebral trauma can be found here.

If you do not have an impairment that meets or equals one of the listings or the duration requirement is not met, the SSA determines what you’re capable of doing despite your impairments – your Residual Functional Capacity (RFC) – and will proceed to Step 4.

RFC is a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments. In short, it is an evaluation of your capacity for full-time work.

Step 4. Are you still capable of performing the work you’ve done in the past fifteen (15) years?

At this step, the SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If the SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity (SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, the SSA goes on to Step 5.

You have the burden of proof at Step 4, which means you must present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.

Some types of objective medical evidence that can support a claim for disability based upon a head injury include:

  • Medical records showing movement problems in at least two limbs, at least three months after the injury
  • Documentation of seriously limiting physical problems
  • Documentation of issues in thinking, finishing tasks, regulating emotions, or interacting with others.

Doctors who specialize in treating cerebral trauma include:

  • Neurologists – doctors focusing on the brain and nerves
  • Neurosurgeons – doctors who further specialize in surgeries on the brain and nerves
  • Psychiatrists – doctors treating behavioral issues and are licensed to prescribe medication.

Note that if you are only treating with your family doctor or primary care doctor for your head injury, the SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).

Step 5. Are you capable of doing other work?

At Step 5, the “burden of proof” shifts to the SSA. If you cannot do your past relevant work, the SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, the SSA will determine you are not disabled. If you cannot do other work, the SSA will find you disabled.

If you are older than 50, there are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.

It is crucial to get the appropriate medical care after you have suffered a head trauma. While people see your symptoms as a cause of concern, they can adversely affect your ability to earn and your life as a whole.

Contact Gillette Law Group

You can pursue an effective disability benefits application with our service at the Gillette Law Group. We have helped numerous claimants succeed in their claim, even when they have previously been rejected. Our extensive experience can work to your advantage, giving you your best chance to get approved by the SSA.

Your consultation with us is free. Call (855) 873-2604 today.

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