Get Social Security Disability & SSI: Epilepsy & Seizures
Winning Your Case
You or your child can win an epilepsy or seizure Social Security disability and SSI case if two criteria are satisfied:
Satisfying the disability criteria means -
- You know how Social Security looks at an epilepsy and seizure case (talked about on this page),
- You satisfy the Social Security Epilepsy Listing (also talked about on this page) or you have disabling Functional Limitations (talked about on the next page), and
- You Submit Winning Evidence (talked about on the last page).
Know To Win
- Non-Medical Criteria
- Disability Criteria
- Epilepsy & Seizures
- Functional Limitations
- Submit Winning Evidence
Overview
Seizure Types. Social Security adjudicates many epilepsy and seizure disability and SSI cases. Epilepsy is a neurological disorder that affects the brain and causes seizures, temporary abnormal behavior, and sensations. There are two types of neurological seizures: general (affects the whole brain) and partial or focal (affects part of the brain). There are six types of generalized seizures: absence ("petit mal seizures" with short loss of awareness, blank stares, and perhaps repetitive movements); tonic (muscle stiffness); atonic (loss of muscle control); clonic (jerking muscle movements); myoclonic (twitching of the arms and legs); and tonic-clonic ("grand mal seizures" with loss of consciousness, stiffening, shaking, loss of bladder control, and tongue biting). There are two types of partial or focal seizures: simple (no loss of consciousness, dizziness, twitching, and alteration of the senses); and complex (loss of consciousness).
There is also a type of seizure called a pseudoseizure which is not neurological but instead caused by mental health impairments. Pseudoseizures are usually caused by stress and a wide array of mental health symptoms. If you or your child suffer psuedoseizures, typical epilepsy testing will be normal, and you will need to pursue your case as a mental health case.
Submissions to Social Security. In any Social Security disability case, you must have medical evidence of your epilepsy diagnosis and treatment. Epilepsy is primarily diagnosed by brain MRI or CT, EEG, patient history, and clinical observation (a doctor witnesses it). Epilepsy treatment is typically anticonvulsant and antiseizure medications (Keppra, Lamictal, Topamax, Depakote, Tegretol), and in extremely severe cases, brain surgery.
Challenges with Social Security. Proving disability with epilepsy can be especially challenging because objective testing often results in normal findings - CT, MRI, and EEG. The EEG is the most objective test to detect seizures, but if you or your child do not have a seizure while the testing is being conducted, the EEG will be normal. If you or your child's objective testing is normal, it is critical you obtain additional evidence to establish you are having seizures - a diary, video recordings, witness statements, and doctor statements.
Another challenge with Social Security epilepsy cases is adherence to one's medications. Many claimants do not take their seizure medications as prescribed. Social Security has great difficulty awarding benefits in these cases because seizure medications are generally quite effective in controlling seizures. Your medical records must reflect you are having seizures even though you are taking your medications correctly. Both medical evidence and the above-noted additional evidence will be needed to prove you are taking your medications as prescribed.
Epilepsy Social Security & SSI Listing
The Step 3, the listing for epilepsy is Adult Listing 11.02 and Child Listing 111.02. An adult must meet points 1, 2, 3, or 4. A child must meet points 1 or 2.
- Tonic-clonic seizures that happen once a month or more for no less than three months in a row, and you are getting ongoing medical care.
- Dyscognitive seizures that happen once a month or more for no less than three months in a row, and you are getting ongoing medical care.
- Tonic-clonic seizures that happen once every two months or more for no less than four months in a row, and you are getting ongoing medical care, and you have a marked limitation in one of -
- Physical abilities,
- Dealing with information,
- Dealing with people,
- Keeping focused on your activities, and
- Taking care of yourself.
- Dyscognitive seizures that happen once every two weeks for no less than three months in a row, and you are getting ongoing medical care, and you have a marked limitation in one of -
- Physical abilities,
- Dealing with information,
- Dealing with people,
- Keeping focused on your activities, and
- Taking care of yourself.
Do you suffer another medical condition? If so, visit our Site Menu-Home page to find that review. You may have another way to prove disability.
"The two key issues in any epilepsy or seizure case are 1) whether the seizures are witnessed by someone credible, and 2) whether the client is compliant with the seizure medication regimen."
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