How To Get Social Security Disability & SSI Benefits: Stroke

Winning Your Stroke Case

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Social Security Is Looking For Specific Stroke Medical Records

Millions of Americans have suffered a stroke or a cerebral vascular accident (CVA), and Social Security deals with a huge number of stroke and CVA disability and SSI claims. A stroke is a deprivation of blood and oxygen to the brain. There are two types of strokes: 1) an ischemic stroke caused by a blocked blood vessel carrying blood to the brain, and 2) a hemorrhagic stroke caused by a brain blood vessel leak or rupture. A transient ischemic attack (TIA) is similar to a stroke. A TIA is a temporary blockage of blood and oxygen to the brain. Most TIAs do not cause lasting physical or cognitive limitations.

Social Security must have objective medical evidence of your stroke diagnosis and disabling symptoms. The stroke itself is diagnosed by a brain CT or MRI. Symptoms vary widely depending on the severity of the stroke. The longer the brain is without oxygen, the more brain cells that die. When brain cells die, the neurological functioning those brains cells controlled are affected. The most common symptoms of a stroke are paralysis of varying parts of the body (usually one side of the body), and cognitive limitations. If you have paralysis of parts of the body, it is important to Social Security that the severity of paralysis is described by your doctor in your medical records. If your stroke caused a cognitive impairment, that review and the appropriate listings can found Here - Intellectual Disorders. Social Security will consider all your medical impairments. You may be disabled on the basis of an intellectual impairment alone or on the basis of both a stroke and an intellectual impairment. If you have cognitive limitations, you need proof - cognitive and memory testing by a mental health professional. Social Security will rarely rely on your own description of your cognitive or memory limitations.

Social Security & SSI Stroke Listing

For a stroke or cerebrovascular accident, you will satisfy Adult Listing 11.04 if you meet points 1, 2, or 3. You will satisfy the Child Listing 111.04 if you meet point 2.

1. For three months or more after the stroke/CVA, one has an extremely reduced capacity to understand or express language;
2. For three months or more after the stroke/CVA, one has such poor functioning in two limbs that one has an extremely reduced capacity to stand, balance, or use the upper limbs; or
3. For three months or more after then stroke/CVA, one has a markedly reduced capacity to perform physical tasks, and perform mental tasks demonstrated by -
1. Applying knowledge,
2. Dealing with the community,
3. Keeping your attention on job duties, or
4. Properly responding to job demands.

Stroke Hearing - The Power Of Statements

Mrs. Schmidt lived in Los Angeles, CA. He had filed for SSDI and SSI disability benefits. She had been diagnosed with a long list of medical conditions: mild diabetes, GERD, esophagitis, obesity, mild bilateral ankle pain, low back pain, abdominal pain, and depression. Her most severe and disabling medical condition was a stroke which resulted in left side body numbness and generalized body pain and severe left arm pain and numbness (neuropathy). She was age 48 at the time of her hearing. Her past work was as an office worker, retail salesperson, and a dispatcher. She had a long and consistent work record. She had filed for Social Security disability and SSI disability benefits.

Mrs. Schmidt underwent a brain MRI and a carotid ultrasound showing an ischemic stroke caused by a blocked blood vessel in the carotid artery. She had also undergone an upper extremity EMG confirming her neuropathy. She had been referred to a neurosurgeon who recommended a carotid endarterectomy. Soon thereafter, she lost her insurance, and she was unable to pay for a surgery. In an attempt to alleviate her pain, she underwent pain injections and physical therapy (PT), and was prescribed pain medications, muscle relaxers, and anti-inflammatories all of which were unhelpful in alleviating her body and arm pain and numbness.

There were three issues of high importance in her case. First, she had plenty of medical records, but the records did not show abnormal clinical findings except for tenderness, pain on palpitation, and mildly reduced range of motion. The medical records did not show she suffered a loss of strength, decreased sensation, reflex loss, or that she had any abnormalities of her left arm. This was true even though she underwent an abnormal EMG and had been prescribed a surgery. Second, she needed to lie down for most of every day to alleviate her body and arm symptoms, but there was no indication in her medical records that she did so or that the restriction was necessary. Third, because she lost her insurance, she was not able to continue treatment with her neurologist or her surgeon.

Fortunately, she was able to continue seeing her primary doctor (PCP) - on a cash payment basis. We send her PCP a residual functional capacity (RFC) form, and the PCP was willing to fill it out. The PCP found Mrs. Schmidt was unable sit, stand, and walk for an eight-hour workday primarily because of her need to lie down throughout the day. We also obtained statements from Mrs. Schmidt's friend, sister, and mother about the difficulties Mrs. Schmidt suffered on a daily basis - concentrating on her need to lie down in the day due to her stroke symptoms.

At the hearing, our disability argument was that she was unable to perform any work because of her need to lie down for most of the day. This, of course, was supported by the PCP's RFC. We took testimony from both Mrs. Schmidt and her husband about the following and focused on her need to lie down:

1. Living situation;
2. Difficulty driving;
3. Difficulty performing housework and laundry (she hardly did any at all);
4. Difficulty caring for her grandchildren;
5. Need for a shower chair and difficulty with hygiene;
6. Inability to run errands;
7. Interrupted sleep because of pain;
8. Loss of her insurance and resulting lack of medical care,
9. Ineffectiveness of her injections, PT, and medications in relieving her pain; and of course
10. Need to recline or lie down for most of every day.

At the hearing, the ALJ agreed with our argument and accepted the RFC from the PCP. We waited four months for the ALJ to write and send a fully favorable decision wherein the ALJ found our argument correct and granted benefits. It was a fair and reasonable decision for a client who deserved Social Security disability and SSI benefits.

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