Does Traumatic Brain Injury Qualify for Disability?
Across the United States, more than 13.5 million people live with a disability caused by a traumatic brain injury (TBI). That number continues to grow by as many as 90,000 people per year, according to the American Association of Neurological Surgeons (AANS).
After any kind of serious injury that results in long-term cognitive or physical deficits, many victims and their families may wonder how they will continue to support their families financially.
If you are unable to return to work because of the effects of a TBI, it’s important to know what resources are available to you, such as Social Security Disability Insurance (SSDI). Find out everything you need to know about TBI disability benefits from Social Security Disability Advocates USA.
Are TBIs Considered a Disability?
A traumatic brain injury alone is not considered a disability in its own right. Although TBIs can be very serious injuries with devastating effects, not everyone who sustains head trauma will become disabled. Others may temporarily suffer ill effects but eventually make a full recovery from their injuries.
For this reason, having a history of a traumatic brain injury is not enough to automatically qualify someone for TBI disability benefits. Your condition must also meet other strict criteria described in the Social Security Administration (SSA) blue book, a list of impairments that meet the administration’s disability eligibility requirements.
What Is the Blue Book Definition of a Traumatic Brain Injury?
According to Section 11.18 of the SSA listing of neurological impairments and evidentiary requirements, a TBI is defined as a fractured skull, closed head injury, or penetration of brain tissue by an object. An individual who has suffered a TBI and also medically documents the following signs and symptoms meets SSA blue book requirements:
(A) Disorganization of motor function in two extremities (arms, legs, or a combination of both) resulting in an extreme limitation in the following tasks for more than three months after the injury:
- Standing up from a seated position
- Balancing while standing or walking,
- Using the upper extremities
OR
(B) Marked limitation in physical functioning, and limited mental functioning in at least one of the following areas for more than three months after the injury:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself
What If My Disability Is Mental, But Not Physical?
The TBI section of the blue book addresses mental or cognitive disabilities resulting from brain injuries, but also has a physical limitation component. However, this doesn’t necessarily mean that you cannot qualify for TBI disability benefits.
If you or a loved one has sustained persistent mental problems after a TBI but do not suffer from marked or consistent physical impairments, you’ll want to consult Section 12.02 of the blue book, which covers neurocognitive disorders including those caused by traumatic brain injuries.
Blue Book Definition of Neurocognitive Disorders
Neurocognitive disorders are characterized by a clinically significant decline in cognitive functioning. This umbrella term includes not only cognitive decline due to TBIs, but also dementia, progressive brain tumors, and other neurological diseases. To qualify for disability benefits based on a neurocognitive disorder, your medical documentation must support the following requirements:
(A) Medical documentation of a significant cognitive decline from a prior level of functioning in one or more of these cognitive areas:
- Complex attention
- Executive function
- Learning and memory
- Language
- Perceptual-motor
- Social cognition
AND
(B) Extreme limitation of at least one or marked limitation of at least two of the following areas of mental functioning:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself
OR
(C) Your mental disorder in this listing category is serious and persistent—that is, you have a medically documented history of the existence of the disorder over a period of at least two years, and there is supporting evidence of the following:
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder, AND
- There has been only marginal adjustment—that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life
What If My TBI Disability Doesn’t Meet Blue Book Eligibility Requirements?
The SSA blue book is a useful tool in determining whether or not you may be eligible for disability benefits, but it isn’t all or nothing. Disability claims are reviewed on a case by case basis. If the exact details of your condition are not listed in the blue book, but you suffer from a combination of partial listings, you may very well still qualify for SSDI benefits.
In addition, you may still be eligible for benefits if the SSA determines that your physical or mental limitations keep you from working any job. The only way to find out for sure whether or not you may be entitled to TBI disability benefits is to begin the Social Security disability application process.
How Do I Get Help Applying for TBI Disability Benefits?
Determining eligibility is a long, often drawn-out process. Many first-time applicants are denied and must file an appeal for reconsideration. You or your lawyer will need to provide sufficient medical documentation of your condition (i.e., diagnosis, treatments, medications, etc.) in order for your disability to be validated by the Social Security Administration.
Those with severe TBI-related disabilities may qualify for benefits after as little as three months, but for many with more moderate injuries, the wait can stretch as long as one year just to be able to file your first application. This is not to mention the application and appeals process, which can go on for months or even years.
When your family’s financial wellbeing is on the line, getting help with TBI disability benefits is essential. To expedite the process of qualifying for the highest possible benefits amount, it is advisable to contact a Social Security disability lawyer who knows the ins and outs of meeting stringent SSA eligibility standards.
Contact Social Security Disability Advocates USA
Need help with the application or appeals process? Wondering if you have a disability case? Contact Social Security Disability Advocates USA today for a free no obligation review of your case. An experienced attorney who specializes in SSDI cases will go over all the details of your injuries, limitations, and get you the maximum benefit amount for you and your family.
Call us today at 602-952-3200 to schedule your free consultation. Alternatively, send us a message with your case details and a representative will contact you directly. You can also find out more by connecting with a representative on LiveChat , or by reading about the seven ultimate disability secrets the SSA doesn’t want you to know about.
