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Epilepsy may qualify for Social Security Disability

| Nov 5, 2014 | Social Security |

About 1 in 26 Americans will be diagnosed with epilepsy at some point, according to the Centers for Disease Control and Prevention. The condition currently affects 2.3 million Americans, including many Chicago residents. Unfortunately, in 3 out of 10 cases, medication is not effective in preventing seizures and other disruptive symptoms, according to the Epilepsy Foundation.

Social Security Disability benefits may be available to people who cannot work or perform daily activities due to epilepsy. However, these people must provide extensive medical documentation to show the condition is debilitating even with the use of appropriate medication.

Medical considerations

People seeking SSD benefits must provide the Social Security Administration with a professional diagnosis of epilepsy and a description of a typical seizure. The applicant’s personal description should be supported with a third-party description. Additionally, the applicant’s doctor should state in writing whether the applicant’s reported symptoms seem reasonable based on the doctor’s own observations.

The applicant should submit a record of past seizures and attempted treatments. The SSA will also need proof that the applicant is taking prescribed medications. The SSA may consider the following things to evaluate compliance:

  • Level of medication detected in the body — the SSA may use blood tests to determine whether an applicant is taking enough medication.
  • Valid reasons for low levels of medication — the SSA recognizes that each individual may absorb or metabolize drugs differently.
  • Adverse effects of medication — large doses of medication may have undesirable or even disabling side effects.
  • If an applicant shows compliance with treatment protocol, and medication use is not disabling in itself, the SSA will consider whether the epilepsy qualifies as a disabling condition.

Means of qualifying

Both grand mal and petit mal epilepsy are included in the SSA book Disability Evaluation Under Social Security. Conditions in this book are automatically considered disabling from a medical standpoint if they meet severity criteria. To meet listing requirements, both types of epilepsy must cause more than one seizure a month. The applicant must also be at least three months into a treatment protocol.

Grand mal epilepsy must cause daytime episodes with loss of consciousness or nocturnal episodes. The nocturnal episodes must cause symptoms that interfere with daytime activities. Petit mal epilepsy must cause loss of awareness or consciousness, along with abnormal behaviors or disruption of daily activities.

People who do not meet these criteria may still qualify for a medical-vocational allowance if the epilepsy prevents gainful employment. The SSA may consider the person’s background, age and job-related skills to determine what kind of employment the person is reasonably qualified for. Medically, the SSA may evaluate secondary impairments and the effects of the medication in addition to the epilepsy.