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EPILEPSY AND SOCIAL SECURITY DISABILITY

At our Social Security disability practice, we receive many inquiries about getting disability benefits for Epilepsy.  It is possible to obtain disability benefits for Epilepsy but Social Security does have some rather restrictive guidelines.

As a brief overview, Social Security takes the view that Epilepsy can usually be controlled with medications.  When this is the case, they do not consider it to be disabling.  Unfortunately, Social Security is convinced that most cases of Epilepsy that are not controlled is due to the patient's failure to follow prescribed treatment.  It seems that alcohol abuse is often associated with lack of control, and when that is not the case, it is an unfortunate stigma that must be overcome for the benefit of legitimate cases.

As to particulars, here is generally what Social Security needs to see in a case involving Epilepsy.
  1. The claimant is not working at the level of substantial gainful activity (which, in 2012, means earning at least $1,010 per month in before tax earnings).  Pensions, insurance annuities, etc. do not count.  SSA considers income that is earned--such as wages, salary, tips, commissions, etc.
  2. The epilepsy is so severe that it restricts the individual from full-time employment.  Seizures must be documented in detail as to what happens, frequency of seizures, and all symptoms.
  3. The type, frequency and duration of seizures will be evaluated to determine if the individual may still be able to perform work in spite of seizures.
  4. The claimant must continue to have seizures at a particular frequency, in spite of 3 months or more of medical treatment where the doctor has had an opportunity to adjust the treatment and has documented the prescribed medications with serum blood tests.  (In short, Social Security will not the patient's word that he/she is taking the prescribed medications; they want blood tests to prove it).
  5. Social Security will evaluate the claimant's age, education, skills and past work history to determine if he/she can do any work that exists in the national economy, even with the epilepsy.  The rules for disability vary by age category.
Here are some examples of probable outcomes at various ages:

Any age, because of epilepsy, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled


Under age 50 and, as a result of the symptoms of epilepsy, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours out of an 8-hour workday and occasionally walk/stand for a total of 2 hours per eight-hour day.

Age 50 or older and, due to the epilepsy disability, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.  (Transferable skills will likely result in a finding of "not disabled").

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to the epilepsy disability unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.  At 60 and over, the claimant will not be expected to adjust to "other work" outside his/her past relevant work.



Epilepsy is evaluated in Part 404, Subpart P, Appendix II in Section 11.02 and 11.03 of the 20 Code of Federal Regulations (sometimes called "the Disability Listings").

Individuals with Epilepsy should continue to see their doctor regularly, follow the doctor's prescribed treatment and have someone document each seizure in detail.  A diary or journal should be kept in which a spouse, family member or close friend documents details of each seizure to show what happens during a seizure, how often they occur, and any other details.  This documentation will be vital in a Social Security disability claim.  We provide free answers to many Social Security disability questions at this website.

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