If you’re living with epilepsy or know someone who is, it’s totally natural to ask. The simple answer is: yes, it is possible to qualify for disability benefits for epilepsy.
But, as with many things in life, it’s not always as straightforward as just having the condition. There are specific requirements and steps to go through to be approved for benefits. This guide will break down everything you need to know about qualifying for disability with epilepsy.
What Is Epilepsy?
Before diving deep into the disability process, let’s take a minute to talk about what epilepsy actually is. Epilepsy is a neurological condition where a person has recurring seizures that aren’t caused by another condition like a brain injury or fever. Seizures are caused by sudden electrical disturbances in the brain.
There are many types of seizures, ranging from short moments where a person might stare off into space to severe convulsions that lead to loss of consciousness. Some of the common types of epilepsy include:
- Generalized seizures: These affect the whole brain and can cause loss of consciousness and violent shaking. This is the type of seizure most people think about when they hear the word epilepsy.
- Focal seizures: These only affect one part of the brain. They can cause a person to feel strange sensations or make them lose control of certain body movements.
- Non-convulsive seizures: These are more subtle and might look like daydreaming, where the person doesn’t respond to people or surroundings for a few seconds.
While seizures vary from person to person, one thing remains constant: living with epilepsy can seriously affect your day-to-day life. It can make work, relationships, and even simple tasks like driving, dangerous.
Can Epilepsy Qualify for Disability?
The next logical question you’re probably asking is: Can I get disability for epilepsy? The short answer is yes, but there are some factors you need to be aware of to help you navigate the process.
Disability benefits, particularly from the Social Security Administration (SSA), are based on how much your epilepsy affects your ability to function in daily life, especially work.
Epilepsy is listed as a qualifying condition in the SSA’s “Blue Book,” which contains the criteria for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
However, just because you have epilepsy doesn’t automatically mean you’ll get benefits. You have to meet the SSA’s criteria, and that can be a bit tricky.
The Social Security Disability Criteria for Epilepsy
The SSA uses a set of guidelines to evaluate whether a person’s condition meets the disability requirements. When it comes to epilepsy, there are a few important things the SSA will want to know about your condition before they make a decision.
The Blue Book and Epilepsy
The Blue Book is essentially the SSA’s medical guide for determining disability. It lists conditions and the criteria for each. Under the section for neurological disorders, epilepsy is included.
Epilepsy isn’t just automatically a “yes” for benefits. The SSA wants to know specifics about how often you have seizures, how severe they are, and how much they affect your ability to do things like work or take care of yourself. If you’re seeking disability benefits, you need to meet at least one of the following criteria:
- Generalized tonic-clonic (grand mal) seizures: These are the severe, convulsive seizures that cause loss of consciousness. The SSA wants to see that you’re having these seizures at least once a month, despite taking medications.
- Focal seizures: These are seizures that affect only one part of the brain. To meet the criteria for disability, the SSA wants evidence that you’re having these seizures at least once a week.
- Non-convulsive seizures: If you have seizures that don’t cause shaking but still affect your daily life (like causing you to be unresponsive for a period of time), these might also qualify if they happen frequently.
What the SSA Wants to See in Your Application
For your disability application to be considered, you’ll need medical records that show the frequency, severity, and impact of your seizures. Here are some things that are typically needed:
- Frequency and Duration of Seizures: How often do you experience seizures, and how long do they last? The more detailed your records, the stronger your case.
- Doctor’s Notes and Recommendations: Your treating physician should provide detailed medical reports explaining your condition, the frequency of your seizures, the effectiveness of treatments, and how the epilepsy affects your ability to work or perform daily activities.
- Work Impact: The SSA wants to know how your seizures affect your ability to perform job duties. Are you unable to go to work regularly? Do your seizures make it unsafe to do certain tasks or interact with people?
Types of Seizures and How They Impact Disability Claims
Not all seizures are created equal. There are many types of seizures that people with epilepsy experience. The severity and frequency of these seizures can directly impact how the SSA views your case for disability. Let’s take a closer look at the different types and how they might affect your ability to qualify for benefits.
Generalized Seizures
These are the classic “grand mal” seizures that people often associate with epilepsy. These seizures affect the entire brain and typically cause loss of consciousness.
They may also cause violent shaking, confusion, and loss of control over bodily functions. This kind of seizure can make it difficult for someone to maintain a job or do everyday tasks safely.
If you have generalized seizures that occur frequently, such as more than once a month, you are more likely to qualify for disability benefits.
The SSA will want to see evidence that despite taking medication, you are still having regular, severe seizures that interfere with your ability to live your life.
Focal Seizures
Focal seizures are more localized and occur in just one area of the brain. They can still cause significant problems, though.
While some focal seizures may involve jerking movements or a loss of control, others are more subtle. A person having a focal seizure might just zone out or experience strange sensations.
Focal seizures can still be disruptive, especially if they are happening frequently or involve loss of control. However, because focal seizures may not be as visibly intense as generalized seizures, the SSA may be more skeptical about how they impact your ability to work.
If your seizures are focal and happen often enough to disrupt your daily activities, it’s still possible to qualify for disability benefits, but you’ll need a solid case with good medical records.
Non-Convulsive Seizures
Non-convulsive seizures can be difficult to spot because they don’t cause shaking or loss of control. Instead, these seizures might look like someone is just daydreaming or “spacing out.”
These seizures can be just as disruptive as the convulsive types, though, especially if they occur often and cause the person to lose focus or control.
Non-convulsive seizures are trickier when it comes to disability claims, mainly because they’re harder to document. The SSA will want to see that these types of seizures are frequent enough to interfere with your ability to function in day-to-day life.
How the SSA Determines Disability for Epilepsy
If you’re applying for disability benefits due to epilepsy, the SSA evaluates your case based on several factors.
They’ll want to understand how your condition impacts your ability to perform basic work functions and your overall quality of life. Here’s what they’ll look at:
1. Frequency of Seizures
The SSA is looking for people who are having seizures often enough that it affects their daily life. If you’re having multiple seizures a week or month, your claim is stronger.
If the seizures are happening only once or twice a year, it might be more challenging to prove your case.
2. Severity of Seizures
The severity of your seizures also matters. If your seizures cause a loss of consciousness or uncontrollable shaking, the SSA will view that more seriously. The more disruptive the seizures are to your life, the more likely you are to qualify for benefits.
3. How Epilepsy Affects Your Ability to Work
The SSA is concerned with whether your epilepsy prevents you from doing your job. If your seizures are frequent and severe enough that you can’t maintain steady employment, you’re more likely to qualify for disability benefits.
They will ask for detailed information about your work history and whether your seizures have impacted your ability to do your job or maintain consistent work.
How to Apply for Disability for Epilepsy
If you think you qualify for disability benefits, it’s time to start the application process. Here’s a breakdown of the steps you need to take.
Step 1: Gather Your Medical Records
The first step is collecting your medical records. The SSA needs documentation of your diagnosis, treatment history, seizure frequency, and any other details that help show the extent of your condition. Be sure to include:
- Doctors’ notes
- Seizure logs or journals
- Prescription records for medications
- Hospitalization records (if applicable)
If you don’t have this documentation, it’s a good idea to get in touch with your healthcare provider. Having a complete medical record is key to your success.
Step 2: Fill Out the Application
You can apply online through the SSA website, or you can schedule an appointment at your local SSA office.
On the application, you’ll need to provide personal information, your work history, details about your seizures, and any medical evidence you’ve gathered.
Step 3: Wait for a Decision
Once you’ve submitted your application, you’ll need to wait for a decision. This process can take months. If your application is denied, don’t give up! You can appeal the decision and provide more evidence to support your case.
Tips to Strengthen Your Disability Claim for Epilepsy
If you want to increase your chances of getting approved for disability, here are some helpful tips:
- Keep a seizure journal: Record the date, time, and nature of each seizure. This will help provide evidence of the frequency and severity of your condition.
- Follow your treatment plan: The SSA wants to see that you’re doing everything you can to manage your epilepsy. Missing doctor’s appointments or not following prescribed treatments could hurt your case.
- Ask your doctor for a letter: A letter from your treating doctor that explains how your epilepsy affects your life can be incredibly helpful.
What to Do If Your Disability Claim is Denied
If your application is denied, don’t lose hope. Many people are initially denied, but that doesn’t mean you’re out of luck. You can appeal the decision. Here’s what to do:
- Request a hearing: If your initial claim is denied, you can request a hearing in front of an administrative law judge.
- Get a disability lawyer: Disability lawyers are experts in navigating the appeals process. They can help you gather additional evidence and represent you in your hearing.
Final Thoughts
Can you get disability for epilepsy? Yes, it’s possible, but it takes work. You need to show the SSA that your epilepsy is affecting your ability to work and live your life. Be prepared to gather plenty of medical records and evidence to support your claim. And if you’re denied, don’t give up. Appeal the decision, and seek help if you need it. It’s a challenging process, but with the right preparation, you can make it through and get the support you deserve.
