Epilepsy And Social Security Disability Benefits

Epilepsy and Social Security Disability Benefits

by

Jonathan C. Ginsberg

Epilepsy is a disorder that results from the generation of electrical signals inside the brain, causing recurring seizures. While one seizure does not classify someone as epileptic, many people experience epileptic seizures regularly and to varying degrees. Epilepsy and seizures affect almost 3 million Americans of all ages, with 200,000 new cases of seizures and epilepsy occurring each year. Here, epilepsy will be discussed further with regard to the causes, symptoms and treatment of epilepsy, followed by a discussion of how someone with epilepsy may qualify for Social Security Disability benefits.

About Epilepsy Epilepsy, also called seizure disorder, is a medical condition that produces seizures affecting a variety of mental and physical functions. When a person has two or more unprovoked seizures, they are considered to have epilepsy. Seizure symptoms vary. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others have full-fledged convulsions. Epilepsy has no identifiable cause in about half of those who have the condition. In the other half, the condition may be traced to various factors. Some of these factors may include the following: -Genetic influence. Researchers have linked some types of epilepsy to specific genes. -Head trauma. -Medical disorders. Events like strokes or heart attacks that result in damage to the brain. -Dementia especially among older adults. -Diseases like meningitis, AIDS and viral encephalitis. -Prenatal injury. Fetuses are susceptible to brain damage caused by an infection in the mother, poor nutrition or oxygen deficiencies. -Developmental disorders, such as autism and Down syndrome. Symptoms vary depending on the type of seizure. Doctors classify seizures as either partial or generalized, based on how the abnormal brain activity begins. In some cases, seizures can begin as partial and then become generalized. When seizures appear to result from abnormal activity in just one part of the brain, they’re called partial or focal seizures. Simple partial seizures do not result in loss of consciousness, but they may alter emotions or change the way things look, smell, feel, taste or sound, and may result in involuntary jerking of part of the body, such as an arm or leg, and spontaneous sensory symptoms such as tingling, vertigo and flashing lights. Complex partial seizures alter consciousness, causing one to lose awareness for a period of time. Seizures that seem to involve all of the brain are called generalized seizures. The following are four types of generalized seizures: -Absence seizures (also called petit mal). Characterized by staring and subtle body movement, and can cause a brief loss of consciousness. -Myoclonic seizures. Usually appear as sudden jerks or twitches of your arms and legs. -Atonic seizures (also called drop attacks). Cause loss of normal muscle tone and sudden collapse. -Tonic-clonic seizures (also called grand mal). Characterized by a loss of consciousness, body stiffening and shaking, and loss of bladder control. Doctors generally start by treating epilepsy with medication and may propose surgery if medications are ineffective. Some of the side effects of seizure medications include the following: -Fatigue -Dizziness -Weight gain -Decreased bone density -Skin rashes -Loss of coordination -Speech problems -Depression -Suicidal thoughts and behaviors -Severe rash -Inflammation of certain organs, such as your pancreas Applying for Social Security Disability Benefits Social Security Disability Insurance (SSDI) is a federal program designed to pay monetary benefits to qualified applicants who have worked long enough and paid their social security taxes. Based on medical evidence, work history, and education history, the Social Security Administration determines whether or not applicants qualify for benefits and how much each applicant can receive. The Social Security Administration (SSA) sets forth specific criteria when qualifying applicants for benefits. With regard to epilepsy specifically, the medical evidence must be consistent with SSAs classification of an immune system disorder as well as the following criteria: A. Epilepsy. In epilepsy, regardless of etiology, degree of impairment will be determined according to type, frequency, duration, and sequelae of seizures. At least one detailed description of a typical seizure is required. Such description includes the presence or absence of aura, tongue bites, sphincter control, injuries associated with the attack, and postictal phenomena. The reporting physician should indicate the extent to which description of seizures reflects his own observations and the source of ancillary information. Testimony of persons other than the claimant is essential for description of type and frequency of seizures if professional observation is not available. Under 11.02 and 11.03, the criteria can be applied only if the impairment persists despite the fact that the individual is following prescribed antiepileptic treatment. Adherence to prescribed antiepileptic therapy can ordinarily be determined from objective clinical findings in the report of the physician currently providing treatment for epilepsy. Determination of blood levels of phenytoin sodium or other antiepileptic drugs may serve to indicate whether the prescribed medication is being taken. When seizures are occurring at the frequency stated in 11.02 or 11.03, evaluation of the severity of the impairment must include consideration of the serum drug levels. Should serum drug levels appear therapeutically inadequate, consideration should be given as to whether this is caused by individual idiosyncrasy in absorption or metabolism of the drug. Blood drug levels should be evaluated in conjunction with all other evidence to determine the extent of compliance. When the reported blood drug levels are low, therefore, the information obtained from the treating source should include the physician’s statement as to why the levels are low and the results of any relevant diagnostic studies concerning the blood levels. Where adequate seizure control is obtained only with unusually large doses, the possibility of impairment resulting from the side effects of this medication must also be assessed. Where documentation shows that use of alcohol or drugs affects adherence to prescribed therapy or may play a part in the precipitation of seizures, this must also be considered in the overall assessment of impairment level. 11.02 Epilepsy – convulsive epilepsy, (grand mal or psychomotor), documented by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once a month, in spite of at least 3 months of prescribed treatment. With: A. Daytime episodes (loss of consciousness and convulsive seizures) or B. Nocturnal episodes manifesting residuals which interfere significantly with activity during the day. 11.03 Epilepsy – nonconvulsive epilepsy (petit mal, psychomotor, or focal), documented by detailed description of a typical seizure pattern including all associated phenomena, occurring more frequently than once weekly in spite of at least 3 months of prescribed treatment. With alteration of awareness or loss of consciousness and transient postictal manifestations of unconventional behavior or significant interference with activity during the day. The medical evidence supporting ones argument that he or she may meet these criteria, and therefore qualify for disability benefits, is crucial to obtaining a favorable finding. Physicians are considered experts in their field of practice, and their diagnosis, treatment and prognosis concerning a persons condition are key to determining if someone who suffers with epilepsy qualifies for Social Security Disability benefits.

Jonathan Ginsberg is a practicing Social Security disability lawyer in Atlanta, Georgia. In addition to his law practice, Jonathan is the editor and publisher of several national Social Security disability related web sites, including a Seizure Disability website which can be found here: http://www.seizuredisability.com/

This website also has a seizure disability blog, which can be found here: http://www.seizuredisability.com/seizuredisabilityblog/

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Epilepsy and Social Security Disability Benefits