Greetings!  I was contacted by Deanna Power, who wanted to share information for people with epilepsy via our blog.  The following information was provided by Deanna, Community Outreach Manager for Social Security Disability Help, a resource that aims to assist people at all stages of the Social Security Disability application process, from initial application to keeping benefits after being approved.  If you’d like to ask SSDH for help with your claim, Deanna can be reached at     drp@ssd-help.org.  - Vicki Kopplin, executive director

Whether you have convulsive or non-convulsive epilepsy, you may be able to qualify for disability benefits from the Social Security Administration (SSA). These benefits are available through two separate programs:

• Social Security Disability Insurance (SSDI)

And

• Supplemental Security Income (SSI)

Each program requires you qualify medically as well as satisfy program-specific technical or financial eligibility rules.

Program-Specific Requirements

For SSDI, you must be a disabled worker who paid into the Social Security system through taxes. Your employment history must typically amount to at least 10 years of Social Security tax contribution. These taxes accumulate as “work credits” and make you eligible to receive benefits through the Social Security retirement and disability systems. Your age at the time you become disabled can reduce the number of credits required, but you must generally have a fairly recent work history in order to qualify. 

To receive SSI benefits, there is no work history requirement. This is why SSI is even available to disabled children with epilepsy, because the program is need-based rather than work-based. In other words, SSI requires you meet specific income and financial asset requirements. Limitations on income and assets are strict but many applicants of all ages meet program requirements.

Medically Qualifying for SSDI and SSI

The SSA maintains a list of disabling conditions. These conditions are considered “automatically” medically qualified for benefits, though applicants must meet severity level measures of the listed disability.

Listings appear in a manual known as the Blue Book, and the epilepsy listings are found in:

• Section 11.02 – Convulsive Epilepsy
• Section 11.03 – Non-convulsive Epilepsy

To meet either of these listings, your medical records must show you have been on prescribed treatments for at least three months and still experience seizures. Additionally, you must have third statements or descriptions of your seizures from people other than yourself. Ideally, at least one of these descriptions will be from your treating physician.

To meet the listing for Convulsive Epilepsy, your records must show you have a seizure at least once a month, along with at least one of the following:

• Seizures in your waking hours that include a loss of consciousness

OR

• Seizures during sleep that cause residual effects during your waking hours, including significantly compromising your normal activities.

To meet the severity level requirements for Non-Convulsive Epilepsy, your medical records must show you have a seizure at least once per week, along with the following symptoms:

• A loss of consciousness or awareness

AND

• Residual effects after a seizure that include compromised or unusual behavior or significant impairments in your ability to complete usual daily activities.

Qualifying for benefits with epilepsy of any type requires formal documentation that you’ve taken your medications as prescribed. The SSA wants to see not just a doctor’s opinion but also blood tests that consistently show anti-convulsive drugs in your system.

Qualifying without Meeting the Blue Book Listing

The fastest way to qualify for benefits is to have medical records that meet a Blue Book listing, but it is sometimes possible to be approved without meeting a listing. For this to happen, the SSA must see you’re severely impaired by your epilepsy and unable to work at all. This is done through a residual functional capacity (RFC) analysis.

An RFC examines the affects of all your symptoms on your daily activities. Daily activities include your ability to cook, clean, drive, shop, bathe, and otherwise care for yourself, your family, your pets, and your household. If your activities of daily living (ADLs) are severely compromised, then the SSA may determine you’re unable to perform typical job duties too and that you are therefore disabled. 

Applying for Benefits

You can apply for both SSDI and SSI, even if you’re not sure you’ll qualify. SSDI applications can be filled out and submitted online via the SSA’s website, or you can apply in person at a local branch office. SSI applications however require a personal interview, and this usually happens at the local office. Call 1-800-772-1213 to schedule an application appointment.  

- Deanna Power