Does Epilepsy Qualify for Disability Benefits?
If you have severe and frequent epileptic seizures that interfere with your daytime activities, you may be able to get disability benefits.
Updated November 18, 2016
Epilepsy is a brain disorder that causes recurring seizures. It can be the result of a condition such as cerebral palsy or strokes, but there is often no known cause. The symptoms of a seizure can range from simple staring spells to convulsions and loss of consciousness. The seizures can also vary in frequency, although in order to be diagnosed with epilepsy you must have had two unprovoked seizures.
Epilepsy is primarily treated with medications, which are successful in reducing the frequency and severity of seizures in more than half of epilepsy patients. However, even mild seizures can be dangerous if they happen at certain times, such as when you’re driving or swimming, and could limit your ability to perform some work activities.
Can You Qualify for Disability Benefits Because of Epilepsy?
Adults with epilepsy may be eligible for Social Security disability benefits. The Social Security Administration (SSA) evaluates epilepsy according to the type, frequency, duration, and nature of the seizures. Because epilepsy isn’t necessarily disabling if it’s well-controlled, you will need to prove that your epilepsy interferes with your daily activities even though you’ve taken anticonvulsant medications as prescribed for at least three months. You’ll also need to show that any alcohol or drug use isn’t contributing to your medication’s lack of effectiveness.
When you file for benefits, a claims examiner, and sometimes a medical consultant, will be assigned to review the evidence and determine if you’re eligible for benefits. They will be looking for the following items in your records:
- a diagnosis of epilepsy
- a detailed description of your typical seizure, including all pre- and post-seizure symptoms
- a statement from your doctor corroborating your account of the nature and frequency of your seizures
- a description of your seizures from a third-party witness
- a record indicating the frequency of your past seizures
- results of an EEG, and
- a detailed treatment history, including medications and other treatments that you’ve tried and your response to them.
Qualifying for Benefits Under the SSA’s Official Listing for Epilepsy
The SSA provides a list of the requirements to qualify for disability benefits based on epilepsy, listing 11.02. (When the SSA updated its listings in September 2016, it combined listing 11.02 for convulsive epilepsy and listing 11.03 for nonconvulsive epilepsy.) The criteria you need to meet to qualify under listing 11.02 depend on the type and frequency of your seizures.
You will now need to show that you suffer from:
- generalized tonic-clonic (grand mal) seizures that occur at least once a month for three consecutive months, or
- dyscognitive seizures that occur at least once a week for three consecutive months.
Less Frequent Seizures
If you have less frequent seizures, you may be able to qualify if you also have a "marked" (severe) limitation in one of the following areas:
- physical functioning, such as standing, balancing, or using your arms and hands
- understanding, remembering, or using information in work activities
- interacting with others
- concentrating, persisting, or maintaining pace, or
- controlling emotions and behavior and maintaining well-being in a workplace setting.
In this case, you must suffer from:
- generalized tonic-clonic seizures that occur at least once every other month for four consecutive months, or
- dyscognitive seizures that occur at least once every other week for three consecutive months.
The requirements are a bit different for children with epilepsy; see our article on disability for children with epilepsy for more information.
Qualifying Under Medical-Vocational Guidelines
If you don’t quite meet one of the listings above (for example, say you have complex partial seizures once a month,) you could still be eligible for benefits if the symptoms of your epilepsy interfere with your activities to such an extent that there are no jobs that you could safely and consistently perform. When making this determination, your claims examiner will not only analyze your medical condition and symptoms, but will also consider other factors, including:
- your age
- your level of education
- your transferable work skills
- any other medical/psychiatric conditions that affect your ability to work, and
- any restrictions that your doctor has given you, such as no driving, no working around machinery, and so on.
However, keep in mind that in order to qualify for disability benefits, you need to be unable to perform any work on a full-time basis. Showing that you are unable to do your previous jobs is not sufficient to be awarded benefits.
In general, being older, with less education, and fewer transferable work skills will increase your changes of being awarded benefits. Having additional conditions that negatively affect your ability to work can also increase the likelihood of your application being improved, as will having a treating doctor who's supportive of your claim and willing to provide a comprehensive statement or fill out a questionnaire regarding your inability to work. For more information, see our section on the medical-vocational rules. Also, you may want to read our tips on how to get disability for epileptic seizures.