A stroke can be caused by a brain hemorrhage (hemorrhagic stroke) or a blocked blood vessel (ischemic stroke), which in turn cause a lack of blood flow to the brain and result in injury. The effects of a stroke vary, but can include difficulty speaking, walking, and seeing. Most stroke patients suffer from some sort of muscle weakness, which usually affects one side of the body, as well as numbness and loss of sensations. For some people, the damage is only short term, for others it is irreversible. About 75% of stroke victims are residual effects from stroke, and for some, these effects make it impossible to work.
Can you be approved for Social Security disability or SSI on the basis of having had a stroke? As with any disabling condition, you can be approved by meeting the requirements of Social Security's disability listing for that particular condition or on the basis of a medical-vocational allowance (which compares your functional limitations to the vocational skills required by a job).
Timing of Social Security's Decision
An important fact to consider in a disability claim for stroke is this: if you apply for Social Security disability or SSI soon after having a stroke, you won't get an immediate answer on your claim. While most initial claims for disability benefits take several months to adjudicate, stroke cases can take even longer due to the fact Social Security defers them for a period of at least three months (this is also the case with claims involving heart attacks).
Social Security defers cases because the residual effects of a stroke (that is, the limitations caused by a stroke) can be nearly impossible to measure in the short time following a stroke. Everyone recovers differently, depending on age, other medicals conditions, and other risk factors, and medical science is not advanced enough to allow for a reliable projection as to how a particular stroke victim may recover from a stroke.
Getting Disability Using the Vascular Accident Listing
Strokes were previously called cerebral vascular accidents, which simply means damage to a blood vessel in the brain. Social Security still calls the disability listing under which stroke is evaluated "Central Nervous System Vascular Accident," which can be found under neurological impairments. This disability listing is short and to the point. Translated into plain-English, it says that to get disability on the basis of stroke, you must not be able to:
- speak or write effectively due to either sensory aphasia (fluent, nonsensical speech and inability to understand, also called receptive aphasia) or expressive aphasia (difficulty forming words, also called motor aphasia), OR
- control the movement of two extremities (either an arm and a leg or two arms or two legs), causing serious problems walking and balancing or using your hands to grasp and manipulate objects.
Ask your doctor fill out this listing form for stroke if you think you qualify, and submit it to Social Security.
If you've suffered TIAs but not full blown strokes, see our article on transient ischemic attacks.
Getting Disability Due to Vision Loss
A small percentage of stroke patients experience a loss of vision following a stroke. The most common type of vision loss following stroke is hemianopia, where a person loses sight in half of each eye’s visual field. For some stroke victims, this vision loss improves in a months following a stroke, but for others it doesn't. You can qualify for disability benefits for hemianopia and other vision loss if your vision tests meet Social Security's standard for legal blindness in its vision disability listing. For more information, see our article on getting disability for visual field loss.
Getting a Medical-Vocational Allowance Based on Stroke
If your condition doesn't satisfy the requirements in either of the listings above, you may be able to get disability benefits through get a "medical-vocational allowance," an approval that is made when it has been determined that you cannot return to your past work or perform a suitable type of other work.
This type of approval will take into account the kinds of jobs you have worked in the past, especially to see what the exertional nature of the work was (that is, did it involve heavy, medium, or light exertion). To determine whether you can still do the same type of work, Social Security will create an RFC for you, which is an assessment of you "residual functional capacity" -- how much there is remaining that you can do after your stroke.
To assess your RFC, Social Security will look to your medical records to see what common stroke-caused impairments you have. A claims examiner will review treatment notes, admission and discharge summaries, lab and imaging studies, and also supporting statements from your treating physician(s). Make sure you take notes for your doctor on what you can and cannot do: whether you can walk up stairs, how long you can stand walk, whether you can use your hands to button your shirt, type on a computer keyboard, and so on.
If your doctor has documented that you have trouble walking, muscle weakness, difficulty with balance, difficulty reading, difficulty understanding directions or remembering, these factors will influence Social Security's opinion of what type of work you can do. If you have muscle weakness in your leg, for example, and you can't stand for six to eight hours per day, you will be able to do only sedentary work. If your old job required light, medium, or heavy exertion, you won't be able to go back to it.
If you can't go back to your past work, Social Security will try to propose other work you can do. A medical-vocational analysis will take into consideration any skills you used on past jobs to determine whether or not you have skills to transfer to "other work." But your limitations can negate the skills you have, if you can no longer do the tasks. For instance, say you are limited to sedentary work and you have experience with clerical work. To work at most sedentary jobs, you need to have good control over both hands. If you have a weakened arm, and you can't use that hand to grasp and lift objects or do things requiring coordination, such as typing, you won't be able to do many desk jobs. In this case, you don't have any transferable skills and your RFC might be for "less than sedentary" work.
For older individuals, age can be crucial because of the way the medical-vocational rules work. At older ages, the rules that are used to make a medical-vocational allowance make it easier to qualify for disability. For example, a disability claimant with a history of medium work who has been limited to light work and who has no transferable skills wouldn't be approved for disability at age 53, but could be approved at age 55.
For more information on getting a medical-vocational allowance, see our section on RFCs and the medical-vocational rules.