Traumatic brain injury (TBI) is an acute injury suffered by the brain, and can be caused by various events, the most common causes being car accidents, falls, and firearms. The injuries sustained from a TBI can vary from mild temporary amnesia to permanent coma. Some impairments may heal over time, and some functions may be regained some through therapy, while other impairments will not improve -- or they actually get worse over time.
Social Security Disability Benefits for TBI
TBIs are specifically listed in the Social Security listing of impairments (called the "blue book") under the cerebral trauma listing. Taking into account the wide range of impairments that a TBI may cause, the cerebral trauma listing simply refers to the medical guidelines of other impairments, including seizure disorders and strokes. If your symptoms match the requirements for one of those listings, you will be automatically approved for disability for cerebral trauma. The referred to listings and requirements are outlined below.
To qualify as disabled under epilepsy (under which all seizure disorders are evaluated), you must have seizures of a certain frequency and type. Your doctor must describe a typical seizure and indicate how much of the description is based on personal observations and how much is is based on others' observations. For more information, see our article on disability requirements for epilepsy.
Central Nervous System Vascular Accident
If you've had a a stroke or strokes, you may be able to qualify for disability under the listing for central nervous system vascular accidents. To qualify, you must have one of the following, more than three months after the accident:
- Trouble with language resulting in ineffective speech or communication, or
- Significant and persistent disruption of the use of arms or legs that interferes with walking and/or the use of fingers, hands, and arms.
For more information, see our article on disability requirements for stroke.
Organic Mental Disorders
To qualify as disabled under the listing for organic mental disorders (cognitive or emotional changes resulting from brain damage), you must demonstrate a change in cognitive abilities, disorientation, personality changes, or mood changes that limits your daily activities, social functioning, or ability to concentrate.
You can also qualify if your IQ is 15 points less than before your accident, or if it is within the severely impaired range on neuropsychological testing. For more information, see our article on requirements for disability based on low IQ.
Ability to Work
If Social Security does not find you disabled under one of the above listings, Social Security will evaluate whether you are able to work. Social Security will assess your physical, mental, and sensory limitations using a residual functional capacity (RFC) form. This RFC form notes all of the limitations that can affect your ability to work.
For those with a TBI, there is often a change in mental and/or physical function that can prevent the return to a previous job.It is important to know, however, that an inability to return to one’s previous job is not enough to collect Social Security disability benefits. Using a predetermined formula, Social Security will also assess your ability to work any job based on your impairments, age, education, and work experience.
TBIs are different than most other illnesses or diseases in that it can be difficult to make a long-term prognosis about an individual's prospects. Social Security has taken into account the high variability associated with TBIs. With many other disabilities, applicants can not receive disability benefits until they have been disabled for over twelve months. However, with TBIs, an individual who sustains profound neurological impairment may be found disabled within three months post injury. If a finding of disability is not possible three months post injury, the applicant will be reassessed when evidence of neurological or mental impairments is received by Social Security at a later point. If there is still not finding of disability, an individual may be reassessed again at six months post injury.