As is the case with many disabling impairments, winning a claim for Social Security Benefits based on seizure disorder can be somewhat difficult. Social Security requires that you have frequent seizures that interfere with your activities and that are well documented. Our article on disability benefits for epilepsy goes over the specific requirements for getting disability benefits for generalized tonic-clonic (grand mal) seizures and "dyscognitive" seizures.
The following checklist of tips may be helpful for applicants who are trying to get disability benefits based on a seizure disorder.
Why are the items on this checklist so important? Let's look at each in detail.
Disability applicants who experience seizures on a regular basis often consider that a trip to a doctor or hospital after a seizure has occurred will mean hours of waiting with no appreciable medical benefit. And, more often than not, this may be the case. Nevertheless, since seizure disorder cases are evaluated by Social Security on the basis of how often seizures occur, for disability applicants, it is essential to make these doctor visits. Without them, there is no corroborating documentation in an applicant's medical records—no proof that you have frequent seizures.
Applicants who don't want to go to a medical facility after a seizure because they feel fine should remember that physicians can often detect post-seizure residual effects and will document them in an applicant's medical records.
You should keep a personal record of seizure occurrences so that you can corroborate information from your doctors, family, and friends regarding the frequency of your seizures. Though documentation of this type cannot replace a doctor's records, in most cases a seizure diary will still be reviewed by a disability examiner or administrative law judge, and it can serve to strengthen an individual's claim.
Disability claims examiners often contact applicants to question them regarding their ability to perform normal daily activities (otherwise known as ADLs, activities of daily living). Sometimes they make similar calls to the friends and relatives of disability applicants.
These calls are known as third-party ADL calls, and the information gleaned from these conversations can be used to help claims examiners justify making a denial on claims. It is for this reason that applicants should ensure that the people they list as contacts on the disability application—friends and family—are fully aware of their medical condition and frequency of their seizures.
Disability examiners and judges will review your medical records to learn if you have been prescribed medication. Prescriptions alone can help validate the severity of a medical impairment.
However, when medical records indicate that prescriptions have been written, but the applicant has not been compliant in taking the prescribed medicine, it becomes difficult to win an approval. Generally, this is due to a question this raises in the mind of the disability examiner or judge, which is simply: Would the disability applicant be able to work if he or she took the prescription as directed? This can be a difficult question to answer since some anti-seizure drugs have severe side effects, such as a loss of coordination, speech problems, confusion, fatigue, and vision changes. But lacking an answer, a disability claim will almost always be denied if the applicant isn't taking the prescribed medicine. For more information on this, including some exceptions to the rule, see our article on disability and failing to take your medication.
Claimants with seizure disorder or epilepsy who wish to follow their doctor's prescription regime, but, for lack of finances or medical insurance, cannot do so, should seek local assistance for this purpose. Occasionally, county health departments and municipal free clinics can provide assistance in obtaining needed medications.
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