Disability & Hydrocephalus: Social Security Benefits

Hydrocephalus is a buildup of cerebrospinal fluid (CSF) in the cavities deep within your brain. Having the right amount of cerebrospinal fluid inside your skull is essential to brain health.

CSF surrounds your brain, allowing it to float within your skull. That protects your brain from injury by providing a cushion. Cerebrospinal fluid also:

• provides nutrients to your brain
• removes waste products, and
• regulates the pressure on your brain.

Cerebrospinal fluid is a clear, colorless liquid—one reason hydrocephalus used to be called "water on the brain." Having too much CFS puts extra pressure on your brain, which can damage it, leading to symptoms that can be debilitating and even life-threatening.

What Are the Different Types of Hydrocephalus?

Two types of hydrocephalus affect adults:

• hydrocephalus ex-vacuo, and
• normal pressure hydrocephalus.

Hydrocephalus ex-vacuo is caused by damage to the brain from a stroke or some type of traumatic brain injury. Normal pressure hydrocephalus can occur in people of any age and is a slow-moving, progressive fluid buildup in the skull. Normal pressure hydrocephalus has many possible causes, such as:

• head injuries
• brain tumors
• infections, or
• bleeding in the brain.

Hydrocephalus can also be associated with Chiari malformations, especially in children.

What Are the Symptoms of Hydrocephalus?

The symptoms of hydrocephalus vary depending on your age. For adults, hydrocephalus can cause any of the following symptoms:

• headache
• blurred or double vision
• problems with balance, coordination, and walking
• nausea and vomiting
• fatigue and/or drowsiness
• loss of memory
• difficulty thinking
• irritability, and
• changes in personality.

Some of the symptoms can get better once the hydrocephalus has been treated. But other impairments are sometimes permanent.

If hydrocephalus isn't treated, symptoms can get worse. The severity of the impairment caused by hydrocephalus is usually directly related to how bad the initial symptoms were and how long it took to get diagnosed and treated.

How Are Hydrocephalus Symptoms Treated?

The most common treatment for hydrocephalus is brain surgery. A neurosurgeon places a shunt (a type of drain) in your brain to allow the excess fluid to drain away.

But the procedure isn't without risk. Severe complications can occur:

• Infections in the shunt can cause:
• cognitive defects
• neurological problems, and
• seizures.
• Obstructions in the shunt and over-drainage or under-drainage of fluid through the shunt can lead to:
• hearing loss
• fatigue
• severe headaches
• muscle weakness, and
• loss of motor function.
• Hemorrhaging can lead to severe neurological problems.

Is it Easy to Get Disability for Hydrocephalus?

The Social Security Administration (SSA) has two types of disability benefits you might qualify to receive based on hydrocephalus symptoms:

• Social Security disability insurance (SSDI) for those who've worked and paid enough Social Security taxes, and
• Supplemental Security Income (SSI) for those with low incomes and few assets, regardless of work history.

You can't get disability automatically for hydrocephalus because it's not one of the conditions included in Social Security's "Blue Book." The Blue Book is a list of impairments the SSA automatically considers severe enough to be disabling.

But there are impairments included in the listings that can arise due to hydrocephalus, and some of the causes of hydrocephalus are also listed conditions. If your condition meets (or "equals" in severity) one of these listed conditions, you'll qualify as disabled.

Neurocognitive Disorder

Hydrocephalus can cause changes in your ability to think or remember things and your mood. The disability listing for neurocognitive disorders (listing 12.02) might apply if you've suffered a drop in IQ or changes in your mental or cognitive abilities that greatly affect your daily functioning. See our article on disability for neurocognitive disorders for more information.

Stroke

Hydrocephalus can cause loss of motor function in any part of the body. The disability listing for vascular insult to the brain (listing 11.04) might apply if you have brain damage from the hydrocephalus that caused speech problems or difficulty walking or using your arms and hands. See our article on getting disability following stroke for more information.

Epilepsy

While hydrocephalus isn't a common cause of epilepsy, shunts can cause seizures. The disability listing for epilepsy (listing 11.02) might apply if you suffer seizures frequently. See our article on getting disability for seizures for more information.

Cerebral Trauma

The disability listing for cerebral trauma (listing 11.18) might apply to impairments caused by hydrocephalus if you have lasting physical problems such as problems with standing or walking. Learn more about getting disability benefits after a traumatic brain injury.

Spinal Cord Disorders

If your hydrocephalus is associated with a spinal cord injury or tumor, you might be approved for disability benefits under the neurological listing for spinal cord disorders (listing 11.08).

Soft Tissue Tumors of the Head and Neck

Hydrocephalus is sometimes caused by tumors in the brain. The listing for brain tumors might apply if you have one or more tumors that are:

• inoperable
• don't respond to treatment, or
• have spread to other areas of your body.

Learn more about getting disability benefits for benign brain tumors and brain cancer.

Medical Evidence Social Security Requires

You'll need ample medical evidence to qualify medically for Social Security disability benefits based on hydrocephalus. Social Security will need to see medical records that support your hydrocephalus diagnosis and explain how your condition limits your physical and mental abilities.

Your file should contain as much of the following as you have:

• your doctor's examination and treatment notes
• your mental health records
• diagnostic imaging reports (MRIs and CTs)
• results from any neuropsychological tests you've had
• information about any treatments you've received, such as:
• hospitalizations
• surgeries, and
• medications you've tried.

Your medical records will need to include evidence that's specific to your hydrocephalus-related impairments. For instance, to meet the listing for neurocognitive disorders, your medical records must include documentation that your cognitive abilities have declined significantly in one or more of the following areas:

• complex attention
• executive function
• learning and memory
• language
• perceptual-motor, or
• social cognition.

Social Security will want to see medical records that establish the history of your impairments and recent records that document your current condition and limitations. Learn more about the type of medical evidence Social Security requires.

When You Can't Work Due to Limitations Caused by Hydrocephalus

Many applicants with hydrocephalus won't meet or equal one of the above listings. Even if you don't meet a listing, you can still qualify for disability benefits based on your hydrocephalus symptoms—if you can show that the limitations caused by your condition make it impossible for you to do any type of work. That includes work you're trained for and work you could be trained for.

Limitations From Hydrocephalus

Hydrocephalus can prevent someone from working because the damage it causes can affect individuals in many areas:

• Problems with balance, coordination, walking, fatigue, muscle weakness, loss of motor function, and seizures can all affect your physical ability to work.
• Difficulty thinking and loss of memory can affect your ability to complete tasks.
• Changes in personality and irritability can affect your ability to respond appropriately to supervision and stress at work or to interact with customers or co-workers.
• Hearing loss and blurred or double vision are sensory limitations that can affect your ability to work any type of job.

How Social Security Assesses Your Limitations

A claims examiner who works for Social Security will look at the physical, mental, and sensory limitations caused by your hydrocephalus to determine whether or not you can perform any type of work. The examiner will create an RFC (residual functional capacity) assessment that details your:

• physical abilities, such as
• standing
• walking, and
• carrying objects
• mental abilities, such as
• completing tasks in a timely manner
• getting along with others, and
• responding appropriately to supervision, and
• sensory abilities, such as seeing and hearing.

Social Security uses this information to determine your RFC in terms of "exertional level"—how much you can physically do given your limitations. Your exertion level is expressed as the kind of work you can still do:

• sedentary work (mostly sitting, with the ability to stand, walk, and occasionally lift up to 10 pounds)
• light work (frequent standing and walking with the ability to push, pull, and lift up to 20 pounds)
• medium work (you can do light work, and you can lift up to 50 pounds)
• heavy work (you can do medium work, and you can lift up to 100 pounds), and
• very heavy work (you can do heavy work, and you can lift more than 100 pounds).

You aren't likely to receive disability benefits if you can do more than light work unless you also have non-exertional limitations, like cognitive difficulties.

How Social Security Uses Your RFC

Social Security will compare your RFC to the types of tasks required to do your past work. For instance, if your prior job was as a janitor, but your hydrocephalus caused you to have trouble balancing and walking, you'd likely receive an RFC for sedentary work. That would mean Social Security wouldn't expect you to be able to work as a janitor anymore.

Next, Social Security would determine if there's any type of work you could learn to do given your:

• age
• RFC
• transferable job skills
• education.

If you're a younger worker with a high school diploma and no cognitive impairments, Social Security will likely find that there is work you could learn to do. But if you're over 50 and you didn't finish high school, you'd likely qualify for disability benefits based on a medical-vocational allowance.

If you have both physical and neurocognitive impairments, Social Security must consider both your physical and mental abilities in determining whether you can still work.

Learn how Social Security assesses neurocognitive and mental impairments to determine your mental residual functional capacity (mental RFC).

How to Apply for Disability Benefits

The fastest way to apply for disability benefits is to file your application online. You can also apply for SSDI or SSI by calling Social Security at 800-772-1213 (TTY 800-325-0778) and making an appointment to apply by phone. But you might encounter long wait times. Or contact your local Social Security field office for an appointment to apply in person.

If you don't qualify for Social Security disability benefits initially—like most people—you can reapply or appeal your denial if your condition becomes worse, as often happens with hydrocephalus.

If Social Security denied your disability application, you might consider speaking with a disability lawyer. An experienced attorney can help you determine what you should do next.

Learn more about hiring a disability attorney to help with your claim.