Speech Disorders and Getting Disability

There are many different types of speech impairments that interfere with your ability to communicate effectively and be understood. Because many jobs require you to respond orally to directions or talk to the public, speech impediments can pose barriers that can rule out most, if not all, work. If you have a speech disorder that keeps you from working full-time for at least twelve months, you might qualify for disability benefits.

Is Speech Impairment a Disability?

Speech impediments alone aren't always enough to qualify somebody for disability benefits. Often, speech impairments can be treated with speech therapy or vocal rehabilitation. Even somebody with a lingering voice disorder, like stuttering or difficulty with volume control, might be able to work in a job that doesn't involve a lot of talking.

But speech impediments are frequently caused by a variety of other disorders that reflect serious damage to the nerves or brain. If your medical record contains evidence of other, related neurological impairments such as Parkinson's disease or amyotrophic lateral sclerosis (ALS), you'll have a stronger claim for benefits such as SSDI or SSI.

Causes of Speech Impediments

Speech impairments frequently appear in adults as a result of a brain injury, tumor, or stroke. Adults who've undergone a laryngectomy (removal of the larynx, or voicebox) or glossectomy (removal of the tongue) to treat throat cancer will likely also have difficulty speaking clearly.

Other speech impediments can be present since childhood, including hypernasality (too much air escaping from the nose while talking, often resulting from a cleft palate) or dysarthria (slurred speech caused by loose vocal muscles).

Types of Speech Impairments

Speech impediments can be categorized into three kinds of disorders, depending on how your ability to speak is affected.

• Fluency disorders cause your speech to be repetitive, with an atypical rate or rhythm. Stuttering is a common fluency disorder, especially in children.

• Voice disorders affect the tone of your voice. You may have difficulty controlling the volume or pitch of your voice, or sound like you have a foreign accent (dysprosody).

• Articulation disorders result in distortion or mispronunciation of certain sounds (phonemes) within words or sentences (apraxia of speech or aphasia).

Muteness—the complete absence of speech—can be the result of a physical or mental trauma. In children, muteness may be associated with language delays that signal developmental disorders such as autism or Down syndrome.

Qualifying for Disability Benefits With a Speech Impairment

If your speech disorder is so severe that it affects your ability to function and maintain a job, you may be able to receive disability benefits from the Social Security Administration (SSA). You can qualify for Social Security disability benefits in one of two ways:

• Meet a listed impairment. To "meet a listing," you must show that your impairment meets all of the requirements of a disability listing in the Social Security Blue Book, a classification of disorders that the SSA has already determined to be disabling.
• Be unable to perform any job. You can get disability if you can show that your impairment causes functional limitations that prevent you from doing any job safely. If you're over the age of 50 and you can't do your past work, the SSA will look at your age, education level, and work experience to see if you can adjust to other types of work.

Getting Disability Benefits by Meeting the Listing for Loss of Speech

The Blue Book has a listing for loss of speech (2.09). To qualify for benefits under listing 2.09, your medical records must show that you can't produce speech that can be heard, understood, and sustained. If you can use esophageal speech (a technique that allows you to talk without using the vocal cords) or a device such as an electrolarynx (a machine that converts vibrations from your throat to sound) well enough to be heard and understood, you won't meet this listing.

The listing doesn't require a specific reason why you have a speech impediment. But because speech impairments are commonly the result of a different disorder—such as cerebral palsy—Social Security will likely evaluate your application for benefits under the relevant listings for your underlying conditions. It's difficult to meet listing 2.09 on its own unless you can show something wrong with the physical mechanisms of speech (the larynx, tongue, and pharynx).

Getting Disability When Your Speech Impairment Keeps You From Working

Even if you don't meet the requirements of a listing, you can still qualify for disability benefits if you can show that your speech impediment prevents you from working at any job full-time.

Social Security will review your medical records for any limitations resulting from your speech impairment to determine your residual functional capacity (RFC).

An RFC is a set of restrictions on the most you're capable of doing in a work environment. Restrictions can be exertional (limits on how much you can lift, carry, stand, and walk) or non-exertional (limits on the types of tasks you can perform and where you can perform them). People with speech impediments will have an RFC that includes their ability to hear, speak, feel, and adapt to their environment.

Your RFC should contain restrictions on how often you can communicate with others and what tools you should avoid using. Examples of these limitations include:

• talking on the telephone
• whether you can be heard in a factory, warehouse, or office setting
• speaking with customers or coworkers, and
• giving directions without having to repeat yourself.

Your RFC might also reflect limitations in your mental abilities, such as understanding and completing tasks in a timely fashion, interacting with your coworkers, responding properly to supervision, and handling normal work stress. For example, if you're having difficulty making yourself understood, you might need to ask extra questions to better understand job tasks. Being frequently misunderstood can also increase your anxiety and frustration, which could cause inappropriate outbursts at work.

Social Security must consider all of your combined impairments when determining your RFC, so if you've been receiving treatment for other physical or mental conditions, make sure to let the agency know. The SSA will (with your permission) request your medical records, including any diagnostic tests your doctor has conducted that confirm your speech impediment.

How to Apply for Disability Benefits for a Speech Impairment

Social Security provides several methods for you to start your application for benefits.

• File online at ssa.gov. Note that people filing for SSDI can complete their entire application online, but if you're filing for SSI, you'll need to speak with a representative from Social Security before you finish your application.
• File over the phone by calling 800-722-1213 from 8 a.m. to 7 p.m. Monday through Friday. If you're deaf or hard of hearing, you can use the TTY number at 800-325-0778.
• File in person at your local Social Security field office.

Even if you're just starting your initial application for disability benefits, consider getting help from an experienced disability attorney or advocate. Your lawyer can help gather and submit your medical documents, handle communications with the SSA, and represent you at a disability hearing.