Speech Disorders and Getting Disability

There are many different types of impairments that can interrupt one's ability to speak and be understood by others, which can affect one's ability to work. The causes of speech impairments are diverse. They can be caused by physical impairments, damage to the nerves or part of the brain that controls speech, or diseases, such as Parkinson's disease or ALS.

Causes of Speech Impairments

Some speech impairments appear in adulthood, including those caused by stroke, traumatic brain injury, or brain tumors, or those caused by laryngectomy (removal of the larynx, or voicebox) and glossectomy (removal of the tongue) to treat cancer caused by smoking or chewing tobacco. Other problems can be present since childhood, including cleft-palate-caused hypernasality and cerebral-palsy-caused dysarthria. Any of these problems can make it difficult to produce useful speech.

Types of Speech Impairments

Some of the types of speech impairments include:

• Dysarthria, a physical weakness or paralysis of the speech muscles caused by nerve or brain damage.
• Dysprosody, characterized by changes in the intensity of volume, timing of words, and rhythm and intonation of words while speaking.
• Articulation disorders, difficulties with physically learning how to produce sounds.
• Phonemic disorders, difficulties learning the different sounds in language and how one sound may be used in many places. It is common for individuals to have both articulation and phonemic disorders together.
• Voice disorders, physical impairments with your larynx or vocal resonance.
• Apraxia of speech, the inconstant production of sound and the rearranging of sounds within words.
• Aphasia, characterized by difficulty using words and sentences.
• Muteness, an inability to speak.
• Stuttering.

Qualifying for Disability Benefits With a Speech Disorder

If your speech impairment is so severe that it affects your ability to function and maintain a job, you may be able to receive Social Security disability benefits. You can qualify for Social Security disability benefits by doing one of two things.

Meet a listing. 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, which is a list that describes impairments that are predetermined to be disabling.

Be unable to perform any job. To show an inability to perform any job, you must show that your impairment limits you so much that you're unable to perform any job safely due to your impairment. If you have recently lost your ability to speak effectively and you can't do your prior work, Social Security will look at your age, education level, and work experience to see if you can adjust to other types of work.

Meeting a Disability Listing

There is a disability listing in the Blue Book that specifically addresses loss of speech (2.09). To meet the listing, your medical records must show that you have an inability to produce speech that can be:

• heard
• understood, and
• sustained.

If you are able to use esophageal speech or electronic devices such as an electrolarynx to articulate well enough to be heard and understood, you won't meet this listing. You don't need to have a specific cause of the speech impairment to meet this listing; the only important information is that your speech is not effective for communicating with others.

Note that if your speech problems are due to stroke, TBI, or cerebral palsy, your impairment will likely be evaluated under the stroke listing, the TBI listing, or the cerebral palsy listing. If your speech problem is due to a mental disorder, your impairment will be evaluated under the mental illness listings. Only if your speech difficulties are related to the physical structures of speech (the larynx, tongue, and pharynx) will Social Security use the loss of speech listing to evaluate your speech impairment.

How Speech Affects Your Ability to Work

If you don't meet the requirements of the listing for loss of speech or another listing, but your speech impairment is considered severe (it has more than a minimal effect on your ability to do work activities), Social Security must assess how your impairment affects your work by using a Residual Functional Capacity (RFC) form. Your RFC assessment will include your ability to hear, speak, feel, or adapt to your environment. For those with speech impairments, a severe communication barrier would make it difficult to complete many tasks, including talking on the phone, speaking with customers or coworkers, receiving direction from supervisors, or otherwise interacting with individuals in any way that requires speech.

Your RFC might also assess your mental abilities, which include your ability to understand and complete tasks in a timely fashion, interact properly with those you work with, respond properly to supervision, and properly handle the stresses present at work. Your inability to be understood may hinder your ability to understand tasks, especially if you can't ask questions to gain a better understanding of what you need to do. Additionally, the inability to be understood may increase your anxiety and frustration and thus affect your ability to properly respond to others in appropriate ways.

If you have other physical impairments, your RFC might also assess your physical abilities. For instance, if your speech impairment is caused by a greater disease or illness such as a traumatic brain injury (TBI), other physical impairments caused by the TBI will be included.

At the least, your RFC should state that you can't do work requiring good speech, such as a teacher, a salesperson, a police dispatcher, or a disc jockey. If your prior job required good speech, or even had a unique feature that required special voice abilities, and you can no longer do the job because of your speech problem, Social Security will assess whether there is other work you can do. If you are older and don't have much education or transferable job skills, Social Security may not expect you to adjust to another type of work. For more information, see our article on medical-vocational disability allowances.