A stroke can be caused by a brain hemorrhage (hemorrhagic stroke) or a blocked blood vessel (ischemic stroke), which in turn cause a lack of blood flow to the brain and result in injury. The effects of a stroke vary, but can include difficulty speaking, walking, and seeing. Most stroke patients suffer from some sort of muscle weakness, which usually affects one side of the body, as well as numbness and loss of sensations. For some people, the damage is only short term; for others it is irreversible. About 75% of stroke victims have residual effects from stroke, and for some, these effects make it impossible to work.
As with any disabling condition, you can be approved for Social Security disability or SSI because of the effects of a stroke by meeting the requirements of Social Security's disability listing or on the basis of a medical-vocational allowance (which compares your functional limitations to the vocational skills required by a job). We'll take a look at both methods below. (If you've suffered TIAs but not full blown strokes, instead see our article on transient ischemic attacks.)
An important fact to consider in a disability claim for stroke is this: if you apply for Social Security disability or SSI soon after having a stroke, you won't get an immediate answer on your claim. While most initial claims for disability benefits take several months to decide, stroke cases can take even longer due to the fact Social Security defers them for a period of at least three months.
Social Security puts off a decision on these cases because the residual effects of a stroke (that is, the limitations caused by a stroke) can be nearly impossible to measure in the short time following a stroke. Everyone recovers differently, depending on age, other medicals conditions, and other risk factors, and medical science is not advanced enough to allow for a reliable projection as to how a particular stroke victim may recover from a stroke.
Strokes were previously called cerebral vascular accidents, which meant there was damage to brain cells due to a problem with a blood vessel in the head or neck. Social Security calls the disability listing under which stroke is evaluated the listing for "Vascular Insult to the Brain." This listing can be found under the section for neurological impairments. Translated into plain English, this listing says that to get disability on the basis of stroke, you must suffer from one of the following sets of symptoms three months or more after the stroke:
Note that marked means seriously limiting; it is worse than moderate, but less than extreme.
A small percentage of stroke patients experience a loss of vision following a stroke. The most common type of vision loss following stroke is hemianopia, where a person loses sight in half of each eye’s visual field. For some stroke victims, this vision loss improves in a few months following a stroke, but for others it doesn't. You can qualify for disability benefits for hemianopia and other vision loss if your vision tests meet Social Security's standard for legal blindness in its vision disability listing. For more information, see our article on getting disability for visual field loss.
If your condition doesn't satisfy the requirements in either of the listings above, you may be able to get disability benefits through get a "medical-vocational allowance," an approval that is made when it has been determined that you cannot return to your past work or perform a suitable type of other work because of functional limitations.
This type of approval will take into account the kinds of jobs you have worked in the past, especially to see what the exertional nature of the work was (that is, did it involve heavy, medium, or light exertion). To determine whether you can still do the same type of work, Social Security will create an RFC for you, which is an assessment of your "residual functional capacity" -- how much you can still do after your stroke.
To assess your RFC, Social Security will look to your medical records to see what common stroke-caused impairments you have. A claims examiner will review treatment notes, admission and discharge summaries, lab and imaging studies, and also supporting statements from your treating physician(s). Make sure you take notes for your doctor on what you can and cannot do: whether you can walk up stairs, how long you can stand or walk, and whether you can use your hands to button your shirt, type on a computer keyboard, and so on.
If your doctor has documented that you have trouble walking, muscle weakness, difficulty with balance, difficulty reading, difficulty understanding directions or remembering, these factors will influence Social Security's opinion of what type of work you can do. For instance, if you have a weakened arm, and you can't use that hand to grasp and lift objects or do things requiring coordination, such as typing, you won't be able to do many desk jobs. To work at most sedentary jobs, you need to have good control over both hands. In this case, your RFC might be for "less than sedentary" work, and you would be approved for disability benefits. Or, if you have muscle weakness in your leg, and you can't stand for six to eight hours per day, you will be able to do only sedentary work. If your old job required light, medium, or heavy exertion, you won't be able to go back to it.
If you can't go back to your past work, Social Security will try to propose other work you can do. A medical-vocational analysis will take into consideration any skills you used on past jobs to determine whether or not you have skills to transfer to "other work." But your limitations can negate the skills you have if you can no longer do the tasks. For instance, say you have experience with clerical work but you can't use your arms for fine motor tasks; in this case you can't do a desk job and you don't have any transferable skills.
For older individuals, age can be crucial because of the way the medical-vocational rules work. At older ages, the rules that are used to make a medical-vocational allowance make it easier to qualify for disability. For example, a disability claimant with a history of medium work who has been limited to light work and who has no transferable skills wouldn't be approved for disability at age 53, but could be approved at age 55.
For more information on getting a medical-vocational allowance, see our section on RFCs and the medical-vocational rules.