Getting Social Security Disability or SSI for Stroke

A stroke—also called a cerebrovascular accident, or CVA—occurs when blood flow to your brain is interrupted, either from a ruptured blood vessel (hemorrhagic stroke) or blocked blood vessel (ischemic stroke). Effects from a stroke may vary, but can include difficulty speaking, muscle weakness, blurred or double vision, and trouble walking.

For some people, damage to the brain from a stroke is temporary. People who’ve experienced transient ischemic attacks (TIAs), or “mini-strokes,” may recover with minimal residual effects. But if these effects linger to the point that they interfere with your ability to work full-time for a year or more, you may qualify for Social Security disability benefits. If you think you’ll need at least twelve months following your stroke before you’re ready to go back to work, it’s helpful to learn what evidence Social Security needs in order to award you benefits.

Can I Get SSDI or SSI Disability Benefits After a Stroke?

People who have significant residual effects one year after a stroke may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the two types of federal benefits offered to disabled adults. You’ll first need to establish eligibility for either program according to the non-medical requirements for SSDI or SSI. SSDI eligibility is based on your work history, while SSI is needs-based and subject to certain income and asset limits.

You’ll then need to show that your stroke has resulted in certain functional limitations that either meet the requirements of a Blue Book listing or prevent you from performing any job on a regular basis. If you meet the criteria of an impairment in the Blue Book, you can qualify for SSDI or SSI automatically, without needing to show that you can’t do any work. Getting approved by showing that you can’t do any job is called a “medical-vocational allowance” and is the most common way that people with disabilities qualify for Social Security benefits.

Qualifying for Disability Automatically Under the Stroke Listing

The Social Security Administration (SSA) evaluates claims for disability benefits due to stroke under Listing 11.04, Vascular Insult to the Brain. In order to meet the requirements of this listing, you’ll need to provide evidence that you’re experiencing at least one of the following sets of symptoms:

• You can’t communicate your needs effectively or understand basic commands due to extreme limitations in your ability to understand speech (a condition called “aphasia”).
• You’re unable to perform basic movements in at least two of your limbs (arms and legs), such as getting up from a chair, walking without falling down, and carrying objects, or
• You can perform basic physical movements with difficulty, and you also have significant difficulty with basic mental functions such as attention and memory.

These symptoms need to be present three months after the date of your stroke. This requirement helps the SSA distinguish people who can make a speedy recovery from their stroke from people who will continue to have trouble with the residual effects indefinitely.

Meeting the requirements of a listing can be challenging, but you can increase your chances by going over the listing criteria with your doctor—preferably your neurologist—and having them submit a medical source statement explaining why you meet the listing (if, in fact, you do). Even if your doctor doesn’t think you meet the listing, they can provide some helpful insight into your limitations that could help you get a medical-vocational allowance.

Getting Disability For a Stroke With a Medical-Vocational Allowance

Not many people with residual effects from a stroke will be so restricted in their functioning that they meet listing 11.04. But if your limitations prevent you from returning to your past work or performing any other full-time work, you can still qualify for benefits through a medical-vocational allowance. To determine whether you can work, Social Security will make an assessment of your residual functional capacity (RFC). Your RFC reflects the agency’s opinion on how much you can still do after your stroke.

What Does an RFC For Stroke Look Like?

Your RFC is a short paragraph that outlines what tasks you should perform at work and what tasks you should avoid. A typical RFC for people who’ve had a stroke will likely contain limitations on how long you can sit, stand, walk, and how much weight you can lift and carry. These strength-related restrictions are called “exertional limitations.”

Other restrictions, such as not working at heights or with dangerous machinery, limitations on how long you can type, and whether you can perform skilled, semi-skilled, or unskilled tasks are called “non-exertional limitations.” Your RFC will likely include both exertional and non-exertional limitations. Depending on how severe your residual stroke symptoms are, these combined limitations may or may not rule out all full-time work.

Can You Do Your Past Work With Your Current RFC?

Social Security will compare your current RFC with the exertional and skill levels of your past jobs to see if you could do the same type of work now. For example, if you have numbness in your legs and you can’t stand longer than two hours per day, Social Security can find that you’re only able to do sit-down (sedentary) work. If your old jobs required you to be on your feet for more than two hours a day, you won’t be able to return to them.

Your RFC and Other Types of Work

If you can't go back to your past work, Social Security will ask a vocational expert or consultant if any other jobs exist that somebody with your limitations could perform. For example, if you have muscle weakness in your right arm that makes it hard to pick up objects or do things requiring coordination, such as typing, you won't be able to do many sedentary jobs. The agency might find that you have an RFC for "less than sedentary" work and approve you for disability benefits.

Any mental limitations can also make it harder to apply skills you’ve previously learned. So if you have experience with clerical work but you can't use your arms for fine motor tasks, the SSA can find you disabled because you can’t do a desk job and you don’t have any transferable skills.

Depending on your age, education, and whether you learned any transferable skills, being able to do only sedentary work might be enough for the SSA to find you disabled using the grid rules that make it easier to qualify for disability. The grid rules are more helpful to older people. An applicant with a history of work at the medium exertional level who is limited by her stroke to light work, and has no transferable skills, wouldn’t be approved for disability at age 53, but could be approved at age 55.

Medical Evidence You’ll Need to Prove Disability Due to Stroke

Your medical evidence is the foundation of your disability claim. The stronger your records are—meaning the more they show objective evidence of your residual effects following a stroke—the better your chances are at getting benefits. Ideally, your record should contain most, if not all, of the following documentation:

• clinical notes from your treating doctor containing their observations on how you move around and communicate
• X-rays, MRIs, CT scans, or other objective medical imaging showing evidence that you had a stroke
• medication lists
• ophthalmology records (if your vision has been affected)
• lab results or blood work showing any abnormalities
• hospital admission and discharge summaries
• physical or occupational therapy records, and
• mental status examinations.

You can still get disability benefits without the above evidence, but it’s an uphill battle. For more information, check out our article on applying for disability benefits without a doctor.

How Much Will I Get in SSDI or SSI If I’m Awarded Benefits?

Social Security doesn't award benefits based on the type of medical condition you have. Instead, the amount you'll receive if you're approved will depend on whether you're eligible for SSDI or SSI. You can learn more—and calculate your estimated benefit—in our article on SSDI and SSI monthly check amounts.

What If I’m Not Approved for Disability?

Only about one-third of disability claimants are approved on their first try. Fortunately, you can submit an appeal within 60 days of receiving the denial letter. You’ll probably have to appeal twice before you can have a hearing with an administrative law judge, which is where you have your best chances of getting approved for benefits.

While you aren’t required to have an attorney to apply for benefits or appeal a denial, it’s usually a good idea. An experienced disability lawyer or advocate can help you gather the proper medical paperwork, make sure you don’t miss important appeal deadlines, and represent you at a disability hearing. And because disability lawyers aren’t allowed to charge you if you don't win—and they’re limited to a small percentage of your disability backpay if you do win—there’s little risk in finding a lawyer near you to help with your claim.