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 CVA vary, but can include:

• difficulty speaking and swallowing
• muscle weakness and numbness (usually affecting one side of the body)
• trouble seeing and visual changes such as blurred or double vision, and
• paralysis or difficulty walking.

For some people, damage to the brain from a CVA is temporary, but for others it's permanent. (If you've suffered TIAs but not full-blown strokes, please see our article on transient ischemic attacks.) About 75% of stroke victims have residual effects from stroke, and these effects can make it impossible to work.

Can I Get Social Security Disability for a CVA?

If you've been unable to work full-time for at least one year because of a stroke, you might qualify for disability benefits. You can be approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) because of the effects of a stroke by either:

• meeting the requirements of the Blue Book listing for CVA, or
• having functional limitations that rule out all available work.

Getting Disability Using the Stroke Listing

The Social Security Administration (SSA) maintains a list of conditions (called the Listing of Impairments, or the "Blue Book") that the agency considers especially serious. Applicants who have certain evidence in their medical record that the SSA has already determined is enough to find them disabled can be awarded benefits without having to show that they can't do any work.

The SSA evaluates applications ("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 CVA. This requirement helps Social Security distinguish people who can make a speedy recovery from their stroke from people who will continue to have trouble with the residual effects indefinitely.

Getting a Medical-Vocational Allowance Based on Stroke

Not many people with residual effects from a CVA will be so restricted in their functioning that they meet the requirements of the listing for stroke. 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 review your treatment notes, hospital admission and discharge summaries, lab results, imaging studies, and doctor's statements for evidence of your physical and mental limitations. The agency will use this information to make an assessment of your residual functional capacity (RFC). Your RFC reflects the SSA's opinion on how much you can still do after your stroke.

An RFC for Stroke

You can help Social Security get an accurate RFC by telling your doctor what you can and can't do. Make sure that your doctor's notes include information such as:

• whether you can walk upstairs
• how long you can sit, stand, or walk,
• whether you can use your hands to button your shirt or type on a computer keyboard
• whether you have difficulty with balance
• whether you have trouble reading or speaking, and
• whether you have difficulty understanding directions or remembering.

Having your doctor document these factors will influence Social Security's opinion of what type of work you can do.

Your RFC and Past Relevant Work

The SSA 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.

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 medical-vocational 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 CVA to light work, and has no transferable skills, wouldn't be approved for disability at age 53, but could be approved at age 55.

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.

Your limitations can also negate skills you've previously learned. 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.

For more information on getting a medical-vocational allowance, see our section on RFCs and the medical-vocational rules.

Getting Disability Due to Vision Loss From a Stroke

A small percentage of stroke patients experience a loss of vision after a CVA. The most common type of vision loss following a 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 CVA, 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.