Social Security Disability for Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) is a type of brain dysfunction caused by a violent blow or head injury. TBIs are classified into two categories: penetrating and non-penetrating. Penetrating TBIs happen when an object goes through brain tissue, such as a bullet or bone fragment. Non-penetrating ("blunt force") TBIs are the result of an external force strong enough to move the brain around inside the skull, like a car accident, fall, or sports injury.

Cognitive and physical changes can result from a TBI. Some of these changes might manifest immediately after the traumatic event, while others take longer to develop. Repeated head injuries may cause a type of brain degeneration called chronic traumatic encephalopathy (CTE). Severe, long-term changes in your mental and physical abilities can make it difficult to complete basic tasks and hold down a job.

Is Traumatic Brain Injury (TBI) a Disability?

The Social Security Administration (SSA) recognizes that some symptoms of a traumatic brain injury can have a serious and permanent impact on your ability to work full-time. Recovery time for severe TBIs can take a year or more. If symptoms from your TBI or CTE keep you from working at the level of substantial gainful activity, you could qualify for disability benefits.

Symptoms of Traumatic Brain Injury

Because TBIs result in damage to the brain, they can have an effect on a wide variety of body systems. The most common symptoms fall into three categories: physical, mental, and sensory.

Physical symptoms of TBI include:

• persistent headache or migraine
• vomiting or nausea
• convulsions or seizures
• dizziness or loss of balance, and
• muscle weakness, numbness, or loss of coordination.

Mental (psychological or cognitive) symptoms of TBI include:

• mood changes or mood swings
• difficulty with memory or concentration
• confusion, and
• agitated, combative or other unusual behavior.

Sensory symptoms of TBI include:

• sensitivity to light or sound
• blurred vision, ringing in the ears, or a bad taste in the mouth
• changes in the ability to smell, and
• slurred speech.

Very severe traumatic brain injuries can cause a temporary or permanent change in consciousness, such as a coma, vegetative state, or brain death. (People who've been in a coma for 30 days or longer can receive a quick approval of disability benefits under Social Security's terminal illness program.)

Diagnosis and Treatment for TBI

Doctors determine how severe the damages to the brain are by reviewing imaging like a CT scan or an MRI. Your disability application should contain documentation of such medical imaging, so that the SSA knows that you've been diagnosed with a traumatic brain injury.

Treatment for TBI will vary depending on the results of the imaging. Mild cases might resolve after a few days or weeks of rest, but moderate to severe TBI can require more invasive procedures or intensive therapy.

• Medications such as diuretics may be prescribed that reduce pressure on the brain due to fluid buildup. Anticonvulsants can help lower the elevated risk of seizures after TBI.

• Surgery might be needed to minimize damage to brain tissue. This includes repairing skull fractures, stopping bleeding in the brain, and removing clotted blood (hematomas).

• Rehabilitation is common for people with TBI to relearn basic skills. Physical therapists may be needed for mobility struggles, while neuropsychologists can improve brain function.

When you submit your application for disability benefits, make sure that you provide Social Security with the names, dates, and locations of all the medical providers you've seen for your TBI. The agency will want to see admission and discharge dates of any hospital stays, as well as progress notes from your doctors, neurologists, and rehabilitation specialists.

How Do I Get Disability for TBI?

You can qualify for disability benefits for traumatic brain injury in one of two ways:

• meet the criteria of the neurological listings for TBI ("medically disabled"), or
• show that your TBI symptoms keep you from doing any jobs ("vocationally disabled").

Qualifying for Disability Under the Listing for TBI

TBI is one of Social Security's Blue Book of listed impairments, disorders that the SSA has already determined are serious enough that applicants who meet the agency's requirements can get disability benefits "automatically" without needing to show that they can't work.

You can meet the requirements of Listing 11.18 for traumatic brain injury if your medical records contain evidence of the following limitations for at least three months in a row after your injury:

• you're having so much trouble using at least two of your extremities—your arms, legs, or both—that you're unable to perform basic movements like standing up from a seated position without help, or
• you can move independently (but with great difficulty) and you're also having significant challenges with mental activities such as interacting with others, finishing tasks, or adapting to changes.

If you suffered a TBI but don't have lasting physical problems, your condition would be evaluated under listing 12.02 for neurocognitive disorders. For more information, see our article on getting disability for a neurocognitive disorder.

Qualifying for Disability by Showing That You Can't Work Due to TBI

You can still get disability benefits even if Social Security doesn't find that you meet (or "equal") the requirements of the above listings. The SSA will look at your functional limitations to determine what you can and can't do in a work environment, a process the agency calls assessing your residual functional capacity (RFC).

Depending on your TBI symptoms, your RFC will likely contain descriptions of physical and mental activities that you should avoid doing at work. For example, if you have trouble with muscle weakness, your RFC might state that you should avoid lifting more than 10 pounds or walking more than two hours total out of an 8 hour day. Any difficulties you have with focus and concentration could be reflected in being limited to unskilled jobs.

The more severe your symptoms are, the more limitations you'll have in your RFC. Multiple moderate limitations in several functional areas might make you unable to work—even though you don't have marked or extreme limitations in any one area—particularly if you have other physical conditions in addition to your TBI.

Social Security uses your RFC to determine whether you're capable of returning to any jobs you've done in the past. If you can't do your past work and you're over 50, you might qualify for disability under a special set of rules known as the medical-vocational grid. For people under the age of 50, the SSA will need to see that you can't do even the easiest, least stressful jobs.

How to Apply for Disability Benefits Based on TBI

You can begin your application for Social Security disability benefits using the following methods:

• File online at the SSA's website.
• Call the SSA at 800-722-1212 from 7 a.m. to 7 p.m. Monday through Friday. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.
• Visit your nearest Social Security field office and apply in person.

If you'd like assistance with your application, consider getting help from an experienced disability attorney or advocate. Your lawyer can gather the evidence needed to document your TBI, request medical source statements from your doctors, and represent you at a disability hearing.

You can get a free consultation from a disability law firm here.

_{Updated January 26, 2023}