Social Security Claims
EPILEPSY AND SOCIAL SECURITY
DISABILITY CLAIMS
By: Pitt
Dickey - Attorney
Epilepsy and Social Security
Disability - This column will exam how the
Social Security Administration evaluates Disability Insurance
Claims for people who suffer from convulsive disorders such as
epilepsy. The Social Security Administration (SSA) has a set of
criteria that it uses called Listings to determine whether a
person is eligible for monthly disability insurance
payments.
To obtain payments from the SSA a person must in general have a
health problem that can be expected to last at least one year or
to result in death and be unable to perform any type of
substantial gainful employment.
To simplify the test, it is not
enough that the disabled person can’t go back and perform his
former work for health reasons, the worker must also be unable to
perform any type of full time work that exists in the American
economy.
To see how the SSA reviews claims
that involve persons who suffer from epilepsy it is helpful to
take a brief look at the medical terms used in describing
epilepsy. Epilepsy occurs when nerves in the brain react
abnormally and send recurring abnormal signals to the body. There
are two types of seizures that occur in persons who suffer from
epilepsy.
Grand Mal Seizures
or Generalized Seizures happen when large bursts of
electrical energy go through all of the brain suddenly. Typically
a person having a generalized seizure has symptoms which
can result is a sudden loss of consciousness, the person may fall
down, and undergo a stiffening of the muscles called tonic
contractions. These are usually followed by clonic contractions
in which the persons muscles cause a twitching and jerking of the
persons arms and legs.
Partial Seizures
occur when the electrical disturbance in the brain effects only
one portion of the brain. The partial seizure then effects
just the part of the body controlled by that particular part of
the brain that is having the disturbance. If the seizure starts in
one part of the brain and then spreads through the rest of the
brain it is called a partial seizure secondarily generalized. Some
patients will have a sensation called an aura which is a
change in their feelings or ability to move that gives them
advance notice that they are about to have a seizure.
Partial Seizures are divided into
Simple Partial Seizures and Complex Partial Seizures.
A patient having a simple partial seizure does not lose
consciousness while having the seizure. A person having a complex
partial seizure will have his consciousness effected either by
losing consciousness or even though he may appear to be conscious
he will be in an altered consciousness or dreamlike state and be
unable to respond logically to outside stimulus.
The SSA evaluates all convulsive
disease according to the degree of impairment suffered by the
person according to the type, frequency, duration and after
effects of the seizure on the person. The SSA requires that there
be at least one medical description of a typical seizure
experienced by the person.
The description must include
whether or not the person had the aura sensation, tongue
bites, sphincter control problems, injuries associated with the
seizures, and any post seizure after effects such as weakness or
confusion.
The doctor making the report
regarding the seizure should also indicate which parts of the
seizure description is from his own observations and which part of
the description comes from other sources. If professional
testimony is not available as to witnessing the seizure then other
lay witnesses can provide this information to the SSA.
The epilepsy must also be
documented by at least one Electroencephalogram. (EEG) An
EEG is a recording of the electrical activity in the brain. The
EEG can be used to demonstrate seizure activity in a person’s
brain by reading the electrical activity report.
A person meets the SSA Listing
for major motor seizures such as Grand Mal or psychomotor
seizures if the seizure is documented by an EEG and the detailed
description of the a typical seizure and that the seizures have
occurred more than once per month in spite of at least three
months of prescribed treatment. The patient must also have at
least one of the following:
A. Daytime episodes (with loss of
consciousness and convulsive seizures) or
B. Nocturnal episodes with
residuary effects which interfere significantly with activity
during the day.
The SSA Listing for minor motor
seizures such a petit mal psychomotor or focal must be documented
by an EEG and have a detailed description of a typical seizure
which occurs more frequently than once a week in spite of at least
three months of prescribed treatment. The petit mal seizure must
also have alteration of awareness or loss of consciousness and
transient post seizure manifestations of unconventional behavior
or significant interference with activity during the day.
Further information on
epilepsy can be obtained from the Epilepsy Foundation of North
Carolina, 3001 Spring Forest Road, Raleigh, N.C. 27616.
It should be kept in mind that a
person can still be found to be disabled by an Administrative Law
Judge even if he does not meet a particular listing if he has
health problems that in combination are the equivalent of a
listing. The Judge has the discretion to decide if a person’s
health problems are serious enough to warrant an award of
disability benefits despite not meeting the specific technical
requirements of one of the SSA listings for disability.
Preface: Since Social
Security Disability is directed under Federal law, the information
in this column will apply anywhere in the United States.
However each Office of Hearings and Appeals and District Office
have their own ways of doing things as does the various Federal
District and Circuit Courts. I have kept this column
primarily dealing the the mechanics of how the Social Security
District Offices and Office of Hearings and Appeals evaluates
disability claims.
- Pitt Dickey
Pitt Dickey has practiced law
in Fayetteville since 1978. He has handled SSA disability claims
for over twenty years. He practices with the firm of Smith,
Dickey, Smith, Hasty & Dempster, P.A. at 555 Executive Place
and can be reached at 910-485-8020 or at pitt@smithdickey.com
. Or at the firm web site of www.smithdickey.com
.
Copyright © 2002 Pitt Dickey -
Used with permission
