SSDI & TBI: Gaining Disability Benefits After a Traumatic Brain Injury

    

A fall on an icy sidewalk. A car wreck. A gunshot wound, an assault. Whatever the initial cause of your traumatic brain injury (TBI), it was an unexpected accident, and your life has now changed in significant and dramatic ways. Social Security Disability Insurance (SSDI) may be a way to help offset the financial strain that comes with an unexpected disability like a TBI. 

The diagnosis of a TBI from a doctor will mean many things for your life. Treatments may include rest, which may mean you are unable to work for a period of time, or indefinitely. Treatments may also include surgery, medication, cognitive therapy, and rehabilitation. You may also require treatment for unexpected symptoms, including anger management and psychological counseling. Whatever treatments and therapies that you may incur, SSDI may be a lifeline to help you and your family cope with the new changes in your health. 

What is Social Security Disability Insurance? What is Social Security Disability Insurance

Social Security Disability Insurance (SSDI) pays for total disability, and does not have programs for partial or short-term disability benefits. The Social Security Administration (SSA) considered someone unable to work if they meet the following criteria

  • You can’t do the work you were able to do before your disability worsened.
  • It’s determined that you can’t do other work because of your medical condition.
  • In addition to your past work history, you must also provide documentation that you cannot do any work in the economy either now, or in the future.
  • Your disability has lasted, or is expected to last, for at least one year, or to result in your death.

Does My Medical Condition Satisfy the Requirements for Disability?

The SSA has created a list of qualifying disabilities, both mental and physical, that qualify for full monthly benefits. You may still receive benefits if your condition is not on this list, but only if you can prove that your condition is severe enough that you are unable to work in the national economy. 

A TBI is classified under listing 11.18 (Neurological), but your medical records must show extreme limitations. Extreme limitation means the inability to stand up from a seated position, maintain balance in a standing position and while walking, or use your upper extremities to independently initiate, sustain, and complete work-related activities. The assessment of motor function depends on the degree of interference with standing up; balancing while standing or walking; or using the upper extremities (including fingers, hands, arms, and shoulders).

It’s common for the Social Security Administration to deny claims for disability. In fact, up to 64% of all claims are denied on their first attempt at benefits. Having the best legal advocate can help you know your rights, prepare your medical evidence, and prepare you for a hearing regarding your claim. 

How Does the SSA Determine if I’m Disabled?

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The SSA goes through a series of steps to determine your ability to work. After all, every case is unique. By seeking legal representation, you can align yourself with specialists who can help you navigate the steps to gaining full disability benefits. With a TBI, it’s important that you allow your attorney to be your 

advocate in legal matters, just as your physician is your advocate regarding your health. 

The thought of not working for a year due to your disability may feel unmanageable. However, once you qualify, you may be eligible for past-due benefits. Your disability attorney will only receive payment if you win your case, and their fee will come from the past-due benefits you are awarded, with a maximum fee of 25% not to exceed $6000 in most cases. By having the right Social Security disability attorneys working for you, you are more likely to have your claim approved.

Here are the questions asked by the SSA to determine if you can be considered disabled:
  • Are you working?
    • If you’re currently earning $1310 or more per month in 2021, you aren’t considered disabled by the SSA, and the agency will not even review your medical records to determine your medical disabilities. In addition, if you are working at amounts less than $1310, the SSA has every right to consider how your work activity shows your ability to function. This is true for part-time work, as well. 
  • How severe is your condition?
    • If your medical impairments have more than a minimal impact on your ability to work, then you have a severe impairment. If you’ve been unable to perform basic job functions like lifting, standing, walking, sitting, and remembering for 12 months, your condition is considered severe enough for you to receive benefits. 
  • Is your condition on the list of disabling conditions?
    • If your disability meets the extremely high thresholds for listing levels of severity, you will be considered for disability. If not, you’ll have to move on to Steps 4 and 5 of the process. If you meet a listing according to SSA, the analysis ends, and you will not move on to Steps 4 or 5. 
  • Are you able to do the work you’ve done in the past?
    • If you can no longer work in a field where you have previous experience because of your disability, this is only half the battle. 
  • Can you do another type of work? 
    • Even if you can’t work in a field where you have previous experience, but you can do other work as defined by the SSA, you are not considered eligible for disability benefits. Attaining the ages of 50 and 55 can change the need to prove that you cannot do any other work. The SSA recognizes that it is harder to transition to other work as a person ages. This is a complicated legal standard that a skilled attorney can navigate for you. 

If your Social Security Disability claim has been denied, or you’re thinking about filing and don’t know where to start, Affleck and Gordon can help. We’ve been helping people in Georgia just like you for over 40 years. Sign up for a free case evaluation here, or call us (404) 373-1649.



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