Traumatic brain injuries (TBIs) are serious injuries that often result in permanent damage. It’s common for TBI victims to experience a wide range of unpredictable and disruptive symptoms that interfere with their personal lives and professional careers for months or even years. Many TBI victims wonder whether their injuries qualify them for disability benefits. The reality is that qualifying for disability benefits from Social Security is often difficult, and the effects of a TBI can be difficult for some victims to prove. However, a TBI victim can qualify for disability benefits under certain conditions.
Social Security Disability Requirements for TBIs
The Social Security Administration (SSA) will approve disability benefits for a TBI victim as long as they meet certain requirements. The SSA defines a TBI as brain damage resulting from a closed-head injury, but they will only approve benefits in two ways:
- The victim’s TBI led to the loss of motor control over two of the victim’s limbs, both legs, arms, or one of each. Additionally, the injury must leave the victim unable to balance, walk unassisted, or use their arms.
- The victim’s TBI caused significant physical limitations for at least three months following the injury’s date. Qualifying limitations may include cognitive impairment, such as inability to think clearly, inability to finish tasks or concentrate problems with regulating emotions, responding to demands, or maintaining situational awareness, or difficulty in social settings, such as involuntary displays of socially inappropriate behavior.
The victim will need to provide documented proof of these qualifying circumstances with their Social Security Disability benefits application. Anyone who has sustained a TBI, even a mild one, should keep these qualifying factors in mind. While the SSA generally does not approve disability benefits for victims of mild TBIs, some such victims may qualify for a medical-vocational allowance from Social Security.
Think of a medical-vocational allowance as an alternative for those who do not qualify for disability benefits. The SSA will evaluate the applicant’s condition and determine their residual functional capacity. This metric evaluates whether the applicant can resume their previous job or be capable of securing equivalently gainful employment. If the SSA determines the applicant’s residual functional capacity is too low for them to qualify for gainful employment, they will likely approve their medical-vocational allowance.
Filing Your Social Security Claim
If you intend to seek Social Security benefits of any kind for a TBI, it is essential to have the right documentation to support your claim. Typically, this means gathering several documents from your medical providers and records of your treatment. You should plan to secure:
- Copies of your emergency room visit records.
- Your physician’s clinical notes from all visits related to your TBI. You may want to visit another doctor for a second opinion; if the second doctor’s impression aligns with your primary doctor’s notes, this can significantly support your claim.
- Notes from any counselors or caseworkers who have assisted in your recovery efforts.
- Imaging results, such as x-rays, MRI scans, and other screenings you have undergone.
- IQ testing results and other neuropsychological testing results following your TBI.
- Written statements from family members, friends, neighbors, and coworkers describing their interpretations of your condition following your TBI.
- Clinical notes from cognitive behavioral therapy and other psychological treatment sought after your TBI.
Ultimately, any documentation related to your TBI can potentially influence your application for Social Security benefits or a medical-vocational allowance from the SSA. The more supporting evidence you can provide, the better your chances are securing some SSA benefits.
When to Seek Legal Counsel
An experienced brain injury attorney can be an incredible asset if you intend to take any legal action for your TBI. Not only can an experienced attorney help you navigate the complex claim system for Social Security benefits, but they can also potentially help you take legal action if another party is responsible for your TBI through a personal injury claim. If another party caused your TBI due to any negligent behavior, it is vital to consult with an attorney and determine whether you have grounds for legal recourse against them.
Disability benefits or a medical-vocational allowance from the SSA can potentially provide substantial economic relief for anyone who has sustained a TBI, but further legal action with the help of an attorney is the best way to ensure a more robust recovery. If you or a loved one suffered a TBI due to another party’s negligence, contact McLachlan Law, APC, today to schedule a case evaluation with our team. We will help you determine your best available legal options and help you secure the recovery you need.