Disability Benefits After Multiple Strokes: What You Need To Know

If you are unable to work due to the effects of a stroke, you may be eligible for disability benefits. To qualify for disability benefits, your condition must meet the Social Security Administration's (SSA) guidelines, outlined in the SSA's Blue Book. The SSA does consider strokes to be a disabling condition, but only if the stroke has resulted in a lasting impairment that has lasted or is expected to last for at least 12 months.

Proving your stroke

To prove that your stroke has left you disabled, you will need to provide evidence that demonstrates the adverse effects of your stroke and how they are keeping you from working and making a living. The Social Security Administration (SSA) will generally require the following:

• Tests that were initially run in the ER that allowed doctors to diagnose your stroke.
• All records related to your hospital stay and time in the ER.
• If you have undergone surgery following your stroke, you will need all surgical notes and documentation.
• Your primary care doctor and/or neurologist will need to provide progress notes that include a physical exam, as well as documentation regarding permanent losses associated with speech, coordination, or other areas.
• You will need a long-term prognosis from either your primary care doctor or your neurologist.
• If you have undergone any type of speech, occupational, physical, or other therapy sessions, you will need to provide these records.
• All prescription medications you have been prescribed, along with the effect the medication had on you, as well as any side effects.

The SSA will also require that people seeking benefits show that their disability matches one of the conditions in their list of qualifying impairments. Strokes can qualify under two separate listings:

• Listing 11.04: Central Nervous System Vascular Accidents. To qualify under this listing, for more than three months after your stroke, you must have suffered from at least one of the following: partial or complete paralysis or uncontrollable movement of at least two limbs, resulting in difficulty walking or using your hands; difficulty communicating verbally or in writing, remembering familiar things, or understanding what people are saying.
• Listing 2.00: Special Senses and Speech.

If you don't meet the requirements of either listing, you can still receive benefits with a Residual Functional Capacity assessment. If this assessment shows that you are no longer able to do your job because of your stroke and can't reasonably be expected to get a different job, you can still qualify for benefits.

Qualifying for disability

To qualify for disability benefits after a stroke, you must meet the Social Security Administration's (SSA) eligibility criteria. The SSA considers strokes to be a disabling condition, but only if the stroke has resulted in a lasting impairment that has been present or is expected to be present for at least 12 months.

Inability to Work

To be eligible for Social Security disability benefits, you must be unable to work for at least 12 months after your stroke. This means that your stroke has left you incapable of performing basic work-related activities such as walking, standing, sitting, or remembering. Your condition must be severe enough to prevent you from engaging in any gainful activity.

Medical Evidence

You will need to provide comprehensive medical evidence to support your claim. This includes records from your hospital stay, emergency room visits, surgical procedures, progress notes from your doctors, and details of any therapies or treatments you have undergone. It is important to ensure that your medical records document all your symptoms, limitations, and residual effects.

Neurological Impairment

You must provide proof of your stroke as described in the Neurological Impairment section of the SSA's Blue Book. Strokes fall under Central Nervous System Vascular Events in Section 11.04 of the Blue Book. This section requires that your ability to speak, write, or communicate has been severely impaired, or that you have significant issues controlling or coordinating movements with two extremities (arms or legs).

Vision or Hearing Loss

If your stroke symptoms do not meet the criteria under Section 11.04, you may still qualify for disability benefits under a vision or hearing loss disability if your stroke has resulted in impairments in these areas.

Residual Functional Capacity Evaluation

If you don't meet the specific listings in the Blue Book, you may still be eligible for benefits through a Medical Vocational Allowance. Your doctor will need to describe your limitations on a Residual Functional Capacity evaluation form. The SSA will then assess your work history and skills to determine if there is any suitable work you can perform. If they cannot find suitable work, you will be eligible for benefits.

Additional Considerations

• The SSA will not process your claim until a minimum of three months after your stroke to ensure that your impairment is long-term.
• The application process can be challenging, and having additional qualifying conditions can improve your chances of approval.
• It is recommended to consult with a social security attorney or disability attorney who can guide you through the process and help you prove your limitations.

Applying for disability

If you have suffered a stroke and are unable to work, you may be eligible for Social Security Disability benefits. The first step is to determine your eligibility. You will need to meet certain criteria and provide evidence of your stroke and its impact on your life. Here is a guide to help you through the process.

Eligibility Criteria

To be eligible for Social Security Disability Insurance (SSDI), there are specific requirements you must meet:

• You must be unable to work for at least 12 months after your stroke.
• You need to provide proof of your stroke as described in the Neurological Impairment section of the Social Security Administration's (SSA) Blue Book.
• Your stroke must have resulted in lasting impairments that are expected to last at least 12 months or result in death.
• You must be under 65 to 67 years of age, which is the full retirement age.
• You must have worked and paid into the program (through payroll taxes) for five of the past ten years.

Evidence and Documentation

To support your claim, you will need to gather various types of evidence and documentation:

• Medical records and test results: This includes ER tests, hospital stay records, surgical procedures, progress notes from your doctors, and long-term prognoses.
• Therapy records: Provide details of any speech, occupational, physical, or other therapy sessions you have attended.
• Medication details: List all prescription medications, including their effects and any side effects.
• Work history: Include information about your work history, such as your job and the number of years worked.
• Non-medical sources: Gather statements from neighbours, friends, relatives, or past employers about how your impairments have affected your functioning.

Application Process

You can start your claim right away, but the SSA won't process it for a minimum of three months after your stroke to ensure that your impairment is long-term. You have several options for filing your claim:

• File a claim online.
• Call the Social Security Administration at 1-800-772-1213 (or TTY 1-800-325-0778 if you are deaf or hard of hearing).
• Visit your local Social Security office and have a staff member assist you with the paperwork.
• If you can't get to the SSA office, a designated caregiver or family member can file the claim on your behalf.

It's important to note that the SSDI application process can be challenging and may take up to several years to receive benefits. You may consider seeking assistance from a Social Security disability attorney or a non-attorney representative to guide you through the process and improve your chances of a successful claim.

Appealing a rejected claim

If you are unable to work for at least 12 months after your stroke, you can file a claim for Social Security disability benefits. However, the Social Security Administration (SSA) denies most initial disability claims due to a lack of compelling medical evidence. If your claim is rejected, the SSA offers a four-stage appeals process to help you get the financial assistance you need.

To appeal a rejected claim, you must demonstrate that you suffer from severe stroke symptoms, including total loss of motor control and acute memory loss. Here are some steps to help you through the process:

• Gather Medical Evidence: Submit the results of diagnostic tests, such as brain imaging scans, that highlight the abnormalities caused by the stroke. If your stroke symptoms have worsened, send the SSA imaging tests over time to illustrate the progression.
• Complete a Residual Functional Capacity (RFC) Assessment: This assessment involves a series of physical tests to evaluate the severity of your stroke symptoms, including motor control and slurred speech. You may also undergo mental sharpness tests to determine your ability to perform job-related tasks.
• Seek Legal Assistance: Contact a Social Security lawyer to improve your chances of a successful appeal. They can guide you in building a persuasive case and ensure you meet crucial deadlines.
• Act Quickly: You typically have 60 days from receiving the denial letter to file an appeal. Prompt action is crucial to ensuring your appeal is approved.
• Provide Comprehensive Information: Ensure your medical records document all your symptoms, limitations, and residual effects. Include records of any physical therapy, speech therapy, or other treatments you have undergone.
• See a Specialist: Seek treatment from a neurologist. Their diagnosis and progress notes will carry more weight in your appeal than those of a general physician.
• Follow Medical Advice: Comply with your doctor's treatment plan, including therapy and rehabilitation. Failure to adhere to medical advice may be used as a reason to deny your claim.
• Address Mental Health Impacts: If you experience depression or anxiety due to the chronic issues and life changes resulting from your stroke, consult a mental health professional. Their diagnosis and documentation of these conditions can support your appeal.
• Provide Work History: If applicable, provide evidence of a long work history and any unsuccessful attempts to return to work or work in a reduced capacity. This information can demonstrate the impact of your stroke on your ability to maintain employment.
• Gather Non-Medical Evidence: Collect statements from neighbours, friends, relatives, clergy, or past employers about how your stroke has affected your functionality. While these may not carry as much weight as medical testimony, they can provide additional support for your claim.

Getting legal help

If you are unable to work due to the effects of a stroke, you may be eligible for disability benefits. However, the process of applying for these benefits can be complex and lengthy, and you may need to appeal if your initial application is denied. For these reasons, it is highly recommended that you seek legal assistance from an experienced disability lawyer or Social Security advocate/attorney. They can help you gather the necessary evidence, meet the requirements, and navigate the entire process.

• Contact a disability lawyer or Social Security advocate/attorney with experience in stroke and disability cases. They will be familiar with the specific requirements and challenges of applying for disability benefits after a stroke.
• Look for a lawyer or advocate who offers a free initial consultation. This will give you the opportunity to discuss your case, ask questions, and understand their fees before committing.
• Ask about their success rate and experience with similar cases. You want to ensure they have a strong track record of helping clients secure disability benefits after a stroke.
• Choose a lawyer or advocate who is compassionate and understanding. The process can be emotionally challenging, so having someone who is empathetic and dedicated to your case can make a big difference.
• Be open and honest about your condition and how it impacts your daily life. Your legal representative needs to have a clear understanding of your limitations to build a strong case for your entitlement to benefits.
• Provide your legal representative with all the relevant medical records, test results, hospital stay records, and information about your treatments and medications. This documentation is crucial for supporting your claim.
• If your memory has been affected by the stroke, ensure your legal representative is proactive in keeping track of important deadlines and gathering the necessary evidence.
• Consider seeking legal assistance as early as possible. They can guide you through the entire process, from the initial application to any necessary appeals.
• Be aware of potential delays in the evaluation process. The Social Security Administration (SSA) may wait at least three months from the date of your stroke to review your claim, as they want to assess whether your limitations are long-term.
• If your initial application is denied, don't give up. Almost 70% of initial applications are denied, but with legal representation, your chances of a successful appeal increase significantly.

Frequently asked questions