Stroke Victims: Disability Approval Chances

do disbility usually get approved for strokes

Strokes are a leading cause of serious long-term disability, and they can have a permanent impact on a person's ability to work. In the US, about 795,000 people suffer a stroke each year, and around a quarter of those affected are under the age of 65. For those who are unable to work due to the long-term effects of a stroke, disability benefits may be available. In this paragraph, we will explore the criteria for receiving disability benefits after a stroke and outline the process for applying for these benefits.

Characteristics Values
Time out of work At least 12 months
Severity of stroke Must be classified as severe
Income $1,040 or less per month
Speech and communication Difficulty communicating verbally or in writing
Motor function Partial or complete paralysis or uncontrollable movement of at least two limbs
Cognitive function Marked limitation in at least one area: thinking, interacting with others, finishing tasks, regulating emotions
Vision Vision loss or other physical impairments

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Qualifying for disability benefits after a stroke

A stroke is a medical emergency that occurs when there is a disruption of blood flow to a part of the brain. It is a disability according to the Social Security Administration (SSA) in the US. If you have had a stroke, you may be able to qualify for disability benefits. In 2021, approximately 31% of Social Security disability beneficiaries qualified for benefits due to a disease of the nervous system and sense organs, which is how the SSA categorizes a stroke.

Qualifying criteria

To qualify for disability benefits, the SSA requires specific eligibility criteria, and you must be unable to work because of persistent symptoms. The SSA evaluates a stroke under section 11.04, vascular insult to the brain, in its Blue Book, which includes a list of qualifying medical conditions. There are three ways the SSA evaluates a stroke under the Blue Book:

  • Your ability to speak or write is severely impaired or lost entirely
  • You have pronounced issues with controlling or coordinating movements with at least two extremities (arms or legs)
  • You have a marked limitation in physical functioning as well as in at least one of the following areas of mental functioning: interacting with other people, concentrating and persisting, remembering, understanding, or applying information, and self-management and the ability to adapt

The above limitations must have been present, or be expected to last, for at least three consecutive months post-stroke.

Other ways to qualify

If you don't meet the Blue Book listing but still cannot work due to your stroke, you may get approved for disability under a "medical vocational allowance". For this, your doctor must describe your limitations on a Residual Functional Capacity evaluation form. The SSA will examine the evaluation form, as well as your work history and skills, to try to find work that you are able to do. If they cannot, you will be eligible for benefits.

Applying for benefits

You can start a claim right away, but the SSA won’t process it for a minimum of three months after the stroke to ensure that your impairment is long-term. You can file a claim online or make an appointment at your local SSA office to get help with your claim. If you can’t get to the SSA office, a designated caregiver or family member can file the claim for you.

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The impact of strokes on your ability to work

Strokes are a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. They are the brain's equivalent of a heart attack. When a person has a stroke, they often experience muscle weakness on one side of their body, and they may have trouble speaking. The effects of a stroke depend on the type, severity, location, and number of strokes, as well as which part of the brain was damaged and by how much.

The ability to work can be impacted by the long-term effects of a stroke, which include:

  • Changes to speech, learning, and understanding
  • Weakness or paralysis on one side of the body
  • Emotional and personality changes
  • Changes to thinking, memory, and perception
  • Communication difficulties

These effects can vary from person to person, but they can have a significant impact on a person's ability to work and perform everyday tasks. For example, a person may experience left-sided weakness or paralysis and sensory loss after a right hemisphere cerebrum stroke, which can affect their ability to perform physical tasks. They may also have difficulty with communication, problem-solving, and memory, which can impact their ability to work in certain industries or perform complex tasks.

In addition to the physical effects of a stroke, the emotional and psychological impact can also affect a person's ability to work. Depression and anxiety are common after a stroke, and these conditions can make it difficult to concentrate, manage everyday life, and interact with others.

The financial costs of a stroke can also impact a person's ability to work. The costs of diagnosis, treatment, and long-term care can be significant, and a person may need to take time off work to recover or adjust to their new situation.

To qualify for disability benefits, a person must be unable to work for at least 12 months after their stroke and provide proof of their stroke and its impact on their functioning. This can include medical records, diagnostic test results, and evaluations from a doctor or rehabilitation team.

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The criteria for disability benefits

To qualify for disability benefits due to a stroke, you must meet the eligibility criteria of the Social Security Administration (SSA). The SSA requires that you are unable to work for at least 12 months after your stroke. This is because the SSA defines a disability as being unable to engage in any substantial gainful activity due to a medical impairment that can be expected to last for at least 12 months or result in death.

The SSA's Blue Book, which includes a list of qualifying medical conditions, categorises strokes as cerebrovascular accidents or vascular insults to the brain under Section 11.04. To qualify for disability benefits, you must provide proof of your stroke as described in the Neurological Impairment section of the Blue Book. This proof must show that your stroke has resulted in severe impairments that affect your ability to work.

There are two main types of strokes: ischemic and hemorrhagic. An ischemic stroke occurs when blood clots or plaque restrict blood vessels in the brain, while a hemorrhagic stroke is caused by a leaking or ruptured artery in the brain. Both types of strokes can result in physical and mental limitations that may qualify you for disability benefits.

To qualify for disability benefits, the SSA will evaluate your stroke under the following criteria:

  • Sensory or motor aphasia: This includes difficulty speaking or writing due to expressive or sensory aphasia. The aphasia must last for at least three months after the stroke.
  • Disorganisation of motor function: You must have extreme limitations in two extremities, such as difficulty standing, balancing, walking, or using your arms. These limitations must also last for at least three months after the stroke.
  • Limitation of mental functioning: You must have marked limitations in at least one area of mental functioning, such as interacting with others, concentrating, remembering, or adapting to changes. Again, these limitations must last for at least three months post-stroke.

In addition to the above criteria, the SSA will also consider your work history, skills, and income when evaluating your eligibility for disability benefits. If you do not meet the specific criteria for strokes, you may still qualify for benefits through a Medical Vocational Allowance. This requires your doctor to describe your limitations on a Residual Functional Capacity evaluation form, which the SSA will use to determine if you are able to work.

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The process of applying for disability benefits

To apply for disability benefits, you must meet the Social Security Administration's (SSA) eligibility criteria. The SSA requires that you are unable to work due to persistent symptoms. The SSA's Blue Book outlines the medical conditions that qualify for Social Security disability benefits, including strokes under Section 11.04, vascular insult to the brain.

  • Determine Your Eligibility: Review the SSA's Blue Book and eligibility criteria to assess if your medical condition qualifies for disability benefits. For strokes, the SSA evaluates the impact on your physical and mental functioning, including your ability to speak, write, and control movements. The condition must be expected to last for at least 12 months or result in death.
  • Gather Medical Evidence: Consult with your doctor to gather medical evidence supporting your disability claim. This includes diagnostic test results, hospital records, surgical notes, physical exam progress notes, therapy session records, and prescription medications. Ensure that your medical records detail your condition, limitations, treatments, and responses to treatments.
  • Complete the Application: You can apply for disability benefits online, over the phone, or in person at your local SSA office. The SSA provides Disability Starter Kits to help you prepare for the application process and ensure you have the necessary documentation. The kits include information about the specific documents and criteria required.
  • Submit Supporting Documentation: Along with your application, submit all relevant medical evidence and supporting documentation outlined in the Blue Book. This evidence is crucial for the Disability Determination Services (DDS) to evaluate your claim. Remember that most claims are denied due to insufficient supporting evidence, so provide detailed information about your condition and its impact on your daily life.
  • Understand the Waiting Period: Social Security Disability Insurance (SSDI) has a five-month waiting period before benefit payments begin. Supplemental Security Income (SSI) provides payments for the first full month after filing your claim or becoming eligible.
  • Expect Delays: The SSA may delay reviewing your claim for at least three months from the date of your stroke, as they consider the potential for significant improvements during this period. Continue to submit additional medical evidence to support your claim while waiting for a disability examiner to be assigned.
  • Prepare for Appeals: Understand that the majority of initial applications are denied. If your claim is denied, you will receive a notice explaining the reason for the denial and the timeframe for appealing the decision. Consult a disability attorney to guide you through the appeal process and improve your chances of approval.
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What to do if your application is denied

A stroke is a disability according to the Social Security Administration (SSA). However, the SSA denies a majority of disability benefits claims due to a lack of compelling medical evidence. If your application is denied, you can file a persuasive appeal. Here are some steps to take:

Understand the reason for the denial:

Your claim may have been denied because your symptoms did not meet the severity test as listed in the SSA Blue Book. The Blue Book lists all the medical conditions that qualify applicants for disability benefits. Simply stating that you had a stroke is not sufficient for the SSA to approve your claim.

Gather additional medical evidence:

To prove that you suffer from severe stroke symptoms, send the SSA the results of diagnostic tests, such as brain imaging scans, that can detect abnormalities in the brain associated with stroke symptoms. If your symptoms have worsened since your initial claim, be sure to send updated test results.

Complete a Residual Functional Capacity (RFC) assessment:

Diagnostic tests are only one part of the story. An RFC assessment will evaluate your physical and mental abilities through a series of tests. This will help the SSA understand the seriousness of your stroke symptoms and how they impact your ability to work.

Act quickly:

You only have 60 days from the day you receive the denial letter to file an appeal. Contact a Social Security lawyer to improve your chances of a successful appeal. They can guide you in gathering and presenting the necessary medical evidence to strengthen your case.

Seek legal assistance:

Disability claims can be complex, so consider reaching out to a qualified social security disability lawyer. They can help ensure your claim is taken seriously and guide you through the appeals process, improving your chances of getting the benefits you deserve.

Frequently asked questions

To qualify for disability benefits, you must meet the SSA's eligibility criteria, which includes demonstrating an inability to work due to persistent symptoms. The SSA will assess if your stroke has resulted in a lasting impairment expected to last for at least 12 months, causing limitations in your daily life and ability to work.

You must provide medical evidence and records that clearly show the adverse effects of your stroke. This includes diagnostic test results, hospital and emergency room records, surgical notes, progress notes from your doctor, prescription medications, and therapy records.

The SSA evaluates strokes under Section 11.04, vascular insult to the brain, in the Blue Book. To qualify, you must have severe issues with controlling movement in at least two extremities (arms or legs) or have severely impaired speech and writing abilities due to expressive or sensory aphasia.

Yes, if your stroke does not meet the medical criteria but still prevents you from working, you may qualify for a "medical vocational allowance." The SSA will consider your age, job skills, education, and medical condition to determine if you can work in any job for which you're qualified.

To be considered for disability benefits, your income must be below a certain level. This level varies depending on the type of benefit. For SSDI, you must earn $1,310 or less per month, while for SSI, your household income must not exceed a certain limit based on your household size.

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