Qualifying for Disability Benefits (SSDI) for a Stroke in Pennsylvania

The Social Security Administration (SSA) is responsible for processing disability benefits claims, making medical evaluations, and ultimately denying or awarding disability benefits based on their conclusions.  In 2013, the SSA reported spending more than $800 billion on roughly 58 million Americans, 8.9 million of whom were classified as being disabled.  In other words, about 15% of the SSA’s benefits budget for 2013 went toward assisting Americans living with disabilities.

However, it can be very difficult to qualify for disability benefits.  The application process is time-consuming and has gained a certain level of notoriety for the stringent and demanding requirements it makes of candidates.  The most basic of these requirements is the presence of a disabling condition, such as stroke.  But even if your physician asserts that you are disabled, the SSA uses their own guidelines, and may arrive at a different conclusion.  To help you understand the SSA’s thought process when determining benefits eligibility, our disability attorneys answer the question:  can I qualify for benefits if I’ve had a stroke?

Stroke Statistics in America

Every year, stroke is among the leading causes of death across the United States.  The Centers for Disease Control and Prevention (CDC) report that on an annual basis, stroke kills about 130,000 Americans.  In other words, roughly one out of every 19 deaths in America is caused by stroke. Nonfatal strokes are even more prevalent and affect approximately 795,000 individuals — 0.3% of the country’s population — every year.

In Pennsylvania, stroke is the third leading cause of death for women and the fifth leading cause for men. In 2010, 5.4% of Pennsylvania deaths were stroke-induced.  In New Jersey in 2005, over 14,000 people were hospitalized for a stroke.

Long-Term Effects of a Stroke

Strokes, which are caused by a disturbance in the supply of blood to the brain, can leave extremely severe health effects behind after they have passed.  Effects which stroke survivors may experience include:

  • Anxiety
  • Bladder Problems
  • Chronic Fatigue
  • Chronic Pain
  • Dementia
  • Depression
  • Difficulty Speaking/Reading/Writing (Aphasia)
  • Incontinence
  • Loss of Vision
  • Memory Loss
  • Muscle Paralysis (e.g. Dysphagia, Foot Drop)
  • Seizures

stroke disability benefits

How the SSA Evaluates Stroke Claims in Pennsylvania

One of the basic guides the SSA uses to determine whether a disability is “sufficiently” disabling is the Listing of Impairments, otherwise known as “the Blue Book.”  The Blue Book is not the ultimate deciding factor (for example, it does not cover many rare conditions which may be eligible for benefits), but it is an important starting point.

There is no listing in the Blue Book explicitly labeled as “stroke.”  However, that does not mean that you cannot qualify for benefits if you are a stroke survivor.  This is for two reasons.  First, stroke can cause numerous disabling effects which can qualify you by themselves.  Second, stroke-specific information is difficult to locate within the Blue Book listings, because the SSA does not call it “stroke.”  If you weren’t reading very closely, you might miss the information altogether.

Section 11 of the Blue Book is dedicated to neurological conditions.  Of special interest to stroke survivors is Section 11.04, which is labeled as “Central Nervous System Vascular Accident.”  This term refers to stroke.

Under Section 11.04, a stroke survivor can qualify for disability if (1.) three months have passed since the stroke, and (2.) the following conditions are still present:

“A. Sensory or motor aphasia resulting in ineffective speech or communication; or

B. Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station…”

In other words, if you had a stroke at least three months ago, and you are still experiencing weakened motor or language skills, you may be able to qualify for disability benefits.

Disability Benefits for Stroke Side Effects

Speech and Vision

In addition to weakened motor and language skills, stroke can cause many other disabling effects which can qualify you for benefits.  For example, two common side effects of stroke are loss of vision, and loss of the ability to speak clearly.  Under Section 2.00 of the Listing of Impairments, which deals with Special Senses and Speech, all of the following conditions may be considered for disability:

  • Loss of Visual Acuity (Section 2.02)
  • Contraction in the Visual Fields in the Better Eye (Section 2.03)
  • Loss of Visual Efficiency (Section 2.04)
  • Loss of Speech (Section 2.09)

Anxiety and Depression

Individuals who have survived a stroke may experience disturbances to their mood.  Some of the most common mood disorders for stroke survivors to experience are depression and anxiety.  These conditions may be considered for disability benefits eligibility under Section 12, which deals with mental disorders: specifically, Sections 12.06 (Anxiety-Related Disorders) and 12.04 (Affective Disorders).

In order to qualify under these conditions, a variety of additional requirements must be met.  For example, sufferers of depression must prove “medically documented persistence, either continuous or intermittent,” of the symptoms of their depression (e.g. sleep disturbance, appetite disturbance, difficulty concentrating). Likewise, sufferers of anxiety must prove “medically documented findings” of their symptoms (e.g. motor tension, vigilance and scanning, persistent irrational fear).

Our Disability Attorneys Can Help You Get Benefits After a Stroke

If you or someone you love has had a stroke, you may be a good candidate for benefits.  To speak with an experienced disability benefits attorney who can help evaluate your case, call (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania or contact the law offices of Young, Marr & Associates online for a free and confidential consultation.