I am often asked by claimants why they were denied by Social Security even though their doctors say they are disabled. It is not enough to be diagnosed with epilepsy. Objective evidence proving severity and frequency is necessary to approve claims.
Comply with Treatment from a Neurologist or Epileptologist
To receive benefits, your disability must be expected to last at least a year or end in death. Besides being diagnosed with epilepsy, you must show compliance with treatment. Non-compliance with treatment such as forgetting to take medication or doing activities that trigger your seizures such as consuming alcohol is a common basis for denial. Objective evidence is very important. Tests such as EEG, MRI, and PET will help provide objective evidence that you have a seizure disorder. If your test results are normal, ask your doctor to have a video EEG. Many people have abnormal EEG results only during an actual seizure. Video EEG tests are done with video monitoring in a hospital over the course of several days. This lengthy test increases the likelihood of capturing your seizure activity that a regular EEG might not capture.
Frequency and Severity of Seizures is Important
SSA provides a list of impairments with requirements to qualify for disability. Listing 11.02 includes convulsive seizures and Listing 11.03 includes non-convulsive seizures. Convulsive seizures are also referred to as grand mal or tonic-clonic seizures. Non-convulsive seizures include petit mal, complex partial, and any other non-convulsive seizures. To meet Listing 11.02 you will need to prove you have more than one grand mal seizure a month despite at least 3 months of prescribed treatment, AND the seizures must occur during daytime or, if they occur during sleep they must significantly interfere with your daily activities. To qualify under Listing 11.03, you must have more than one non-convulsive seizure a week despite at least 3 months of prescribed treatment and your seizures include loss or impairment of conscious that cause unconventional behavior or significantly interfere with your daily activities.
Document Your Seizures and Gather Supporting Evidence
Keep a journal with specific dates each time you have a seizure. If you live with someone, have them assist you by describing the seizures in as much detail as possible including the length and symptoms experienced before, during and after the seizures. This would not only help your case, it would also help your doctors treat you. Make sure your doctor documents the frequency and nature of your seizures. Your doctor's records are critical in deciding your case. Also keep records of hospital stays and ambulance reports. If you are applying for your child, make sure the school documents whenever your child has a seizure. Though school records are not considered medical evidence, they can provide supporting evidence of the frequency and severity of the seizures.
How to Qualify if Without Meeting a Listing
Unfortunately, seizures are unpredictable and usually do not occur on a strict schedule. If you cannot meet the strict listing requirements of 11.02 or 11.03, you can still get approved if you can prove that your functional capacity prevents you from working. Factors such as age, education, and transferable skills would then be considered by SSA to determine whether you can still qualify for disability.
Consider Hiring a Disability Attorney
Your chances of getting approved are much better if you are represented by a good Social Security attorney experienced with epilepsy. Many people are unaware that unlicensed representatives, sometimes referred to as advocates are legally allowed to represent disability claimants even at hearings in front of a judge. They often charge the same as lawyers but are unlicensed by the Bar. A good attorney should work closely with you from beginning to the end.
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