Disability Benefits for Traumatic Brain Injury

About Traumatic Brain Injury

A traumatic brain injury (TBI) is the result of an external force injuring the brain. The resulting brain damage usually occurs as a consequence from a direct impact to the head. The damage can inflict permanent complications that can reduce an individual’s ability to function physically and mentally. TBI is one of the leading causes of disability and death around the world.

Common causes of TBI include auto accidents, sports accidents, construction accidents, physical violence, and more.

Symptoms of a Traumatic Brain Injury

The symptoms of a TBI can vary significantly depending on the severity of the damage. Some symptoms may go away hours after the head injury while others may progress and get worse. Symptoms include but are not limited to:

• Headaches
• Vision loss
• Dizziness or nausea
• Memory problems
• Seizures
• Unequal dilation of pupils
• Sleep disturbances
• Over sleeping
• Mood swings
• Anxiety
• Depression
• Unusual behavior

If you are experiencing any of the symptoms above after a head injury, it is recommended you see your doctor if you haven’t done so already. The end result of TBI can range from full recovery to a permanent disability and sometimes even death. In several cases, surgery may be required to address certain complications such as blood clots or skull fractures.

Qualifying for Disability with Traumatic Brain Injury

When evaluating whether or not an applicant’s condition qualifies for Social Security Disability benefits, the Social Security Administration will compare the condition to the appropriate listing(s) within the Blue Book. Traumatic brain injuries are evaluated under listing 11.18 Cerebral Trauma. The listing simply refers to four other listings that TBI can potentially meet.

11.18 Cerebral Trauma

Evaluate under listings 11.02, 11.03, 11.04, and 12.02 where applicable.

11.02 – Convulsive Epilepsy

Seizures happening at least once a month despite 3 months of treatment with daytime episodes inducing convulsive seizures and loss of consciousness, or nighttime episodes creating residual effects that interfere with daily activities.

11.03 – Non-convulsive Epilepsy

Seizures happening at least once a week despite 3 months of treatment with loss or change in consciousness as well as postictal stage induced behavior or interference that affects activities of daily living.

11.04 – Central nervous system vascular accident

One of the following at least 3 months after accident:

A.) Motor or sensory aphasia (language/speech disorder caused by damage to the brain) causing ineffective communication or speech

B.) Critical and continuous disorganization of motor functioning in at least two extremities causing persistent interference of gross/dexterous movements or disturbance in gait and station

12.02 – Organic mental disorders

The requirements for this listing will be meet when requirements A & B are fulfilled or when requirement C is satisfied.

A.) Loss of cognitive abilities with one of the following:

1.) Disorientation to time and place
2.) Memory impairment (short, intermediate, or long term)
3.) Thinking or perceptual interferences such as delusions or hallucinations
4.) Changes in personality
5.) Disturbance in mood
6.) Emotional instability
7.) Loss of intellectual ability measured by a loss of at least 15 I.Q. points

AND

B.) At least two of the following:

1.) Marked limitations in activities of daily living
2.) Marked limitations in maintaining social functioning
3.) Marked limitations in maintaining concentration, perseverance, and tempo
4.) Reoccurring episodes of extended decompensation

OR

C.) Historical documentation of the mental disorder going back at least 2 years and one of the following:

1.) Reoccurring episodes of extended decompensation
2.) Residual disease process that predicts the applicant will likely decompensate due to an increase in current mental demands.
3.) Documentation of one year or more showing the applicant has been unable to function outside a supportive living arrangement and is expected to continue needing such an arrangement.