Tips on Applying for Disability Benefits with a Traumatic Brain Injury
Written by Ram Meyyappan
If you have suffered a traumatic brain injury (TBI), you may be able to receive disability benefits through Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). The following tips will help you better your chances of being approved for benefits.
Make sure you meet the financial eligibility criteria for SSDI/SSI benefits
The Social Security Administration (SSA) has set financial limitations for both SSDI and SSI. SSDI is a program available to disabled workers that earn less than $1,040 per month (for 2013), which is what the SSA considers substantial gainful activity or gainful employment.
For SSI on the other hand, the financial eligibility rules are stricter. You must have very limited income and other financial resources at your disposal to pay for your everyday needs.
It is also important to understand that to qualify for SSDI, you must have sufficient work credits that are built up from your previous employment.
Learn more about the SSDI and SSI program here.
Find out if your TBI matches a blue book condition
When the SSA reviews disability claims, they look at whether or not the condition matches one that appears in the Blue Book, which is a manual of common disabling conditions. Your TBI will be considered under one of the following listings, dependent upon the symptoms you experience and the complications your TBI causes:
- Section 11.02 – convulsive epilepsy
- Section 11.03 – non-convulsive epilepsy
- Section 11.04 – stroke or stroke-like complications
- Section 12.02 – organic mental disorders
It is also important to understand that the SSA will take all of your symptoms and complications under consideration. That means they may consult multiple listings in the Blue Book when reviewing your application for benefits.
You can learn more about medically qualifying with TBI here.
Learn how to qualify for benefits without a meeting a blue book listing
You can still potentially qualify for disability benefits through SSDI and/or SSI even if you do not meet a listing in the Blue Book. To do so, you must prove that your TBI has caused such severe limitations that it prevents you from working. The SSA will need to review your activities of daily living and determine if your “residual functional capacity” (RFC) is so limited that you are unable to maintain employment.
You can get a better idea of what information the SSA reviews by looking at the Function Report Form.
File an application
Even if you are unsure if you qualify for benefits, you should still file an application. Doing so is the only way to know for sure if you can receive SSD benefits. You can have someone help you file online, like a friend, family member, or advocate. You can also file your application in person at your local SSA office and have another person accompany you to the appointment and assist in providing the necessary information.
It is crucial you thoroughly complete the application, leaving no information blank or details scarce. It is also important that you provide the SSA copies of as many of your medical records as possible at the time you file or shortly after.
File a timely appeal if necessary
If you are denied benefits after the initial review of your application that does not mean you cannot eventually be found eligible. In order to continue trying for SSD however, you must file a timely appeal. You will have just 60 days from the date of the denial letter you receive to submit your request for a reconsideration of your claim or for an appeal hearing.