Tips on Applying for Disability Benefits with a Traumatic Brain Injury

Written by Ram Meyyappan


Wheelchair

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.

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6 Responses to Tips on Applying for Disability Benefits with a Traumatic Brain Injury

  1. Jon Altman July 29, 2014 at 7:42 pm #

    Hi, my name is Jon. In 2009 I was diagnosed with having a brain tumor. It was located inside the third ventricle in my brain near the pineal gland and brain stem. An endoscopic biopsy was performed causing the tumor to swell and block the flow of the fluid in my brain. My brain swelled (hydrocephalus) and a shunt was put in to divert some of the fluid off my brain into my abdomen. When I woke up most of my short term memory was gone. My wife was visiting me in the ICU holding our two month old daughter. I asked her if she was my baby. People would come to visit me for hours and would step out briefly to use the restroom and upon their return I would say, “Hey! When did you get here?”. I would wake up in the middle of the night and call my wife and ask, “Why am I here? What’s going on?”. Long story short I had surgery and radiation. About 5 months after all of that I asked my surgeon to release me to go back to work. Reluctantly he did. I still struggle with my memory every day. It resulted in a demotion. It continues to annoy and frustrate my co-workers. I’ve been sat down and talked to on multiple occasions about these issues and I am at my whits end. Do you know if my case would qualify for help?

  2. Marci Huebert October 16, 2014 at 1:06 pm #

    If I have been diagnosed as having a “closed head injury” and a “short term memory disability” which has in turn prevented me from maintaining employment, then why am I being denied for social security disability benefits?

    • Jimbo April 22, 2015 at 6:07 pm #

      They seem to deny everyone until it gets to the judge, even if you were a
      Quadrapelegic they would probably deny you initially. Get an Attny
      And just go through their process, took me about 18 months to get approved. Good luck!

  3. Andrew M. February 9, 2017 at 8:54 pm #

    I have a longstanding TBI; and I was no longer able to work because I did not receive the proper treatment (cognitive rehabilitation therapy), and my condition became worse due to interpersonal trouble, increased anxiety, and depression. I was denied after appearing before a judge (ALJ) at the hearing.

    • shannon March 13, 2017 at 7:30 am #

      HI adrew im going through the same thing i no how you feel ,the saying is you look fine therefore you are fine ,let them live in our heads ,get a lawyer

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