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If you are viewing this page, there is at a least fair chance that you are connected to someone who has had a stroke, and has filed or needs to apply for social security disability (or ssi) benefits. The reason I say this is because the residual effects of stroke often involve memory difficulties and problems with motor coordination and function, and for this reason a stroke victim may have difficulty navigating the internet. What are the things to keep in mind for an individual who has had a stroke and is attempting to win disability benefits? Well, the first fact to consider is this: if a claimant has recently had a stroke and then applied for disability, they won't get an immediate answer on their claim. Most initial claims for disability benefits, of course, take several months to adjudicate. However, stroke cases can take even longer due to the fact they are deferred for a period of not less than three months (this is also the case with claims involving heart attacks). What does deferment mean in this case? It means this: disability cases involving strokes cannot be decided for at least 3 months from the date of the occurrence of a stroke. The reasoning for this is actually very understandable. As is the case with myocardial infarction (a heart attack), the residual effects,i.e. limitations, of a stroke can be nearly impossible to measure in the short time following a stroke. Medical science is simply not advanced enough to allow for a reliable projection as to how a stroke victim may recover from a stroke. The outlook may be influenced by factors such as age and the existence of other medical conditions and risk factors. Also, not all individuals will recover at the same rate. How can a claimant be approved for social security disability or SSI on the basis of stroke? As with any physical, psychiatric, or psychological condition that is disabling, an approval for disability benefits can be made on the basis of a medical vocational allowance or on the basis of a listing. A medical vocational allowance is an approval that is made when it has been determined that a claimant cannnot return to their past work, or perform a suitable type of other work. Obviously, this type of approval will take into account the kinds of jobs a disability claimant has worked in the past, specifically the exertional nature of the work (i.e. did it involve heavy, medium, or light exertion?). However, a medical vocational allowance will also take into consideration the skills used on past jobs as this will determine whether or not those skills can be expected to transfer to "other work". Finally, a medical vocational allowance will take into account the current functional capacity of the claimant (what the individual can still do despite their illness), their education (though this is not a very large factor), and the age of the claimant. For older individuals, age can be crucial since, at certain ages, the rules that are used to make a medical vocational allowance turn increasingly in favor of the claimant (for example, a claimant with a history of medium work who has been limited to light work may not be approved at age 53, but with this same profile may be approved at age 55). Most social security disability and SSI claims are approved on the basis of a medical vocational allowance. However, a disability claim can also be approved on the basis of meeting, or equaling, the requirements of a listing in the social security administration's impairment listing manual. The manual, also known as the blue book, details the approval criteria for a number of different impairments. Stroke is given consideration under neurological impairments and the listing is titled 11.04, Central Nervous System Vascular Accident. The social security administration blue book listing for stroke is actually fairly short and essentially says the following: 1. Stroke residuals will be evaluated at least 3 months following a stroke (meaning a case may be deferred). 2. To be approved on the basis of the stroke listing, a claimant must demonstrate: A. Ineffective speech or communication that results from sensory or motor aphasia (the loss of ability to speak or comprehend due to brain illness or injury) OR B. Persistent, significant motor function disorganization in two extremities (this could be two legs, two arms, or an arm and a leg) that results in a sustained disturbance of gross and dexterous movments, or in gait and station. The part A criteria simply refers to the cognitive and expressive deficits that many victims of stroke suffer, immediately after a stroke and sometimes for long periods following a stroke. As a disability claims examiner, I very quickly became accustomed to speaking with stroke victims who had difficulty making themselves understood due to the lingering effects of stroke residuals. The part B criteria, not unexpectedly, is occasionally taken as incomprehensible by many. However, it mainly refers to certain physical effects that many stroke victims must suffer with, such as motor function impairment in the arms or legs (which often is partial to one side) that may seriously affect an individual's ability to grasp and manipulate objects and may seriously affect an individual's ability to safely ambulate (walk and move around). Can a claim for disability be won on the basis of having suffered a stroke? Yes, without a doubt. However, as with all disability cases (social security disability or SSI), a claim will not be decided on the basis of a diagnosis, but, rather, on an individual's current (and projected) level of functional restriction and impairment. One's level of impairment (referred to by the social security administration as residual functional capacity, or RFC) will be determined solely by a review of a claimant's medical records, which will include treatment notes, admission and discharge summaries, lab and imaging studies, and also (and this is quite important at the hearing level) supporting statements from one's treating physician(s).
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