The key to getting the disability benefits you need often boils down to a single question: do you meet the Social Security Administration’s strict rules for a disabling condition?
Those rules are collected in the Social Security Blue Book. Once an actual physical blue book called Disability Evaluation Under Social Security, it's now a database describing hundreds of ailments and injuries. If your condition meets one of the ailment listings in the Blue Book and is expected to last at least 12 months (or is expected to be fatal), then you should qualify for Social Security disability insurance benefits.
Many people are surprised to find out that the Blue Book gives very specific details for each ailment. One ailment may qualify as a disability, while a second ailment may not, even if they seem similar and affect the same part of the body. Often, only someone who is well-versed in both medical and legal terminology—such as your disability attorney—can decipher which rules apply and whether you may be eligible.
To demonstrate how the Social Security Administration (SSA) evaluates different conditions, we'll compare two different ailments that affect the brain: traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).
Traumatic Brain Injuries and Social Security Disability
A traumatic brain injury happens when a force outside the body causes damage to the brain. The injury can be caused by a blow to the head, severe shaking of the head, or an object puncturing the skull. Concussions are the most common form of TBI, and are usually minor injuries. More serious forms of traumatic brain injury can lead to:
- Memory lapses
- Loss of motor skills
- Intellectual deficits
- Emotional disturbances such as anxiety or depression
- Seizures
- Increased vulnerability to serious conditions such as Alzheimer’s disease or Parkinson’s disease
- Coma
The SSA categorizes traumatic brain injuries as neurological disorders. To qualify as disabled, an applicant must show that the TBI has either:
- Imposed extreme limits on his ability to stand up, balance while standing or walking, or use his upper limbs
- Imposed marked limits in information handling, interacting with others, maintaining concentration on a task, or managing his demeanor and adapting to circumstances
Post-Traumatic Stress Disorder as a Disabling Condition
In contrast to traumatic brain injuries, PTSD may not involve any physical injury at all—it's often a purely psychological ailment, caused by experiencing an intense and unpleasant event. Some sufferers develop symptoms of PTSD immediately after the event, while others may not experience the effects until weeks or months later.
PTSD affects a patient’s emotional outlook, although a person suffering from it may show changes in his body chemistry over time. The signs of the ailment vary from person to person, but may commonly include:
- Anxiety or “jumpiness”
- Depression
- Sudden outbursts of anger or irritability
- Avoidance of places associated with the event or similar to the site of the event
- Emotional detachment, often with withdrawal from social interaction
- Sleep disturbances
- Flashbacks, which may range from feelings that the traumatic incident is happening again to sonic or visual hallucinations
The SSA Blue Book classifies PTSD as a mental—rather than a neurological—disorder. Because there are no physical signs of the ailment, the standards to prove PTSD is disabling are much more complex than for a TBI.
First, the patient will have to produce medical records showing persistent anxiety; a persistent irrational fear, obsession, or compulsion; a history of panic attacks; or recurrent and intrusive recollections of a traumatic experience. Additionally, the patient will have to document how his emotional instability has led to significant restrictions in two or more areas of his life, or has left him completely able to function outside his home.
Collecting Social Security Benefits for TBI or PTSD
Although TBI and PTSD are completely different conditions, there's some overlap. In fact, quite a few people suffer from both ailments at the same time. For instance, a severe car accident can cause a traumatic brain injury, and the experience of the crash can trigger PTSD.
A person suffering from both conditions may be able to show that the total effect of his ailments is disabling, even if no single ailment is disabling by itself. Your application has to demonstrate the limits imposed by all your conditions leave you unable to work effectively. Proving a functional disability exists is a lot harder than showing you qualify under one of the ailment listings, and the aid of a skilled Social Security lawyer is highly advised.
Reach out to the lawyers at the law offices of Johnson & Gilbert, P. A., by using the quick contact form on this page. We’d like the opportunity to hear about your case and possibly guide your recovery of the benefits that you are owed.
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