Disability Benefits for Stroke Victims

Strokes are caused by either a blocked blood vessel or hemorrhage in the brain. In either case, blood flow to the brain is decreased or stopped, causing significant brain injury. Some people are able to recover from the effects of a stroke but others are left with lifelong disabilities. Stroke victims may lose the ability to communicate, have significant trouble with walking and balance, and may experience damaged vision.

Can I Get Disability for My Stroke?

To qualify for disability for your stroke the Social Security Administration (SSA) must first make several basic determinations:

• You may not earn more than about $1,550 a month (referred to as Substantial Gainful Activity or SGA).
• Your disability must last at least 12 months.
• Your disability must be "severe" (have at least a minimal impact on the ability to perform your work related activities).

Once the SSA has established your initial eligibility, it must next determine whether your stroke meets or equals one of the conditions established in the Listing of Impairments. If your stroke meets or equals a listing you will be automatically approved for disability.

Listing 11.04, Vascular Insult to the Brain

Strokes are a qualifying condition under listing 11.04, vascular insult to the brain. To be automatically approved under listing 11.04, you must show that you have suffered one of the following sets of symptoms for more than three months following your stroke:

• The inability to speak or communicate effectively due to either expressive aphasia (having difficulty forming words, also called motor aphasia) or sensory aphasia (characterized by fluent, nonsensical speech and the inability to understand, or also called receptive aphasia).

OR

• The inability to control the movement of at least two extremities (either an arm and a leg or two arms or two legs), despite at least three months of treatment. This must result in extreme difficulty in the ability to balance while standing or walking, to stand up from a seated position, or to use the arms.

OR

• "Marked" physical problems along with a "marked" limitation in any one of the following:
  • thinking (understanding, remembering, or using information)
  • interacting with others (social problems)
  • finishing tasks (problems with concentration, persistence, or speed), or
  • regulating emotions and controlling behavior (such as problems responding to demands, adapting to changes, or being aware of normal hazards).

Note that marked means seriously limiting; it is worse than moderate, but less than extreme.

Listing 2.00 Special Senses and Speech

Some stroke victims suffer significant damage to their vision as a result of their stroke. If you experience vision complications, you could automatically qualify for disability under listing 2.00. There are several ways to qualify under Listing 2.00; you must meet only one of the following requirements.

• Your corrected (with glasses) vision in your better eye must be 20/200 or less.
• You suffered significant loss in your visual field.
• Your visual efficiency in your better eye is 20% or less with glasses.
• You no longer have the ability to speak and be understood by others even with an assistive device.

What If My Stroke Doesn't Meet the Disability Listing Requirements?

Even if your stroke doesn't meet the severity requirements of a listing, you may still be approved. The SSA must determine whether you can do your old job despite the limitations caused by your stroke. If it believes you can do your old job despite your stroke, your claim will be automatically denied. But if the SSA agrees that your stroke prevents you from doing your old job, it will next determine if there is any other work you can do.

To establish whether there is any other work you can perform despite your stroke, the SSA will consider the combined effects of your age, education, past work experience, and documented work-related limitations. Social Security will develop a Residual Functional Capacity (RFC) assessment for you, a detailed report that details the limitations you have on your ability to perform basic work-related activities. For example, if you are prescribed a walker or cane, this should be included in your RFC. If your memory is impaired because of your stroke and it has become difficult to remember and follow simple instructions, this should be discussed in your RFC. Also, if your stroke has caused significant weakness and you now are required to rest throughout the day, your RFC should reflect this as well.

It is important that your doctor include in your medical records any evidence of your work-related limitations. If you can prove that, because of your stroke, there is no work you can do, your claim will be approved.