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SSDI Evaluation

Epilepsy and Social Security Disability Insurance

Here is an explanation of Social Security's five-step process to determine if an epilepsy patient qualifies for SSDI:

1.  Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $1,040 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

2.  Conclude the epilepsy disability must be severe enough to significantly limit one's ability to perform basic work activities needed to do most jobs. For example:

  • Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
  • Seeing, hearing and speaking
  • Understanding/carrying out and remembering simple instructions
  • Responding appropriately to supervision, co-workers and usual work situations
  • Dealing with changes in a routine work setting

3.  In epilepsy, regardless of etiology, degree of impairment will be determined according to type, frequency, duration and sequel of seizures. At least one detailed description of a typical seizure is required. Testimony of persons other than the claimant is essential for description of type and frequency of seizures if professional observation is not available. Epilepsy is evaluated under the neurological body system - medical listing 11.02 and 11.03.

11.02 Epilepsy - convulsive epilepsy (grand mal or psychomotor) documented by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once a month, in spite of at least three months of prescribed treatment. This also includes daytime episodes (loss of consciousness and convulsive seizures) or nocturnal episodes manifesting residuals which interfere significantly with activity during the day.

11.03 Epilepsy - non-convulsive epilepsy (petit mal, psychomotor or focal) documented by detailed description of a typical seizure pattern, including all associated phenomena, occurring more frequently than once weekly, in spite of at least three months of prescribed treatment. This also includes alteration of awareness or loss of consciousness and transient postictal manifestations of unconventional behavior or significant interference with activity during the day.

4.  Explore the ability of an individual to perform work they have done in the past despite their epilepsy. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

5.  Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine epilepsy disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of epilepsy, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to the epilepsy disability, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to the epilepsy disability unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.

Any age and, because of epilepsy, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.

Check out information regarding the prescription drugs used to treat epilepsy.

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