Strokes occur when a blood vessel in the brain either ruptures or is blocked by a clot. Both events can cause serious damage, which is why strokes are also known as ‘brain attacks.’ Depending on the severity, a stroke can lead to brain damage, disability, or even death.
Although strokes occur more commonly in those past retirement age, roughly one-quarter are happening in people under the age of 65. In many cases, these individuals are unable to work afterward, impacting their ability to take care of themselves and their families. If this happens to you, you may be eligible for medical and cash benefits through the Social Security Administration or your employer’s long-term disability plan. Let an experienced disability attorney at Bross & Frankel, PA, help you pursue the best option for your circumstances.
An Overview of Strokes
According to the Centers for Disease Control (CDC), every year over 795,000 people in the United States have a stroke. (The risk of stroke is higher in those with high blood pressure, heart disease, and certain other medical conditions.) Common symptoms include:
- Blurred, blackened, or double vision
- Numbness, weakness, or paralysis
- Speech problems
- Sudden severe headache
- Trouble walking, loss of balance and coordination during physical activity
A stroke’s effects vary depending on its type, what part of the brain was damaged, and how much damage was done. There are two main types: ischemic stroke and hemorrhagic stroke.
- Ischemic stroke: This condition is caused by a blockage or clot in a blood vessel in the brain. A blockage occurs when plaque accumulates on the inside wall of an artery. About 87% of all strokes fall into this category.
- Hemorrhagic stroke: This type of stroke occurs when an artery in your brain bursts or ruptures. The interruption of blood flow damages your brain. A major contributor to hemorrhagic strokes is high blood pressure, which weakens arteries over time.
Some stroke patients experience what’s known as a transient ischemic attack, or TIA, beforehand. Also known as ‘warning strokes,’ they are often caused by blood clots. Approximately one-third of people who don’t get treatment for TIAs have a major stroke within a year. A small percentage of these patients (10 to 15%) go on to have major recurrent strokes within three months.
According to this study, the average cost per stroke patient per year in the U.S. is $59,900. Between 2017 and 2018, stroke-related costs in the United States totaled nearly $53 billion. The total includes health care services, medicines to treat strokes, and missed work days.
Can You Get Disability After a Stroke?
If you suffer a stroke so intense that it affects your ability to hold a job and your condition is expected to last at least 12 months, you may be eligible for Social Security Administration (SSA) disability benefits. People who have experienced severe strokes often report the following disabling symptoms:
- Weakness and Paralysis: A stroke can impact your motor ability and leave you with weakness and/or paralysis in the extremities on the same side of the body.
- Balance Issues: Strokes often affect balance and walking ability without actually causing weakness. They can also result in unilateral neglect, which is when the brain fails to recognize a limb, rendering it useless.
- Vision Problems: Strokes usually affect only one eye and can alter your depth perception, peripheral vision, and other aspects of vision.
- Language Problems: Sometimes strokes result in aphasia, which reduces your ability to express yourself and/or understand others.
- Personality Changes: When a stroke occurs in the right part of the brain and is large enough, personality changes may occur.
Individually and as a group, these symptoms can make it impossible for you to work in most jobs, even if you undergo speech therapy or work with an occupational therapist afterward.
What Disability Benefits Can You Get After a Stroke?
The SSA pays cash benefits to those who cannot work because of a medical disability that lasts at least one year or results in death. There are two primary programs available, each one aimed at a specific type of applicant.
- Social Security Disability Insurance (SSDI): Workers with disabilities receive monthly benefits based on their past earnings. In order to qualify for SSDI, you must have paid into Social Security during your previous employment. After two years, you will be eligible for Medicare.
- Supplemental Security Income (SSI): People with minimal to no work history and those with low incomes, such as the elderly, are eligible for SSI. With few exceptions, your assets must not exceed $2,000 in value and your household income (if any) must not exceed the limit for its size. If approved, you will also be eligible for Medicaid.
Following a severe stroke, you may also be eligible for long-term disability (LTD) benefits through your employer. LTD benefits are based on a percentage of your income (usually 50% to 80%). To determine how long your benefits will last, you will have to review the terms of your specific policy: some plans pay until retirement age, while others pay for a fixed period, usually five or ten years.
Does a Stroke Qualify You for Disability?
The SSA evaluates disability applications based on a medical reference book called the Blue Book. There is a listing for strokes in 11.04: Vascular Insult to the Brain. To qualify, you must be able to meet at least one of the following criteria for at least three consecutive months following your stroke:
- Difficulty or inability to talk or communicate due to sensory or motor aphasia OR;
- Significant and persistent motor function issues in two extremities that impact your ability to function physically OR;
- Significant limitation in physical functioning (e.g. mobility impairment) and one of the following areas of cognitive functioning:
- The ability to understand, remember, or apply information
- Engaging in social interaction
- Concentrating, persisting, or maintaining pace
- Adapting or managing yourself
Should you not qualify under Listing 11.04 for any reason, there are other listings under which stroke patients may be approved. They include:
- 2.10: Hearing loss not treated with cochlear implantation (if you’ve suffered hearing loss)
- 2.04: Loss of visual efficiency (if your vision is impacted)
- Section 12.00, which covers mental disorders (if your cognitive abilities are affected)
Applying for SSDI and SSI Disability After a Stroke
After a stroke, it is critical to have documentation to prove your disability. The following medical and non-medical evidence should be obtained so the SSA can assess the effects of your stroke on your ability to maintain gainful employment:
- Your medical history
- Results of medical examinations
- Relevant laboratory tests
- The results of imaging tests such as x-rays, computerized tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG)
- Inpatient and/or emergency room hospital records
- Surgical notes from any operations you’ve undergone
- Notes from your primary care physician or neurologist documenting long-term or permanent loss of coordination, speech, etc.
- Physical, occupational, speech, or other therapy records
- Prescription medications you take or have taken and their effects
- Your impairments, restrictions, daily activities, or work efforts as described by others
Your doctor must complete a residual functional capacity form (RFC) for the Social Security Administration to determine whether your stroke symptoms have made it difficult for you to work. Your transferable skills will also be evaluated to see if there’s any other work you can do. If you are applying for SSI, which is means-tested, you will be interviewed by a representative of the Social Security Administration and required to prove that your income and assets do not exceed a certain level.
Can I Qualify for Disability Benefits if I Don’t Meet a Blue Book Listing?
It’s possible. If your post-stroke symptoms don’t meet any listing but still prevent you from working, you may get approved for disability under a medical-vocational allowance. The SSA will review the residual functional capacity (RFC) information that you and your doctor provide to assess your functional limitations and ability to indulge in gainful activity. Factors taken into consideration include your:
Job skills and training
Medical condition (e.g. physical and/or cognitive impairment)
The SSA can grant you a medical-vocational allowance if all these factors show that even after speech therapy or working with specialists like an occupational therapist, you’re unable to work in any job you’re otherwise qualified for.
What If My Application for Disability Benefits is Denied?
Most SSD claimants are initially rejected, so receiving a denial is upsetting but not the end of the line. In fact, over 60% of applicants have to go through the appeals process to get the cash and medical benefits they need.
You can file a request for reconsideration within 60 days of receiving the denial letter. During this initial appeal stage, an examiner who was not involved in your original denial will review your claim and determine whether you should receive benefits. If they decide against you, the next step is to request a hearing before an administrative law judge (ALJ). If the ALJ denies your claim, you can seek a review by the SSA Appeals Council or sue in federal court if the Council declines to hear your case.
The appeals process is intended to give disability claimants the best chance of getting the financial resources they need. Unfortunately, it’s also difficult and time-consuming, so you should engage the help of an experienced SSD lawyer. They can confirm that you meet the necessary disability qualifications, submit your claim, and represent you at any appeal hearings. When you hire an SSD attorney to handle your disability claim, your chances of getting benefits actually go up and you don’t have to pay them upfront: their fees will be taken from your settlement once you receive it.
Get a Free Consultation About Applying for Disability After a Stroke
A stroke can permanently alter your ability to work and even function. If you have been denied Social Security or LTD benefits, contact Bross & Frankel, PA today. We are a top-rated disability benefits firm that has handled thousands of cases for claimants in Southern New Jersey, Pennsylvania, and Delaware. We know how important a successful outcome is to you and your family and will not settle for anything less. To schedule your free consultation, call 856-210-3345 or contact us online.