Considerations When Pursuing a Maine Social Security Disability Claim Based on a Seizure Disorder

There are a number of important considerations to keep in mind when suffering from a seizure disorder as you consider applying for Social Security disability benefits whether you’re in Maine, Massachusetts or New Hampshire.  Understanding how the Social Security Administration (SSA) analyzes such claims can help avoid unexpected surprises down the road.

As with any disability claim before SSA, it is important to understand that one needs to prove that they are suffering from a medically determinable impairment (MDI) that remains severe and disabling, despite prescribed treatment,  for what will be a year or longer.  There are two different ways to qualify for benefits: one is to prove that you meet one of Social Security’s medical listings of impairments  (at step 3 of the sequential evaluation process).

Social Security listing 11.02 addresses epilepsy (seizures) and requires documentation of what are referred to as dyscognitive seizures or generalized tonic-clonic seizures.  Dyscognitive seizures were formerly referred to as “partial complex seizures” for what are deemed to be focal seizures with altered awareness.   These are seizures that involve altered awareness or responsiveness (such as what is also called a petit mal seizure).  The other type of seizure referenced within the listing, generalized tonic-clonic seizures, refers to the type of seizure that involves loss of consciousness and violent muscle contractions.

First and foremost, as a Social Security lawyer advising Maine, Massachusetts and New Hampshire disability claimants for 28 years, we ensure our clients are remaining in consistent treatment with a specialist (that is, a neurologist) and not just a primary care.   Listing 11.02 provides, whether for dyscognitive seizures or generalized tonic seizures, the very initial requirement that the seizures be “documented by a detailed description of a typical seizures.”  Likewise, the Listing requires that the frequency of the seizures be documented: with generalized tonic clonic seizures needing to occur at least once a month for at least 3 consecutive months, and with dyscognitive seizures documented as occurring at least once a week for 3 consecutive months.

Given the impact such seizures have on one’s cognitive and physical functioning, and certainly over time, Listing 11.02 does include provisions for less frequency of such seizures if there is found to be a marked limitation in one of the following: 1) physical functioning, 2) understanding, remembering or applying information, 3) interacting with others, 4) concentrating, persisting or maintaining pace or adapting or managing oneself.    A treating neurologist who is familiar with one’s condition and can comment on these issues is critical to establishing that one meets the criteria of Listing 11.02.

However, even if one doesn’t meet Listing 11.02, one can still prove entitlement to Social Security disability benefits at at steps 4 and 5 of the sequential evaluation process by showing that one remains disabled from performing any of the past work they performed in the 15 years prior (their past relevant work) and that they remain incapable of performing any other forms of gainful employment that exist in significant numbers in the national economy.   In doing so, it’s important to understand that one needs to show that one’s seizure condition remains severe and disabling despite prescribed treatment.  This means taking one’s medication as prescribed by their treating neurologist and following their recommendations.

One of the big problems one can see in these types of cases is that one may not take their medication regularly as they may not like the side effects to the medications.   It’s important to remember that showing one remains disabled despite prescribed treatment is required, and so taking one’s medications is quite important.  SSA will take into account the side effects of one’s medications (whether they impact one’s focus or cause drowsiness) in assessing one’s ability to work (and with respect to the cognitive limitations associated with Listing 11.02).

Finally, one cannot expect to receive benefits under Social Security’s rules if alcohol and/or drugs are deemed to be substantially contributing to one’s disabling condition then benefits are not payable.   This rule has been interpreted to mean the continued use of alcohol and/or drugs, and not simply if one’s condition may have initially been brought about due to alcohol and/or drugs.  Certainly, any neurologist will explain that the use of alcohol is contraindicated when on anti-seizure medications and may not only hinder the effectiveness of the medication, but also cause additional seizure activity.

If you or someone you love has an uncontrolled seizure disorder or other disabling condition, contact the Law offices of Russell J. Goldsmith at 1-800-773-8622 to see how we can assist.

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