Stroke

A stroke, or cerebrovascular accident (“CVA”) is a disruption of blood supply to the brain that causes a rapid loss of brain function.  This can be a caused by a blockage or ischemia.  The effects of a stroke depend on which area of the brain is affected.  The effects can be temporary or permanent.  The residuals, or lingering effects, of a stroke can vary greatly from person to person.  Often people have lingering weakness on one side of their body.  Speech, vision and memory can be affected to varying degrees.  Sometimes the residuals are obvious, but often people say they just feel different but cannot describe how.

If you have had a stroke, be aware that many people recover quite well.  However, the residuals that you still have after a year following your stroke are more likely to linger into the future.  After you have had a stroke, the Social Security Administration most probably will want to wait a year to see how well you have recovered due to the durational requirement for disability benefits.  The durational requirement states that a condition must have lasted or can be expected to last for a  year or more before it can be considered part of your disability application.

A stroke can lead to disabling limitations of function.  If you are over 50 and have a history of unskilled work, you could be considered disabled if you have one sided weakness that limits you to no more than sedentary work.  That term is defined under the regulations as being able to stand or walk in combination no more than 2 hours total out of 8 hour work day, and lift no more than 10 lbs. occasionally and nothing more than light things such as papers or files frequently.  A person of any age who is limited to no more than sedentary work, but cannot use their bilateral hands any more than occasionally during the work day, could be considered disabled on that basis.

Proving disability on the basis of stroke often comes down to proving what you were like before versus what you are like now.  For that reason, it is often helpful to get statements from witnesses attesting to the change in your abilities.  Did you volunteer at church and now you cannot keep up simple tasks enough to do that anymore?  Did you bowl a perfect score every time but now you can hardly pick up the ball?  Getting statements from witness to show that how you have changed can make the difference in otherwise hard to prove cases.

If your stroke has effected a specific body system, the loss of function in that body system will be evaluated as meeting or equaling the listing related to that body system.  For instance, if you are unable to talk, you would be evaluated under the listing for speech, copied below.

2.09    Loss of speech due to any cause, with inability to produce by any means speech that can be heard, understood, or sustained.

If you have cognitive limitations related to your stroke, you should be sure to try to get a neuropsychological evaluation.  These are expensive, but they are usually the only way to clearly define what your limitations are.  The Social Security Administration’s listing of impairments covers organic brain damage in Section 12.02.  The requirements of the listing are copied below.

12.02 Organic mental disorders: Psychological or behavioral abnormalities associated with a dysfunction of the brain. History and physical examination or laboratory tests demonstrate the presence of a specific organic factor judged to be etiologically related to the abnormal mental state and loss of previously acquired functional abilities.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

1. Demonstration of a loss of specific cognitive abilities or affective changes and the medically documented persistence of at least one of the following:
2. Disorientation to time and place; or
3. Memory impairment, either short-term (inability to learn new information), intermediate, or long-term (inability to remember information that was known sometime in the past); or
4. Perceptual or thinking disturbances (e.g., hallucinations, delusions); or
5. Change in personality; or
6. Disturbance in mood; or
7. Emotional lability (e.g., explosive temper outbursts, sudden crying, etc.) and impairment in impulse control; or
8. Loss of measured intellectual ability of at least 15 I.Q. points from premorbid levels or overall impairment index clearly within the severely impaired range on neuropsychological testing, e.g., Luria-Nebraska, Halstead-Reitan, etc;

AND

1. Resulting in at least two of the following:
2. Marked restriction of activities of daily living; or
3. Marked difficulties in maintaining social functioning; or
4. Marked difficulties in maintaining concentration, persistence, or pace; or
5. Repeated episodes of decompensation, each of extended duration;

OR

1. Medically documented history of a chronic organic mental disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
2. Repeated episodes of decompensation, each of extended duration; or
3. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
4. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Blindness and visual impairment

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