Gardberg & Kemmerly, P.C. Attorneys at Law

CHANGES IN THE SEIZURE LISTINGS FOR SOCIAL SECURITY DISABILITY

CHANGES IN THE SEIZURE LISTINGS FOR SOCIAL SECURITY DISABILITY

The Social Security Administration issued changes to the Listing section 11.02 Epilepsy for Adults.

The current criteria requires both medical and non-medical evidence to assess the effects of a neurological disorder. Non-medical evidence includes statements about impairments, restrictions, daily activities, or efforts to work. For Epilepsy, limitations must exist despite adherence to prescribed treatment, which means that you are taking medication or following treatment procedures as prescribed by a physician for three consecutive months but impairment continues to meet the other listing requirements despite the treatment. The new listing defines epilepsy as a pattern of recurrent and unprovoked seizures that are manifestations of abnormal electrical activity in the brain. Psychogenic nonepileptic seizures and pseudoseizures are not epileptic seizures for the purpose of 11.02 (those are evaluated under the mental disorders body system, 12.00). The most common disabling seizure types are generalized tonic-clonic seizures and dyscognitive seizures. At least one detailed description of seizures from someone, preferably a medical professional, who has observed at least one typical seizure is required.

When determining the number of seizures you have had in a specified period, they will:

· Count multiple seizures occurring in a 24-hour period as one seizure.

· Count status epilepticus (a continuous series of seizures without return to consciousness between seizures) as one seizure.

· Count a dyscognitive seizure that progresses into a generalized tonic-clonic seizure as one generalized tonic-clonic seizure.

· They do not count seizures that occur during a period when you are not adhering to prescribed treatment without good reason. When we determine that you had good reason for not adhering to prescribed treatment, we will consider your physical, mental, educational, and communicative limitations (including any language barriers). We will consider you to have good reason for not following prescribed treatment if, for example, the treatment is very risky for you due to its consequences or unusual nature, or if you are unable to afford prescribed treatment that you are willing to accept, but for which no free community resources are available.

The new listing for Epilepsy is:

A. Generalized tonic-clonic seizures (see 11.00H1a), occurring at least once a month for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C).

OR

B. Dyscognitive seizures (see 11.00H1b), occurring at least once a week for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C).

OR
C. Generalized tonic-clonic seizures (see 11.00H1a), occurring at least once every 2 months for at least 4 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C); and a marked limitation in one of the following:

  1. Physical functioning (see 11.00G3a); or
  2. Understanding, remembering, or applying information (see 11.00G3b(i)); or
  3. Interacting with others (see 11.00G3b(ii)); or
  4. Concentrating, persisting, or maintaining pace (see 11.00G3b(iii)); or
  5. Adapting or managing oneself (see 11.00G3b(iv)).

OR
D. Dyscognitive seizures (see 11.00H1b), occurring at least once every 2 weeks for at least 3 consecutive months (see 11.00H4) despite adherence to prescribed treatment (see 11.00C); and a marked limitation in one of the following:

  1. Physical functioning (see 11.00G3a); or
  2. Understanding, remembering, or applying information (see 11.00G3b(i)); or
  3. Interacting with others (see 11.00G3b(ii)); or
  4. Concentrating, persisting, or maintaining pace (see 11.00G3b(iii)); or
  5. Adapting or managing oneself (see 11.00G3b(iv)).

The new Epilepsy criteria are different from the previous listing set out by the Social Security Administration. These changes will affect the way an Epilepsy claim is processed and evaluated at not just the initial level, but by an Administrative Law Judge at the hearing level. Understanding and evaluating your claim under the Epilepsy listing will require medical record documentation and lab results in order to be properly presented before the Social Security Administration.

If you are disabled due to Epilepsy or any neurological condition and in need of assistance navigating the disability process, call one of the experienced disability attorneys at Gardberg & Kemmerly, P.C. today at 251-343-1111 for a free consultation. Gardberg & Kemmerly specialize in helping the injured and disabled.

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