You had a stroke six months ago. You’re doing better than you were immediately after the stroke, but the effects of the stroke are severe enough that you can’t go back to work. You are considering applying for SSDI. Do you qualify?
If you have worked and paid Social Security taxes for five of the past ten years, you are eligible to apply for SSDI. If you are under 31, you may not need to have worked quite as long.
The SSA's 5 -Step Process to Determine Eligibility
The Social Security Administration (SSA) uses a five-step process to determine if you are eligible for benefits.
Step 1: Are you working? The effects of your stroke are preventing you from working, so you qualify.
Step 2: Is your condition severe? The SSA considers your condition severe if it interferes with basic work activities such as seeing, hearing, speaking, standing, walking, sitting, carrying, lifting, pushing, pulling, handling, understanding, remembering, using good judgment, and interacting with co-workers and supervisors.
Step 3: Is your condition included in the Blue Book list of disabling conditions? The easiest way to qualify for SSDI is to meet a Blue Book listing. A stroke is listed under “Vascular insult to the brain” in Neurological section 11.04. To be eligible for disability under this category, you must satisfy parts “A,” “B,” or “C”:
A. Sensory or motor aphasia resulting in ineffective speech or communication that persists for at least 3 consecutive months after the insult.
B. Disorganization of motor function in two extremities that results in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use the upper extremities, persisting for at least 3 consecutive months after the insult.
C. Marked limitation in physical functioning and in one of the following areas of mental functioning, both persisting for at least 3 consecutive months after the insult:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself
If you qualify for SSDI and meet the conditions of listing 11.04, you will likely be approved for disability benefits. However, you can still qualify for SSDI even if you don’t meet this listing.
You may qualify for SSDI under another listing. For example, some people lose their vision after a stroke. If you are unable to see, you may qualify for SSDI under listing 2.02, loss of visual acuity.
If you don’t quite meet a listing, the SSA will determine if your disability is equal in severity to another medical condition on the list. If it isn’t, they will go to Step 4.
Step 4: Can you do the work you did previously? If your condition doesn't meet or equal the requirements of a Blue Book disability listing, the SSA will evaluate your claim further. The first step is for SSA to assess your Residual Functional Capaicity (RFC) which is their assessment of your physical and mental limitations.SSA then uses this RFC to determine whether you can perform your past work given your disability. Your application will be denied if the Social Security Administration determines that you are able to do any job you have done in the past. If you can’t do the work you have done previously, the SSA will move to Step Five.
Step 5: Can you do another type of work? At this point, the SSA will consider your age, work history, education, and skills to determine if there is any other suitable type of work that you can do. It is very important that you provide good documentation of your limitations so your benefits are not denied.If you cannot perform other work based on your RFC you should qualify for benefits.
[Related: Qaulifying for SSDI After a Stroke: Part 1]
Three Ways to Qualify for SSDI after a Stroke
- Meet or equal disability listing 11.04, Vascular insult to the brain
- Meet another disability listing
- Not be able to perform your past work or any other work based on your physical and mental limitations.
Applying for SSDI can be overwhelming. Filling out the application and gathering the necessary documentation can feel like a full-time job for anyone. It can be especially difficult if your disability makes it hard to get around or communicate. Our Omaha disability attorneys can help. Learn more in our free guide, Give Yourself the Best Chance of Winning Your Social Security Disability Case, or call Cuddigan Law at 402-933-5405.