Guide to Getting Disability Benefits for a Child With Epilepsy

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Epilepsy is a neurological disorder of the brain that causes repeated seizures. During episodes of epileptic activity, the brain, for unknown reasons, abnormally, sends electrical signals to the body. This can result in convulsions, loss of awareness, loss of consciousness (such as generalized tonic-clonic seizures), and behavioral changes (such as absence seizures, psychomotor seizures, etc.)

While epilepsy is still only partially understood, it can manifest following head injuries, trauma, or brain tumors, and there may be a genetic component. Regardless,  doctors often are unable to determine the exact cause in individual cases. Unfortunately, epilepsy, especially in children, is very complex and difficult to treat. Furthermore, the number of epilepsy diseases in the US is an eye-opener.

When epilepsy results in disability or limitations in a child’s ability to perform day-to-day tasks, that child may be eligible for federal disability benefits through the Supplemental Security Income (SSI) program. Eligibility is decided on a case-by-case basis and can depend on a myriad of circumstances.

However, to be eligible, the child’s condition must meet the definition of disability in Social Security Administration’s terms and an income and asset test, which will be based on the financial situation of the parents of the child in question. According to the process, if the SSA considers a child to meet the definition of disability due to epilepsy, the child could still not be eligible if their parents have resources and income above the thresholds.

It is always better to talk with an experienced disability lawyer and fully understand your complete legal situation before filing a claim. The experienced attorneys at Chermol & Fishman, LLC are here to help you and your loved ones get the disability benefits for epilepsy that you deserve.  

Eligibility to qualify

A child with epilepsy may be eligible for Supplemental Security Income (SSI) based on medical documentation of their condition and proof that the child’s parents or guardians have assets and income below the SSA thresholds. Once the child turns 18, he or she will need to qualify under the SSA’s adult listing for epilepsy. To seek benefits for Epilepsy, the SSA will look for the type of seizure disorder, its frequency, and severity. The SSA blue book covers epilepsy in a  listing of 112.02, which defines convulsive and nonconvulsive epilepsy.

Dyscognitive Seizures and Absence Seizures

The first type of seizures defined in the blue book are dyscognitive seizures such as partial seizures or focal seizures, complex partial seizures, and absence seizures, such as petit mal seizures.. To meet the SSA’s definition and be eligible under dyscognitive or absence seizures, the seizures must appear at least once a week for three consecutive months despite taking proper medication.

Generalized Tonic-Clonic Seizures

Another listed type of seizures are the generalized tonic-clonic seizures, commonly known as grand mal seizures or convulsive seizures. Under the blue book definition, the generalized tonic-clonic episodes must appear once a month for three consecutive months despite being under proper medications.

What are the included medical reports?

Proper medical documentation is key to any successful SSI application. If you are planning to file a claim for your child’s disability due to epilepsy, make sure the medical records contain the following:

  • A clear and convincing diagnosis of epilepsy;
  • Comprehensive doctor’s report that details the nature and frequency of the seizures typically suffered. This can include descriptions of the episodes including convulsions, losing consciousness, and memory lapses.
  • A copy of your child’s neurological examination;
  • A narrative description of how your child was before the epilepsy began. This will help determine the extent of change and damage;
  • A detailed history of every episode of seizure that the child has experienced;
  • Results of an EEG or other diagnostic tests.

If you and your family are concerned about getting benefits for a child with epilepsy, you don’t have to face the challenge alone. Instead, you may contact experienced disability attorneys to discuss your case.

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