Is Epilepsy a Disability? SSDI Eligibility Requirements

Epilepsy can be a disability that qualifies for Social Security Disability Insurance (SSDI) benefits if there is medical documentation, proof of treatment and limited ability to do certain tasks. It may also qualify for work accommodations under the Americans with Disabilities Act (ADA).

» MORE: People with certain disabilities can qualify for Medicare before age 65

There is no universal fixed dollar amount of SSDI benefits for epilepsy. SSDI benefits are based on, among other things, how much a person has contributed to Social Security from past earnings.

The average monthly Social Security Disability Insurance benefit was about $1,487 in September 2023, according to the Social Security Administration^[0]

» MORE: See the SSDI payment schedule

In its listing of impairments (called “the Blue Book”), the Social Security Administration details how it evaluates epilepsy for disability benefits. There are two common types of epilepsy^[0]

1. Generalized tonic-clonic seizures and dyscognitive seizures. These are characterized by loss of consciousness, sudden muscle tensing and convulsions. The SSA considers whether these occur at least once a month for at least three consecutive months despite treatment, or at least once every two months for at least four consecutive months despite treatment and with a “marked limitation” in either physical functioning; understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; or adapting or managing oneself.

2. Dyscognitive seizures. These are characterized by alteration of consciousness, but without convulsions or the loss of muscle control. Symptoms may include blank staring, change of facial expression and repetitive gestures or sounds. The SSA considers whether these seizures occur at least once a week for at least three consecutive months despite treatment, or at least once every two weeks for at least three consecutive months despite treatment and with a “marked limitation” in either physical functioning; understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; or adapting or managing oneself.

Epileptic episodes characterized by less than what’s listed above could also qualify if the symptoms prevent full-time employment, according to Jennifer Cronenberg, who is senior counsel and director of legal information with the National Organization of Social Security Claimants’ Representatives (NOSSCR).

» MORE: Learn the difference between SSDI and Supplemental Security Income (SSI)

The Americans with Disabilities Act considers epilepsy a disability, and it requires employers to provide reasonable accommodations to employees who have epilepsy^[0]

These workplace accommodations might include:

• A rubber mat or carpet to cushion a fall.

• A private area to rest after having a seizure.

• Breaks to take medication.

• Schedule adjustments, schedule consistency, permission to work at home or leave to take medicine or get treatment.

• Room for a service animal trained to alert and protect the person before and during seizures.

• Checklists to help with remembering tasks, or access to written information or instructions and voice-activated recorders for verbal instructions.

• The removal of marginal job functions to allow for more focus.

• Extended training time and refreshers.

• A mentor for daily guidance.

Epileptic events can look different for different people. Individuals should feel comfortable working with their employers to come up with a plan of action in the case of an epileptic event. This could include educating co-workers about the signs of epilepsy and what to do if someone is having a seizure.

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The SSDI application process can be arduous. It helps to have all the information required. To start the process, you’ll need the following^[0]

1. Your work history.

2. A medical history, diagnosis information, test results and medication records.

3. Information about your treatment (including physician, hospitals or clinics that provided care, plus the dates of your visits).

4. Information about any family members who may qualify for benefits if you receive benefits.

Once you’ve filled out your initial application, your local SSA office will verify your nonmedical eligibility for disability (such as whether you’ve paid Social Security taxes). Then, it transfers the application to the Disability Determination Services office in your state, which makes the decision about whether you qualify for SSDI.

You may have to fill out additional forms regarding your work history and daily functioning. Be as accurate as you can when filling these out, says Amanda Bonnesen, managing partner at the Berger and Green law firm in Pittsburgh. They are the best way to communicate your symptoms and daily struggles.

There are four levels of appeal you might pursue if your application is denied^[0]

The SSA denies the majority of disability applications (62%)^[0]

The best way to set your case up favorably is to follow the rules, Bonnesen says. That means remaining in medical treatment, sticking with recommended specialists, undergoing any necessary testing and taking all medications prescribed. Refrain from drug and alcohol use during this time, Bonnesen added.

Bonnesen also recommends keeping a daily symptom journal that you can submit to SSA. “It can just be something simple where the person writes down things like ‘had a seizure today — lasted five minutes, did not lose consciousness, but had to sleep for two hours afterward,’” she said. “Simple stuff like that, recorded in real-time, can be helpful for the decision-makers at SSA to see.”

The process for an SSDI application can last up to three years, Bonnesen said. “If a person is diagnosed with epilepsy but has been episode-free for a prolonged period, they are not likely to be found disabled, because the diagnosis is not causing any day-to-day disruption in functioning,” she said.