Does Traumatic Brain Injury Qualify for Disability?

Is TBI a Disability?

Traumatic brain injury, or TBI, usually occurs after a strong blow or jolt to the head or from a penetrating wound to the head. It results in damage to the brain but can vary in terms of severity – people with milder TBIs may have minor symptoms and recover fully.

But if your TBI causes a permanent, severe impairment that prevents you from working, you may qualify for disability. Here are some potential symptoms of a TBI that could cause disability and prevent you from working, especially if they become permanent:

• Chronic headaches
• Dizziness
• Tinnitus
• Epilepsy or seizures
• Sleep difficulties
• Issues with balance or coordination
• Light or sound sensitivity
• Muscle weakness
• Vision problems
• Memory issues
• Cognitive difficulties, including trouble focusing or thinking clearly
• Mood swings
• Mental health issues like depression or anxiety
• Changes in personality
• Loss of impulse control
• PTSD
• Motor control or movement difficulties
• Problems with speech, language, or communication

How to Get On Disability for a Traumatic Brain Injury

In most cases, you will need to convince the Social Security Administration (SSA) that you meet the criteria for TBI as a neurological or neurocognitive disorder. If you were injured at work or have some type of disability insurance, you will probably need to get approval from your employer or an insurance company based on the terms of their policy.

In both situations, people often run into difficulties in getting their claims approved for various reasons. A traumatic brain injury lawyer can assist you and improve your chances of receiving the disability benefits you deserve.

What Are the Social Security Administration’s Criteria for TBI Disability?

First, for any disability claim, you will need copies of your medical records and an evaluation by your doctor stating that you have reached Maximum Medical Improvement (MMI) and still suffer from one or more impairments, which are likely permanent. If you’re having trouble collecting your records, your attorney may be able to help.

There are two main categories of disability that the SSA will consider when evaluating your medical records. These documents will need to show at least one of the following:

Your Tbi Caused Physical Problems With Moving at Least Two Limbs

You’re unable to control the movement of two arms, two legs, or one arm and one leg for at least three months after your injury. This causes you to have “extreme difficulty” balancing, standing, or walking, standing up from a seated position, or utilizing your arms.

You Have “Marked” Physical Problems With a “Marked” Limitation in One of the Following Areas

As with the previous category, these issues must have existed for at least three months after the injury. There are several possible categories for marked limitation:

• Thinking or cognitive issues. These might include challenges with comprehension, memory issues, following instructions, or processing information.
• Task completion. These problems might show up as difficulty with concentration or focus, doing things much more slowly than you did previously, or struggling with persistence.
• Issues with emotional regulation or behavior. You could have a hard time responding to requests, adapting to change, or understanding typical hazards.
• Social interaction. Some people with TBI develop difficulty with recognizing and understanding socially appropriate behavior.

Our clients often ask what “marked” means in this context. Sometimes, the SSA may disagree with you and your doctor about whether your symptoms are “marked,” and we may be able to present more evidence to show the severity of your difficulties.

In general, the SSA considers “marked” problems to be worse than moderate but not necessarily extreme. “Worse than moderate” can sometimes be difficult to quantify and prove, but an experienced lawyer will know what type of documentation is most likely to receive a positive response for your particular type of injury.

We’ll talk with you about your issues and ask questions regarding how they affect your life to determine the best way to help you.

What Is a Medical-Vocational Allowance for a TBI?

In some situations, there is not enough medical evidence to qualify for SSA disability under the previous parameters. We understand that this can be frustrating if you are too impaired to work but not too impaired to receive disability, and we’ll consider other options.

One possible solution is a medical-vocational allowance, an alternative way that some people can be approved for disability.

The SSA will assess your Residual Functional Capacity, or RFC, which is your capacity to perform work with your current physical and/or mental limitations. If your RFC prevents you from doing your present or most recent job, the SSA will consider if you can do other, less taxing jobs instead.

They base this determination on your education, training, skills, and work history. For example, if your current job fixing small computer components requires a high level of hand-eye coordination that you no longer have, you might not be able to do this type of work anymore.

Still, you may be able to do other jobs that don’t require such an intense level of precision. 

Should the RFC conclude that you aren’t able to maintain any gainful employment with your current limitations, they may approve you for disability under the Medical-Vocational Allowance. For many people with TBIs, this is the best path to disability approval.

How Much Does Social Security Disability Pay?

If you are approved for Social Security disability payments (SSDI), the SSA uses complex calculations to determine your monthly payment based on your previous work history (how much you’ve paid in) and previous earnings.

As a result, an older worker who has spent more years paying into the system will probably receive more than a younger worker with a similar salary. However, the amount is not particularly high for anyone – the average benefit in 2023 is $1,483/month.

Your attorney can help you calculate what your monthly payment will be. If it isn’t enough to meet your monthly needs—which is not uncommon—we can recommend other assistance programs.

For example, most Utah residents who qualify for Social Security disability are eligible for medical care through Medicaid, although you will have to fill out a separate application. (Some states automatically enroll SSDI recipients in Medicaid, but Utah is not one of them.) You may also qualify for SNAP assistance with food costs.

Can You File a Lawsuit for Your TBI?

While helping you with your disability case, we can also evaluate the situation that led to your TBI to determine if you have grounds for a civil suit. If we find evidence that your TBI was caused by the negligence of another party, you can sue them for damages, including:

• Medical bills, current and future
• Lost income, current and future
• Other economic damages
• Permanent disability or disfigurement
• Pain and suffering, both mental and physical

You can seek SSDI and file a civil claim. If you win your civil case, it should not affect your SSDI benefits because the SSA doesn’t count a personal injury settlement as income. However, if you are seeking disability benefits through the Workers’ Compensation system because you were injured at work, you will not be able to file a civil suit.

When filing a lawsuit, in addition to providing evidence of your disability, you will also have to show that it was caused by the other party’s negligence. Your lawyer will search for evidence to support your case.

Here are some examples of situations where you may have grounds for a lawsuit:

• Your TBI was caused by a car accident in which another driver was at fault.
• You sustained a TBI in another transportation accident, such as a boat or golf cart accident, and another party was at fault. In many of these cases, there are multiple parties who might be liable, and fault may not be easy to discern, but a knowledgeable attorney may be able to help you figure out what happened.
• You slipped and fell on another party’s property – such as a friend’s home or a business – and hit your head.
• You suffered a TBI as the result of a gunshot wound to the head. In some cases, it may be possible to sue the perpetrator even if there wasn’t enough evidence to convict them in criminal court because the burden of proof in a civil trial is lower. However, this is not feasible if the perpetrator hasn’t been apprehended or has no assets. In these situations, we may be able to pursue a premises liability claim if the injury happened on another party’s property due to a lack of security.

The above list contains examples of some of the more common situations we see involving TBIs. Even if your injury doesn’t fit into one of these categories, it’s a good idea to speak with an attorney so we can identify any negligent parties.

Get Help From a Utah Disability Attorney Today

If you need help with your disability application or have been denied by SSA or an insurance company, please contact Valley Law Accident and Injury Lawyers for a free consultation. We’ll review your claim, answer your questions, and explain the options. 

Valley Law was established by lead attorney Brigham Richards. After graduating from Arizona State University’s law school, he devoted himself to helping injured people and their families get the help and resources they need to move forward.

Mr. Richards can serve clients who speak English or Spanish. Work with his expert team today by calling Valley Law at 801-810-9999.