Getting Social Security Disability Benefits For a Stroke

A stroke occurs when blood flow to the brain is stopped or reduced—typically due to a blocked blood vessel or cranial hemorrhage—causing significant brain damage. After a stroke, people may have difficulty speaking, trouble maintaining balance while walking, or have vision problems.

While some people are able to fully recover from the effects of a stroke, others are left with serious physical and mental limitations on their activities of daily living. People who have severe limitations after a stroke that significantly affect their ability to work may qualify for Social Security disability benefits.

How Can You Get Disability for a Stroke?

In order to qualify for disability after a stroke, Social Security first needs to see that you're financially eligible to receive disability benefits (SSDI or SSI). SSDI eligibility is based on how much you've paid in payroll taxes, while SSI is needs-based and has certain income and asset limits.

Once Social Security is satisfied that you're legally allowed to get SSDI or SSI, the agency then needs to see that you aren't working above the substantial gainful activity threshold (about $1,550 a month). Social Security must also see that you have limitations severe enough to have "more than a minimal impact" on your ability to perform work-related activities for at least one year.

You can qualify for disability benefits when these limitations either meet the requirements of a listed impairment (a medical condition that Social Security considers especially severe) or keep you from working any job on a regular, full-time basis.

Does a Stroke Ever Automatically Qualify You for Disability?

In certain instances, yes. You can qualify for disability automatically if you have limitations following a stroke that meet the requirements of Social Security's "Blue Book" listing 11.04, Vascular insult to the brain.

You can qualify automatically for a stroke under listing 11.04 in one of three ways:

• You're unable to communicate effectively due to sensory or motor aphasia (damage to the parts of the brain that control language), such as being unable to convey your thoughts in simple language or follow one-step instructions.
• You're unable to control motor function in at least two extremities (either an arm and a leg or two arms or two legs), causing you to have extreme difficulty performing basic movements such as balancing while walking, standing up from a seated position, or using your upper extremities.
• You have "marked" limitations in both physical and mental functioning, specifically in the mental areas of understanding information, interacting with others, concentrating on tasks, and adapting to changes.

A "marked" limitation means you find it difficult to regularly function independently in a particular area. If you need help getting dressed or take a long time to write a short grocery list, for example, it's likely that Social Security will find that you have a marked limitation in physical or mental functioning respectively.

Strokes often cause visual impairments and trouble speaking. Social Security has several listings in Blue Book category 2.00, "Special Senses and Speech," that cover disabling sensory complications resulting from a stroke. If you have medical documentation of these complications, you might qualify for disability automatically under the following listings:

• Listing 2.02, Loss of central visual acuity, if the remaining vision in your better eye after correction (meaning with glasses or contacts) is 20/200 or less.
• Listing 2.03, Contraction of the visual field in the better eye, if you have a significant reduction in your visual field ("tunnel vision").
• Listing 2.04, Loss of visual efficiency in the better eye, if you have both reduced visual field and loss of visual acuity ("blurred vision") after correction.
• Listing 2.09, Loss of speech, if you no longer have the ability to speak and be understood by others even with an assistive device.

You'll need to have certain visual tests performed, such as reading a Snellen chart (the eye chart with a big "E" on the top) in order to demonstrate the vision loss needed to meet the above listings. When needed, a loss of speech determination can be made by an otolaryngologist (ear, nose, and throat doctor) or a speech pathologist.

Is a Stroke Considered a Disability Even If You Don't Meet the Listing Requirements?

Yes, you can qualify for disability benefits without meeting the listing criteria if you're unable to work after your stroke. Social Security will review your medical records, daily activities, and doctors' opinions for evidence of limitations, physical and mental, that could affect your job performance. This process is called assessing your residual functional capacity (RFC).

Your RFC is a set of restrictions on what you can and can't do at work. For example, if you have a prescription for a walker or a cane, your RFC should mention that you need "ambulatory aides" to perform your job duties, or you might be limited to sit-down jobs. If you find it difficult to remember and follow simple instructions, your RFC might restrict you to unskilled work. And if you need to rest or take breaks because your stroke has caused you to become easily fatigued, your RFC may say that you'd be "off-task" a certain percentage of the workday.

Social Security compares your RFC with the demands of your old jobs to see whether you could still do those jobs today. If not, the agency will need to determine whether other jobs exist that you could perform despite the limitations in your RFC, taking into consideration factors such as your age, education, and work history. If no jobs exist that you could do, Social Security will find you disabled in what's called a "medical-vocational allowance."

Applying for Social Security Disability Benefits After a Stroke

Social Security provides several easy methods for you to start your disability application. You can choose the one that you're most comfortable with:

• File online at Social Security's official website.
• Call 800-772-1213 (TTY 800-325-0778 if you're deaf or hard of hearing) from 8 a.m. to 7 p.m., Monday through Friday, to speak with a Social Security representative.
• Go in person to your local Social Security field office.

If you'd like help with your application, consider speaking with an experienced disability attorney. A lawyer can be especially helpful for people whose memories have been affected by a stroke, as they can keep on top of important appeal deadlines and gather the necessary medical evidence. Most disability attorneys offer free consultations, so you can get a sense of the strengths and weaknesses of your claim and what you'll need to qualify for disability.

_{Updated April 25, 2024}