WHAT IS A STROKE?
A stroke is a condition in which the brain cells suddenly die because of a lack of oxygen.
A stroke can be caused by an obstruction in the blood flow or the rupture of an artery that feeds the brain. You may suddenly lose the ability to speak, or have memory problems, or one side of your body can become paralyzed.
The two main types of stroke are ischemic stroke and hemorrhagic stroke. Both types of stroke result in a lack of blood flow to the brain and a buildup of blood that puts too much pressure on the brain.
Ischemic stroke – Ischemic stroke is the most common type of stroke and occurs when a blood clot, or thrombus, forms that blocks blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause ischemic stroke.
Hemorrhagic stroke – A hemorrhagic stroke occurs when a blood vessel on the brain’s surface ruptures and fills the space between the brain and skull with blood (subarachnoid hemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral hemorrhage).
The outcome after a stroke depends on where the stroke occurs and how much of the brain is affected. Smaller strokes may result in minor problems, such as weakness in an arm or leg. Major strokes may lead to paralysis or death. Many patients are left with weakness on one side of the body, difficulty speaking, incontinence, and bladder problems.
WHAT ARE THE SYMPTOMS OF STROKE?
Within a few minutes of having a stroke brain cells begin to die and symptoms emerge. Recognition of the symptoms is important, as prompt treatment is crucial to recovery.
Common symptoms include:
- Trouble walking, loss of balance and coordination.
- Speech problems.
- Numbness, weakness, or paralysis.
- Blurred, blackened, or double vision.
- Sudden severe headache.
Smaller strokes (or silent strokes), however, may not cause any symptoms, but can still damage brain tissue.
A transient ischemic attack (TIA) may be a sign of an impending stroke – TIA is a temporary interruption in blood flow to part of the brain. Symptoms of TIA are similar to those of strokes but last for a shorter period and do not leave noticeable permanent damage.
WHAT ARE THE EFFECTS OF STROKE?
Strokes can range in degree of severity, and the type of damage done depends on where in the brain they occur and how long they last. Strokes can cause death immediately, or cause little limitation. Some of the common and lasting effects caused by strokes include:
- Weakness, paralysis, numbness. This refers to limitations in movement or motor ability, such as weakness and paralysis in an arm and leg on the same side of the body as a result of the blockage.
- Speech and language problems. Strokes sometimes produce some degree of loss of ability to understand or express certain aspects of written or spoken language in various combinations (known as aphasia).
- Personality changes. Strokes may produce personality changes if it is large enough and in the right area of the brain.
- Vision problems. Usually to one eye only and can affect depth perception, peripheral vision, and cause other vision issues.
- Balance problems. Strokes can affect balance and ability to walk without producing any actual weakness. Strokes may also cause unilateral neglect, or where the brain does not recognize one of the limbs, which makes it functionally useless.
CAN I RECEIVE SOCIAL SECURITY DISABILITY BENEFITS FOR STROKE?
A stroke can cause symptoms, limitations and restrictions that can impact your ability to work. Social Security Disability benefits may be available to you if you have suffered a stroke and have residual symptoms.
If you are not engaging in gainful activity due to a stroke and the effect of residual symptoms, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)
Generally, to establish a stroke as a medically determinable severe impairment, you should provide:
- Objective medical testing establishing the CVA (i.e., MRI or CT); and
- Treatment records detailing your initial hospitalization and ongoing therapy or residual effects.
At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For stroke, SSA will determine if your condition meets Listing 11.04:
- 11.04A requires you to have had a stroke with sensory or motor aphasia resulting in ineffective speech or communication more than 3 months after your stroke.
- 11.04B requires you to have had a stroke and more than 3 months afterward you have significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station.
The key to meeting the listing is to have the appropriate objective medical testing and a longitudinal medical history that addresses each of the requirements. A knowledgeable social security attorney can help you determine if your residual effects meet the listing.
If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your stroke), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.
TIPS FOR SSDI APPLICATION FOR STROKE
- Make sure that the medical records diagnosing the stroke are included. This may be an MRI, CT Scan, or other appropriate testing. It is important that you “know your medical records.”
- Make sure your medical records document ALL of your symptoms and limitations and the residual effects you experience. Your medical records should not just document your stroke, they should include your physical therapy, speech therapy or other therapy you have undergone. You need to let your doctor how often you feel symptoms, how severe each symptom is and how long each symptom lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms. Make sure any side effects of medication are noted in your records.
- Have someone assist you with your claim if your memory, concentration, etc. prevent you from completing the forms yourself.
- See a specialist. Treatment of stroke and recovery by a neurologist will carry more weight than the same diagnosis from a family physician or internist professional.
- Comply with your doctor’s orders and try what is recommended.
- See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic problems and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions.
- See your doctor regularly and keep your appointments.
- If you can, provide evidence of a long work history.
- Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity, if applicable.
- Include information from non-medical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time. These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
- Keep a journal. Make regular notes about your impairment, level of function, and treatments.
- If you need assistance with your claim, contact an attorney who specializes in Social Security Disability. For a free case evaluation, call Loyd Bourgeois at 985-240-9773