Facts about Cerebral Palsy and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Cerebral palsy encompasses a variety of motor disorders that develop under the age of three, including during pregnancy. Movement and posture are primarily affected, but disabilities in cognition, communication and behavior may also be involved.
2. Cerebral palsy is a physical and not a mental disability, and therefore does not affect intellect. Those with cerebral palsy do have increased risk of learning disability.
3. Cerebral palsy does not affect life expectancy. However, independent ability, particularly the ability to feed one-self, seem related to longevity.
4. Cerebral palsy does not affect the ability to reproduce. Those with cerebral palsy can have children and many are able to care for and raise their children.
5. A 2003 study by MMWR estimated the lifetime cost of cerebral palsy, including medical expenses and lost income, at about $900,000 per individual.
6. Prevalence of cerebral palsy has increased in recent years. The cause of this increase is likely medical advancements that have decreased deaths among babies with low birth weights, since low birth rate is a risk factor for developing cerebral palsy.
7. In the United Kingdom, a 1952 charity called The Spastics Society described those with cerebral palsy as spastics. Spastic and spaz became derogatory terms are often taken with great offense among cerebral palsy patients and advocates in UK, while in the United States these terms are considered a mild insult that has no connection with any developmental disability.
8. Cerebral palsy has been recognized through a number of pop culture entertainment avenues, as well as through many notable people with the condition. This type of pop culture referencing has helped increase public awareness and understanding of cerebral palsy and it's affects.
9. The severity of disability among those with cerebral palsy varies greatly. Some may be able to live completely independently, while others may require assistance in all daily activities. Many others need assistance for only some activities but are otherwise independent.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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