Do You Automatically Get Approved For Disability If You Had A Stroke?

Although strokes are most certainly a significant medical occurrence, they do not always lead to permanent limitations that are at a level considered disabling by Social Security. When an individual files for disability on the basis of a stroke, the disability examiner will not make a medical disability determination until at least three months have passed since the stroke occurred. They do this because Social Security considers that there is a clearer picture of what an individual's maximum medical improvement might be after three months. The disability examiner will base the disability claim on the limitations caused by the stroke.

The Social Security listing book (referred to as the blue book) evaluates cerebral vascular accidents (strokes) under impairment listing 11.04, Central Nervous System Vascular Accident. The listing criteria states that there must be one of the following more than three months after the stroke.

A. Sensory or motor aphasia (damage to the region of the brain that is responsible for language or speech caused by the stroke) that results in ineffective communicating abilities or speech; or

B. Severe and constant disorganization of motor function (paresis or paralysis, involuntary movement or tremor, ataxia, or sensory disorders) in two extremities that causes sustained disorder of an individual's gait and posture or gross and dexterous movements (assessment of the impairment of motor function depends upon how much it interferes with walking, standing, etc. and/or the use of fingers, hands, and arms).

If an individual meets the above listing criteria, they will be approved for disability benefits on the basis of their stroke. However, even if they do not meet or equal the listing criteria, they still may be approved through a medical-vocational allowance.

Medical vocational approvals consider what an individual is able to do in spite of their disabling condition, along with the individual's age, education, job history, and the transferability of their job skills.

As such, medical vocational approvals are based on a certain type of decision-making called "sequential evaluation", a five step process that requires the social security administration's decision-maker to evaluate whether or not the claimant's condition is severe, will last at one full year, and, for this period, will prevent the performance of substantial and gainful work activity at either one of their former jobs (that fall into a relevant 15 year past work history) or at some type of other work that the claimant's skills might potentially be transferrable to.

Of course, the evaluation of a claim in this manner is highly dependent on the availability (to a disability examiner or to a disability judge, depending on what level the claim is currently at) of:

1) medical records and

2) a detailed work history.

Why both? Because the disability claim decision maker will need to determine the physical and mental requirements of the claimant's past work and compare this to the claimant's current capabilities. This will also be done in conjunction with considering whether or not the claimant can transfer his or her work skills to some type of other work (that they have never done before).

In summary, if a disability examiner is able to rule out an individual's past work activity and finds that their functional ability is so compromised that it precludes the performance of other work, then the claimant may be approved for disability benefits even without meeting the requirements of the stroke listing, listing 11.04.

Note: most Social Security Disability and SSI claims are approved on a medical-vocational basis, not on the basis of satisfying the criteria of a listing in the blue book.

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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