A traumatic brain injury (TBI) is a severe injury that can cause cognitive and physical symptoms, altering several aspects of your life, from doing simple house chores to your capacity to reason or think clearly. Even with intense medical treatment, a TBI could cause residual symptoms severe enough to cause lifelong disability.

If you have TBI, it could be challenging to continue working to earn an income because of this condition. In that situation, you should consider filing a compensation claim to receive damages for the losses caused by the injury.

Whether your TBI was caused by a car accident, defective product, or workplace injury, disability benefits or compensation can help you deal with the symptoms and other losses caused by the condition, like lost income. Unluckily, the Social Security Administration (SSA) is surprisingly known for significantly making this process complex to discourage invalid compensation claims.

Retaining the services of a seasoned attorney can increase your odds of obtaining adequate disability benefits if you or a loved one have a TBI. A skilled and seasoned disability benefits attorney can help you gather the necessary evidence and provide legal guidance through every stage of the claim process for the best possible outcome.

Is TBI a Permanent Disability?

A TBI typically results from a serious head injury or trauma that damages your brain instead of just inflicting a wound on the outside of your head. A TBI is often known as an "invisible" type of injury since it causes uncomfortable symptoms that are not apparent or obvious and are difficult to prove.

However, the severity of symptoms caused by a TBI could vary from one person to another because of the age and severity of the injury. While treatment and rehabilitation could greatly improve the symptoms associated with this condition, there is no assurance that a victim with a TBI will completely become well again.

In most situations, symptoms caused by TBI will make it challenging for you to secure reliable employment to earn an income to take care of yourself and your family. Below are some common life-altering difficulties a TBI could cause:

Cognitive Symptoms

Problems with reasoning, problem-solving, thinking, and short-term memory are the most severe and common effects of a TBI. These problems could make it challenging to organize tasks, remember crucial information, or perform daily activities while managing your household or maintaining a job. Other cognitive symptoms of TBI include:

  • Anxiety and depression.
  • Post-traumatic stress.
  • Uncontrollable mood swings.
  • Difficulty with attention and focus.
  • Personality changes, like increased aggression and anger.

Behavioral Symptoms

A TBI could damage brain sections that manage your mood, social skills, and judgment, leading to behavioral and emotional changes. People with TBI can suddenly become impulsive, irritable, become aggressive, and show poor judgment.

Physical Symptoms

A TBI has effects that go beyond the emotional or mental ones. A TBI could also cause physical challenges that could negatively affect your capability to drive a vehicle, work, or perform your usual house chores. Below are common incapacitating physical symptoms associated with a TBI:

  • Abnormal or Irregular sleep patterns.
  • Headaches.
  • Seizures or convulsions.
  • Muscle weakness.
  • Fatigue.
  • Dizziness.
  • Lack of coordination and balance.
  • Sensitivity to light and noise.
  • Blurred vision.

How to Apply for SSD (Social Security Disability) Benefits if You Have a TBI

The severe symptoms associated with a TBI could make it challenging or impossible to continue working to earn an income to care for yourself and your loved ones. That is why SSD benefits are offered to help you deal with the financial burdens caused by a TBI. However, you must meet strict eligibility criteria for these benefits, including non-medical and medical requirements or conditions.

Two programs, namely Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), offer financial support to people disabled by TBI. A sufficient tax contribution to social security is a requirement for SSDI approval. SSI is additionally accessible for low-income people, irrespective of their employment history.

Your injuries must fall under the Social Security Administration's (SSA) definition of "disability," based on the period they will last and the seriousness of your symptoms, to qualify for either SSI or SSDI. In a nutshell, explained below are the non-medical and medical requirements you need to meet to qualify for SSD benefits:

Non-Medical Requirements

To qualify for SSD benefits, the TBI should be anticipated to last about one year or cause the claimant's or plaintiff's death. The symptoms caused by the injury must also limit your capability to sit, walk, concentrate, remember instructions, and perform basic job-related duties.

The SSA will use a medical guideline known as The Blue Book to determine whether your medical conditions or symptoms caused by the TBI are severe enough to stop you from performing substantial gainful work.

According to this guide, you must have experienced any of the symptoms below for at least three (3) months to qualify for SSD benefits:

  • Difficulty understanding others and speaking.
  • Neurological symptoms like migraines, vision problems, and seizures.
  • Difficulty with attention, memory, applying information, concentrating on assigned tasks, and other cognitive capabilities.
  • Challenges with motor skills like coordinating legs and arms or balance, causing severe physical limitations.
  • Disruptive behavioral and emotional changes, like anxiety, depression, aggression, and irritability.

Even if your injury symptoms do not meet the above criteria, you could qualify for substantial disability benefits using the RFC (residual functional capacity) assessment option. RFC is an individualized evaluation method that can help determine your ability to resume your usual work duties.

As a TBI victim, you must prove that the combined limitations of your mental, cognitive, and physical abilities are significant enough to cause disability, even though they do not meet the required criteria for the above individual categories.

Generally speaking, the SSA will consider several factors, including your symptoms, medical record, work experience, education, and age, to decide what you could manage to do with the injury.

Non-Medical Conditions or Requirements

Aside from meeting the above medical criteria, when applying for SSD benefits, you must also meet other non-medical criteria, based on the kind of SSA program you choose, such as:

  1. Social Security Disability Insurance (SSDI)

Workers who meet specific income requirements and have a certain amount of work experience, especially those who pay payroll taxes into Social Security, are primarily eligible for SSDI benefits. The SSA typically will use a system known as work credit to establish whether an applicant has contributed enough to be eligible for SSDI benefits based on the following:

  • Your age.
  • When the disability occurred and when you stopped working.

Generally speaking, when applying for disability benefits under this program, you must have a minimum of forty credits, with a minimum of twenty credits earned within the past decade. However, if you are a younger worker, you could be eligible for fewer work credits.

  1. Supplemental Security Income (SSI)

SSI is typically a need-based special program for SSD benefits applicants with few resources and income, primarily if they have not worked long enough to qualify for SSDI.

What to Anticipate When Applying for SSD Benefits After Sustaining a TBI

Applying for disability benefits after sustaining a TBI is a complex bureaucratic and legal process that many people find intimidating and confusing, especially while experiencing symptoms of a TBI. Many people applying for this vital financial support after a TBI will encounter one or more denials.

Therefore, persistence is vital if you want this financial help to live a comfortable life after suffering a TBI. Having a skilled and knowledgeable attorney who comprehends the ins and outs of the legal system and the involved process can increase your chances of proving your injuries' extent to obtain disability benefits. Here is what to expect through each stage of your application process:

Gather Adequate Medical Documents

Providing the SSA with enough evidence to prove how the symptoms of a TBI impact your daily activities is critical. That means you should have well-detailed medical documents as proof of the medical diagnosis you had to undergo, the treatment offered, and any ongoing medical healthcare needs, such as:

  • Neuropsychological examinations which evaluate your memory issues and cognitive impairment.
  • Diagnostic medical tests, like magnetic resonance imaging (MRI) and computer tomography (CT) scans, show the severity of your injury.
  • Statements from therapists, doctors, physicians, and other health professionals about the challenges and limitations you are experiencing due to the TBI.
  • Documentations for therapies, medications, and all surgeries you had to undergo to treat or manage the TBI.

Initial Claim Review

Once you submit your application or claim and all the necessary documents, the DDS (Disability Determination Services) agency will review them to determine whether you qualify for disability benefits. The DDS could require you to undergo a medical examination and check-up with a medical practitioner selected by SSA or provide additional details.

Eventually, the DDS will send you a written judgment or decision, either accepting your application for disability benefits or detailing the reasons for the denial. The DDS could reject your application if it does not contain enough medical documentation, either by failing to demonstrate the seriousness of the TBI-related symptoms or by failing to demonstrate you will experience them for not less than a year.

Nonetheless, several other common technical issues could affect your claim, possibly leading to denial, for example:

  • Not returning or receiving calls from the DDS agents.
  • Not showing up for the scheduled appointment.
  • Not filling and completing necessary paperwork correctly.

In a few words, staying responsive and proactive throughout this crucial process is vital to obtaining much-needed disability benefits. Luckily, you can file an appeal with enough strong evidence to support your claim if the DDS rejects your application for SSD benefits.

File an Appeal

Most claims for disability benefits are initially unsuccessful but later accepted through appeals, meaning you do not have to be discouraged because of this common hitch. You can choose to take your disability claim through the following four administrative decisional levels or stages of the appeal process:

  1. Reconsideration

Once the DDS denies your claim for disability benefits, you will have up to sixty days to ask for a reconsideration. That means another DDS examiner will review your case again, and you or your attorney can submit any additional evidence to strengthen your claim.

  1. Administrative Law Judge (ALJ) Hearing

If the DDS denies your claim again at the reconsideration stage, you can petition for a formal hearing or proceeding before an (ALJ) administrative law judge. During this hearing, you can present your claim in person and strengthen it with additional evidence, including eyewitness and doctor testimonies, which can help prove the seriousness of the symptoms caused by the TBI.

You will need a reliable attorney with experience handling similar cases to aid you in preparing a convincing claim for the best possible results.

  1. Appeals Council

When the ALJ denies your disability claim, you can ask the Appeals Council (AC) to assess the decision. The AC can either accept your disability application, refuse it, or return it for a new ALJ hearing or proceeding.

  1. Federal District Court Review

You can file your suit with the federal district court when everything fails. Although it is a time-consuming process level of appeal, it could be the best option for you, depending on your attorney's advice and the case's circumstances.

How Your Disability Benefits Attorney Can Help

A TBI is a severe issue that can significantly alter your life. The emotional, physical, and financial distress caused by this injury can overwhelm some people because they will never regain their full health. Fortunately, SSD benefits are available to help people with TBI receive the financial help they need to deal with these challenges.

However, it is challenging to have your disability claim approved, especially if you do not have an attorney. A skilled and seasoned attorney with significant knowledge and experience handling disability claims can help you present your unique case and use the best arguments to help you obtain the best possible outcome.

To increase your odds of obtaining a favorable outcome, your disability benefits attorney will do the following:

  • Work with all your doctors and other medical experts to obtain the necessary medical evidence of the TBI and associated symptoms.
  • Assist you in gathering, preparing, and filling all the paperwork involved in the process of obtaining disability benefits, avoiding unnecessary mistakes with your application.
  • Provide the necessary legal guidance at each level of the appeal process and fight for your best interest at every formal hearing to obtain a favorable outcome.

Find a Disability Benefits Attorney Near Me

Aside from preventing you from returning to work, TBI symptoms can negatively impact your quality of life. Fortunately, you could qualify for SSD benefits to cope with the financial problems caused by the injury and live a comfortable life.

At Jacksonville Personal Injury Attorney, we can help you make knowledgeable and informed decisions at every step of the claim process and help you prove the severity of your TBI symptoms to obtain the best possible outcome. Call us at 904-800-7557 to schedule your initial, cost-free appointment with our understanding attorneys.