Traumatic Brain Injury (TBI) And Social Security Disability Benefits
A traumatic brain injury (TBI) can have lasting effects on your ability to think, move, speak and function in daily life. These symptoms can make it difficult for many individuals to maintain steady, full-time employment.
Each year, approximately 2.8 million Americans sustain TBIs from falls, vehicle accidents, fire-arm related incidents, assault or other forms of physical trauma. These injuries can range from mild concussions to severe, coma-inducing brain damage, with symptoms including cognitive impairments, mobility limitations, psychological disorders and significant personality changes.
When these limitations affect your ability to work and function in daily life, you may be eligible for Social Security disability benefits.
On this Page
- Does a Traumatic Brain Injury automatically make me eligible for Social Security disability benefits?
- What counts as a Traumatic Brain Injury (TBI)?
- What other conditions can a Traumatic Brain Injury cause?
- How the Social Security Administration evaluates Traumatic Brain Injury
- How do I prove I have a Traumatic Brain Injury (TBI)?
- What evidence do I need for a Disability Claim for TBI?
- How long does a Traumatic Brain Injury (TBI) Disability Claim take?
- Contact National Disability Alliance for your Traumatic Brain Injury (TBI) disability claim
Does a Traumatic Brain Injury automatically make me eligible for Social Security disability benefits?
A traumatic brain injury (TBI) does not automatically qualify you for Social Security disability benefits.
To qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you must have TBI symptoms that last at least three months and are severe enough to prevent you from working on a consistent, full-time basis.
The SSA evaluates your TBI under its Blue Book Listing 11.18 and reviews your medical records and functional limitations. As part of its evaluation, it will review your work history to determine whether you can perform your past work or adjust to another type of employment.
What Counts as a Traumatic Brain Injury (TBI)?
A traumatic brain injury (TBI) is any brain injury caused by an outside force, such as a blow, jolt or penetrating injury to the head. The initial impact can cause displacement of the brain inside the skull or direct injury due to penetration of an object. TBIs can range from mild concussions to severe brain damage causing life-long complications.
Traumatic brain injuries can be categorized into four main types:
- Concussions: The most prevalent form of a traumatic brain injury, a concussion is a mild TBI caused by a blow to the head or body. Usually caused by falls, concussions cause symptoms such as headaches, confusion, amnesia, and ringing of the ears.
- Contusions: Bruising of brain tissue that occur in 20-30% of brain injuries, specifically coup or contre-coup injuries. Contusions are associated with brain bleeds, cerebral edema (swelling), and intracerebral hematoma (blood clot in the brain).
- Penetrating Injuries: Brain damage is sustained by gunshot wounds, stabbings, falls or sharp objects accidentally penetrating the skull.
- Anoxic or Hypoxic Injuries: Caused by a lack of oxygen in the brain, these injuries are not always caused by direct physical impact. Diffuse axonal injuries (DAIs) are a particularly severe form of TBI caused by strong forces (rotation, acceleration or deceleration) ripping the long connecting fibers of the brain.
Common Symptoms of a Traumatic Brain Injury
Traumatic brain injuries can cause a wide range of symptoms, which may appear immediately after an injury or develop over time. Common symptoms include:
- Cognitive symptoms: Memory loss, difficulty concentrating, confusion or slowed thinking, loss or altered consciousness
- Physical symptoms: Headaches, nausea or vomiting, dizziness or balance problems, blurred vision or light sensitivity, hearing or vision disturbances, weakness in the arms and legs, and sensory changes
- Sleep-related issues: Fatigue, difficulty falling asleep (insomnia), sleeping more than usual, disrupted sleeping patterns
- Social, emotional or behavioral problems: Mood swings, personality changes, depression or anxiety, irritability or aggression, impulsivity, and difficulty managing behavior.
These symptoms can significantly interfere with your ability to perform basic work activities, especially when they affect concentration, physical coordination, or emotional regulation.
Even mild TBIs, such as concussions, can cause symptoms that impact daily functioning, especially if it co-occurs with other disorders that impact daily functioning.
What Other Conditions Can a Traumatic Brain Injury Cause?
A traumatic brain injury (TBI) can affect more than just the brain. Many individuals experience additional physical, neurological and psychological conditions, as well as lasting changes in mood, personality and cognitive function. The effects of a traumatic brain injury can affect TBI patients for the rest of their lives.
TBIs are commonly associated with a range of secondary conditions affecting both physical and mental health, including:
- Seizures and post-traumatic epilepsy
- Depression and anxiety
- Sleep disorders (insomnia, fatigue, sleep apnea)
- Increased risk of stroke
- Cognitive impairment and memory loss
- Increased risk of schizophrenia
- Personality changes, such as anger or emotional instability
- Vertigo and balance issues
If your traumatic brain injury has caused you several other ailments that affect your livelihood, the Social Security Administration will evaluate your physical and mental health conditions according to their combined impact on your ability to work. Even if one impairment is not severe enough on its own, the cumulative effect of all medically determinable impairments may still qualify you for Social Security disability benefits.
For this reason, it is vital that you document all symptoms and related conditions when applying for disability benefits.
How the Social Security Administration evaluates Traumatic Brain Injury
The Social Security Administration (SSA) evaluates traumatic brain injury (TBI) claims under its Blue Book Listing 11.18. This listing covers brain injuries caused by events like skull fracture, closed head injuries caused by blunt force trauma, and objects penetrating the skull and damaging brain tissue.
To assess your condition, the SSA generally requires medical evidence documenting your symptoms from at least three months after your injury. This allows the SSA to evaluate the long-term effects of your TBI. In limited cases, the severity of the initial injury may be enough to establish a medically determinable impairment before the three-month mark.
To qualify for disability benefits, your TBI must result in severe, ongoing limitations. In most cases, you must show that, for at least three consecutive months, you experience either:
- Disorganization of motor function in two extremities that causes difficulty standing up from a seated position, poor balance while standing or walking, or limited use of your arms and hands, OR
- Marked limitation in physical functioning, and in one of the following areas of mental function:
- Understanding, remembering, or applying information
- Interacting with others
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself
If the traumatic brain injury resulted in a coma or a persistent vegetative state, the SSA will evaluate your claim under Blue Book Listing 11.20.
Even if your condition does not meet these exact criteria, you may still qualify for disability benefits if your symptoms prevent you from working.
How Do I Prove I Have A Traumatic Brain Injury (TBI)?
There is no single test that definitively diagnoses a traumatic brain injury. Instead, medical professionals rely on a combination of clinical evaluations, imaging studies, and documented symptoms to establish a medically determinable impairment.
Healthcare providers may evaluate a suspected TBI using:
- Glasgow Coma Scale (GCS): A standardized tool used to assess a person’s consciousness and neurological functioning post-injury. It measures speech abilities, eye response, and motor responses, and can be used to monitor recovery.
- Computerized tomography (CT) scan: Often performed in emergency settings, CT scans use X-rays to identify skull fractures, hemorrhage, blood clots, contusions or brain swelling.
- Magnetic resonance imaging (MRI) scan: MRIs use radio waves and magnets to detect more subtle brain abnormalities, such as minor brain bleeding (microhemorrhage), tissue damage, or scarring not initially picked up by a CT scan.
- Neurological and cognitive testing: Additional evaluations may include neuropsychological assessments, speech and language tests, cognitive function testing, social communication skills evaluations, and evaluations of coordination, breathing or swallowing.
Assessments may be performed by emergency medical professionals, neurologists, neurological surgeons or other specialists depending on the severity of your injuries. It is important to contact all relevant medical care providers to get the documents you need to prove the existence of your condition.
What Evidence Do I Need For A Disability Claim for TBI?
Your Social Security disability application does not depend on a diagnosis alone. The Social Security Administration (SSA) will evaluate how your condition affects your ability to work on a sustained, full-time basis. A key part of this evaluation is residual functional capacity (RFC), which measures the most you can do in a work setting on a regular and continuing basis despite your physical and mental limitations.
The SSA uses your RFC to determine whether you can perform your past work or transition to other work available. For this reason, your disability claim application must include evidence that your traumatic brain injury (and potentially related ailments) constitutes a medically determinable impairment that limits your ability to perform basic work activities.
Your Social Security disability claim will be bolstered by the following evidence:
- Medical records: Obtain complete medical documentation, such as doctor’s notes, imaging results, and clinical medical assessments. Records of emergency medical care and follow-up care are especially important, as they help establish the severity of your condition and document how your symptoms fluctuate over time.
- Work history: A detailed work history report should describe the duties and physical or mental demands of your previous jobs, along with specific ways your condition limits your ability to perform those tasks.
- Medical source statements: Written opinions from your doctor or healthcare provider can explain how your TBI and related ailments affect your ability to function in a work setting. This may include concentration issues, mobility problems, communication or attendance records.
- Third-party statements: Friends, family members or colleagues can attest to changes in your behavior, cognitive ability and daily functioning not otherwise reflected in medical records or statements.
How Long Does A Traumatic Brain Injury (TBI) Disability Claim Take?
The length of your TBI disability claim can depend on the severity and impact of your condition on your ability to work, how quickly the Social Security Administration can gather medical evidence, and other factors of the application process.
After the initial application is submitted, the Social Security Administration will typically take six to eight months to reach an initial determination. Approximately 30-40% of initial applications for disability benefits are approved. If your application was denied, you have 60 days to request a reconsideration.
Contact National Disability Alliance for your Traumatic Brain Injury (TBI) disability claim
Traumatic brain injuries can be difficult to prove. Symptoms are often subjective, fluctuate over time, and are not always consistently documented in medical records. In many cases, the same physical and cognitive limitations that interfere with your ability to work can also make the disability application process much more difficult to navigate.
Our team can help you build a strong claim before the Social Security Administration by clearly demonstrating how your condition limits your ability to function. We will work together and gather medical evidence that reflects the cumulative effect of your symptoms over time, properly document your work history, and show how your impairments affect your ability to sustain full-time employment.
If your condition has left you unable to work, it is vital that you understand your options. Our disability advocates at National Disability Alliance can provide an overview of disability benefits and explain how to apply for Social Security disability benefits.
We offer free consultations for no upfront cost, and we do not charge you any fees upfront. Our advocates are paid only if we are successful in your claim. To get started, contact us online or call 833-693-4722 for a free consultation.
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