Traumatic brain injury (TBI) usually happens when you suffer an injury to the brain. Usually, this can be caused by different events. The most common include falls, car accidents or sports injuries. Most people recover well from symptoms caused by the injury. However, sometimes symptoms can last much longer.
Symptoms of traumatic brain injury
Traumatic brain injuries can cause many different symptoms. These can include difficulty thinking, feeling slowed down or difficulty concentrating. Traumatic brain injuries can cause physical symptoms. These include headaches, nausea or vomiting or feeling tired. Traumatic brain injuries can also cause mood symptoms. Mood symptoms include irritability, sadness or anxiety. Traumatic brain injuries can also interfere with sleep.
Social Security disability benefits for traumatic brain injury
You can apply for Social Security disability if you have a TBI. However, you must meet certain requirements to receive benefits. Generally, your condition must interfere with your normal daily activities. Additionally, your symptoms must keep you from working for at least 12 months. To qualify for Social Security disability insurance benefits (SSDI) you also must have worked a certain number of years recently.
Social Security definition of traumatic brain injury
Social Security provides a listing of impairments, known as the “Blue Book”. The Blue Book provides specific conditions you must meet to qualify for disability benefits. Typically, the listings consider the most extreme severity of symptoms. Social Security considers traumatic brain injury under listing 11.18.
Listing 11.18 traumatic brain injury
Social Security considers traumatic brain injury as brain damage caused by skull fracture, a closed head injury or penetration by an object into the brain tissue. To qualify under the listing you must show:
The inability to control the movement of at least two extremities (either an arm and a leg or two arms or two legs AND
Extreme difficulty in balancing when standing or walking, standing up from a seated position or using the arms OR
“Marked” physical problems and a “marked” limitation (for at least 3 months post-injury) in any one of the following:
Thinking
Interacting with others
Finishing tasks
Regulating emotions and controlling your behavior
Meeting the listing for traumatic brain injury
Social Security defines marked as more than moderate but not extreme. “Marked” means having a serious limitation in that area of functioning. “Extreme” means not being able to function in that area at all.
What if my traumatic brain injury doesn’t meet the listing?
Many people will not meet the listing for traumatic brain injury. However, you can still get disability benefits. Specifically, you need to show that your traumatic brain injury limits your functioning and keeps you from working. If you don’t meet the listing, Social Security considers your residual functional capacity (RFC). Your RFC includes the most you can do despite your conditions.
Example 1: traumatic brain injury and Social Security disability
For example, Donald had a car accident and hit his head. He lost consciousness when he hit his head. Following his accident, Donald started having frequent headaches. He started having problems with his balance. Donald also started having trouble remembering things and concentrating. He became irritable easily. Social Security found that Donald’s symptoms would cause him to miss work frequently. They also found that he would not be able to stay focused throughout a work day. Therefore, Social Security approved his case.
Medical evidence for traumatic brain injury
Social Security needs evidence showing that your symptoms cause severe problems. Therefore, you must provide medical evidence related to your traumatic brain injury. Generally, medical evidence includes your doctor’s notes, test results and imaging. Your doctor should document:
Any physical problems using your arms or legs
Difficulty with balance or coordination
The frequency and severity of ongoing symptoms such as headaches or blurred vision
Behavioral changes in your mood or personality
Problems with focus or concentration
Side effects from medications
RFC forms for traumatic brain injury
Frequently, traumatic brain injuries cause both physical and mental symptoms. An RFC form can help explain how your condition impacts your functioning. It should be very detailed. It should include all of your symptoms and treatment. Your doctor should include both your physical and mental limitations. An experienced disability advocate can provide these forms to you.
Social Security grid rules
Social Security uses a chart called the Medical-Vocational guidelines, known as the “grid rules”. They use this chart to help evaluate your disability claim. These grid rules make it easier for people over 50 to win their disability case. The grid rules make it even easier for people over 55. The grid rules allow Social Security to approve your case if you can’t do your past work, even if you can do other types of less physical work.
Example 2: grid rules over 50
For example, Paula, 53, suffered a TBI. Her symptoms included frequent headaches, poor sleep and difficulty concentrating. Paula previously worked as a cashier and warehouse worker. Social Security found that Paula could not stand or walk for long periods. They also found she could only perform simple and routine tasks. She was not able do either of her past jobs. Social Security found she could do simple, seated jobs. However, under the grid rules, Paula was approved for benefits.
Example 3: grid rules over 55
In another example, Bob worked as a mail carrier. He suffered from a TBI. Following his injury, he started having seizures. He also suffered from weakness in his arms and legs and mood swings. Social Security found that Bob could not return to his job as a mail carrier. Social Security found that he could do other less physical jobs. However, since Bob was 57 years old, the grid rules applied. Social Security approved his disability claim.
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You can receive both VA disability and Social Security disability benefits. Frequently, disabled veterans apply for both benefits. Receiving Social Security disability doesn’t provide extra VA disability benefits. However, it can help increase your VA disability rating.
VA disability vs. Social Security disability
The VA offers disability benefits for disabilities connected to your service. You can get partial disability benefits from the VA. VA disability compensation rates range from 10% to 100% in 10% increments. Social Security offers two types of benefits. You must have worked to apply for Social Security disability insurance benefits (SSDI). You must meet certain financial conditions for Supplemental Security Income benefits (SSI). Under both SSDI and SSI, your medical conditions must keep you from working for at least 12 months. Unlike the VA, Social Security doesn’t offer partial disability.
VA disability benefits
The VA requires that you meet certain conditions for disability benefits. Most importantly, you must show that your medical conditions are service-connected. You must also show a medical nexus or connection between your condition and in-service incurrence. Service-connected means:
Your condition was directly caused by military service
A condition was caused by conditions that are service-connected
VA disability: TDUI
It can be hard to get a 100% disability rating when you have more than one disabling condition. Fortunately, the VA provides an alternate way to total disability. You can receive VA total disability under total disability individual unemployability (TDUI). You meet the conditions for a TDUI rating if your disabilities prevent you from working and have a single service-connected rating or have a combined disability rating of 70%
Increasing your VA disability rating
Social Security recipients can use their decision to help increase their VA rating. Social Security hearing decisions provide detailed reasons for approval. You can use your Social Security decision to:
Help establish your diagnosis, establish service-connection or establish severity
Using your Social Security decision to establish a diagnosis
Social Security looks at your medically determinable impairments (MDI). An MDI includes any conditions that have more than a slight impact on your functioning. Your Social Security hearing decision lists all of your disabilities. Therefore, your Social Security approval helps determine your diagnosis.
Example 1: establishing a diagnosis
For example, Sam applied for Social Security benefits for both physical and mental conditions. In Sam’s decision, the judge listed all of the conditions he considered when deciding disability. The judge also included specific medical evidence that supported his diagnoses. Sam was able to use his hearing decision to help establish his diagnoses.
Using your Social Security decision to establish service-connection
During a Social Security disability hearing, judges ask a lot of questions about your disabilities. Frequently, you have to provide detailed explanations about your conditions. Often, this includes when your conditions started. A Social Security hearing decision includes a summary of what you said during your hearing. Therefore, your Social Security hearing decision can help establish service-connection.
Example 2: establishing service-connection
In another example, Paul applied for Social Security disability benefits for degenerative disc disease and spinal stenosis. During the hearing, he testified that he injured his back while on active duty. Paul’s testimony included specific details how his injury occurred. The judge’s decision included Paul’s testimony. Paul was able to use his Social Security hearing decision to help establish that his back condition was connected to his service.
Using your Social Security decision to establish severity
Social Security has very difficult conditions to meet for disability benefits. You must show that your medical conditions prevent you from working in any job. A judge’s decision explains why a case meets the conditions for disability. Specifically, the decision explains how significantly medical conditions impact your functioning. Therefore, a Social Security disability decision can help explain the severity of your conditions.
Example 3: establishing severity
For instance, John applied for disability benefits for PTSD. During his hearing, he testified that he often had flashbacks and nightmares as a result of his service. John also testified that he would become paranoid. His paranoia made it difficult to be around others. He had difficulty concentrating because of his poor sleep. In the hearing decision, the judge explained that John’s PTSD symptoms caused severe problems concentrating. The judge also explained that John’s symptoms would cause him to miss work a lot, making him unlikely to keep a job. John provided the VA a copy of his decision, helping him qualify for TDUI.
Using your Social Security disability evidence to support your VA disability
Many times, veterans receive treatment from both the VA and civilian doctors. Social Security disability claims need a lot of medical evidence. Therefore, your Social Security disability file should include most of your medical records. You can use your Social Security disability file to help support your VA disability claim or appeal.
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What Are the Social Security Disability GRIDS? Generally, Social Security defines disability as having the inability to work. Social Security considers your ability to go back to your past work. They also look at your ability to do other types of work. However, Social Security understands it may be harder for older individuals to learn new work. Therefore, Social Security has more favorable rules for people over age 50.
What are the GRIDS?
Social Security uses a medical-vocational chart known as the GRIDS when evaluating disability claims. The GRIDS consider different factors including your age, education and work background. They also consider your residual functional capacity or RFC. Social Security looks at the GRIDS chart to see if you qualify for disability even if you can do other types of work.
Social Security Disability GRIDS and your past work
When you apply for disability, you must provide your work history. Social Security asks you to explain the type of jobs you had going back 15 years. They ask you how long you did each job. They also ask how much you earned at your past jobs. Only work done in the past 15 years that resulted in significant earnings is considered relevant for your disability claim. The GRIDS won’t apply if Social Security thinks you can do any past work.
Social Security Disability GRIDS and your RFC
Social Security defines your RFC as what you can do despite your limitations. An RFC includes both mental and physical limitations. Social Security reviews your medical records to figure out your RFC. Therefore, it is extremely important that tell Social Security about all of your doctors. You should see your doctors regularly. Your doctors can help you case by completing an RFC form. They should include both physical and mental limitations caused by your medical conditions. They should also include any side effects from medications or pain levels. Your disability advocate can provide these forms for your doctor.
Social Security Disability GRIDS: categories of work
The GRIDS divide work into several different physical categories. The more physical your past work, the more likely the GRIDS will help you win your case. These categories include:
Sedentary – sitting jobs that don’t require lifting more than 10 pounds
Light – usually require more standing and walking and don’t require lifting more than 20 pounds
Medium – requires lifting between 25-50 pounds
Heavy – requires lifting more than 50 pounds
Social Security Disability GRIDS: transferable skills
In addition to physical limitations, Social Security also considers skills required to do your past work. They must figure out if you can use skills from your past work to do other types of jobs with little or no new training. Social Security considers these types of skills “transferable skills”. If your past work has transferable skills, it may be harder to apply the GRIDS. Any problems you have with memory, attention or concentration can help eliminate transferable skills. If Social Security finds that you can only perform simple or routine tasks, transferable skills don’t apply. Usually, to prove this limitation, you need mental health treatment.
Example 1: applying the GRIDS over 50
In one case, a 53 year old man applied for disability benefits after he broke his ankle. He required surgery and had pins and screws in his foot, developed arthritis in the ankle and ongoing pain. He required a cane, previously worked as a line cook and dishwasher. Social Security found that he could no longer perform his past work as a line cook or dishwasher. They also found he could only do sedentary jobs. Since his past work had no transferable skills, the GRIDS applied. Social Security approved his disability claim.
Example 2: applying the GRIDS over 50
In another case, a 50 year old woman applied for disability benefits because she had lumbar disc disease, osteoarthritis in her knees and depression. She previously worked as a medical receptionist and office clerk. Social Security found despite her impairments, she could still perform sedentary work. However, they also found she could only perform simple and routine tasks due to her depression. Since her job required more complex tasks, she was not able to return to her past work. Therefore, the GRIDS allowed Social Security to approve her claim.
Example 3: applying the GRIDS over 55
For example, a 58 year old man applied for disability after he had a heart attack. He needed heart surgery and had several stents placed. His doctor told him he could no longer lift more than 10 pounds due to the stents. Despite surgery, he also continued to have chest pain and shortness of breath. He previously worked as a dump truck driver. Social Security found that he could not perform his past work. However, they felt he could do light work. Since he was 58 years old and could no longer perform his past work, the GRIDS applied. He was awarded disability benefits.
Example 4: applying the GRIDS over 55
In another example, a 60 year old woman filed for disability due to diabetes, diabetic neuropathy, asthma and anxiety. She previously worked as an auditor and housekeeper. Social Security found that she could not return to her past work as an auditor because she could only perform simple tasks. They found she could not return to her past work as a housekeeper because she could not stand or walk for long periods. They applied the GRIDS and found her disabled.
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Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
Can I Get SSDI if I am 60 years old? You can get disability benefits up until full retirement age. Currently, full retirement age is 66 and 2 months. Generally, winning a disability claim gets easier for people as they get older.
SSDI vs. Early Retirement
You can file for early retirement benefits once you turn 62. However, collecting early retirement rather than filing for SSDI has some drawbacks. If you take early retirement, your benefit amount will be permanently reduced. The amount Social Security reduces your benefit depends on the number of months you have until your reach full retirement age. If you apply and get approved for SSDI, you will receive 100% of your monthly benefit. That benefit continues when it switches over to Social Security when you reach full retirement age.
Filing for SSDI at 60 years old
SSDI benefits can be time consuming and challenging. However, if you have the proper documentation to support your claim, you can win your claim. SSDI requires that your medical conditions prevent you from working. Additionally, you must be incapable of working for at least 12 months. Luckily, Social Security can make it easier to receive SSDI when they are close to retirement age.
SSDI at 60: medical evidence
Social Security has to figure out how your conditions interfere with your daily activities. They do this by reviewing your medical records. Therefore, you need to see your doctors regularly for your conditions. Additionally, you should be in treatment with specialists. Frequently, records kept by specialists document your symptoms and problems better than your general doctor. Your doctors can also help your claim by completing a form explaining how your conditions impact your functioning, known as an RFC form.
SSDI at 60: grid rules
Social Security considers several factors to decide if a person qualifies for SSDI. These factors include a person’s age, education, residual functional capacity (RFC) and their work history. Your RFC includes what you can do despite your medical conditions. Once Social Security figures out your RFC, they consider the grid rules.
SSDI at 60: applying the grid rules
Once Social Security figures out your RFC and you past work, they will look to the grid rules. Basically, the grid rules allow Social Security to approve your SSDI claim even if you can do other work. Social Security has separate charts for different physical categories. Specifically, they include sedentary, light and medium physical categories.
SSDI at 60: Your past work
In order to apply the grid rules, Social Security must categorize your past work. The grid rules only apply if you can’t return to any of your past work. Social Security only considers past relevant work. Past relevant work includes work you’ve done within the past 15 years. Additionally, it should have resulted in significant earnings. Temporary or part-time jobs might not count as past relevant work. Your past work gets classified under one of the physical categories.
SSDI at 60: your job skills
Social Security looks at the type of skills required to do your past work. Social Security considers whether any skills you learned at your previous jobs could be used to do something else. If you do, Social Security considers them “transferable skills”. Generally, people who performed semi-skilled or skilled jobs will have developed skills they could use doing something else. This can make it harder to apply the grid rules. However, at age 60, there must be little to no additional training or adjustment. Some jobs require such specialized skills, Social Security will decide that the worker doesn’t have transferable skills.
SSDI at 60: your RFC
Your RFC can include both mental and physical limitations. Social Security evaluates your ability to perform activities required for you to work. You must show that your medical conditions interfere with your daily activities. Social Security reviews your medical records to figure out your RFC.
Example 1: applying the grid rules at 60
Julia, a 61 year old woman applied for SSDI due to coronary artery disease and high blood pressure. She also suffers from depression. Julia previously worked as a cook. Her job required her to lift and carry up to 50 pounds at times. Social Security found that she could not perform her job as a cook. She had no transferable skills. Social Security awarded Julia disability benefits.
Example 2: applying the grid rules at 60
Frank, a 60 year old man applied for SSDI due to a right shoulder injury. He previously worked as a janitor. He also had past work as a construction worker. Frank has difficulty lifting and carrying heavy items with his right arm. In fact, he can’t pick up more than 15 pounds. Social Security found that Frank could perform light work. Frank has no transferable skills. Therefore, Social Security approved Frank’s SSDI claim.
Disability Help Group: SSDI at 60 case study
For example, Matthew applied for SSDI because he had arthritis in his knees. He was 62 years old and worked as a fork-lift operator in a warehouse for many years. Matthew had only visited his primary care doctor. His doctor gave him a referral to physical therapy. Unfortunately, Matthew as denied for SSDI. He then contacted Disability Help Group for help with his appeal. Our advocate suggested that he get x-rays and imaging of his knees. She also suggested that he get a prescription for the cane he used. Matthew followed his advocate’s advice. On appeal, Matthew’s additional medical evidence helped show that he could not return to his job as a fork-lift operator. Therefore, Social Security applied the grid rules and approved his case.
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Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
What Are the GRIDS for SSDI? Social Security has special disability rules for people over the age 50. Social Security uses a chart called the Medical-Vocational guidelines to evaluate your claim known as the “grid rules”. The grid rules make it easier for older people to win their case.
SSDI GRIDS factors
Social Security understands that it may be harder for people over 50 to do new or different work. First, Social Security considers whether your conditions meet specific requirements under their medical listings. Often, these conditions can be very difficult to meet. Next, Social Security considers the GRIDS. The grid rules consider several factors. These include:
Your age, education or work history
Skills from your past work
Your residual functional capacity (RFC)
SSDI GRIDS and your age
Generally, Social Security divides people into four age groups. Typically, if you are 50 or older, Social Security can use the GRIDS to approve your case even if you can do other work. The rules can be even more favorable for people over 55. These age groups include:
Younger individuals: ages 18-49
Closely approaching advanced age: ages 50-54
Advanced age: ages 55-59
Closely approaching retirement age: ages 60 and older
SSDI GRIDS and your education
Social Security considers your education level. Generally, the less education you have, the harder it would be to find other types of jobs. Social Security used to consider a person’s ability to communicate in English. However, a recent rule change removed this factor. Education categories include:
Illiteracy – inability to read or write in any language
Marginal – completed 6th grade or less in any country
Limited – completed 7th through 11th grade in any country
High school education and above in any country
SSDI GRIDS and you work history
Social Security must categorize your past work before applying the GRIDS. The GRIDS only apply if you can’t perform any of your past work. Social Security only considers past relevant work. This includes work performed in the last 15 years. It must have resulted in significant earnings. Temporary or part-time jobs might not count as past relevant work. Providing accurate information about your past work can be very important to your SSDI case.
SSDI GRIDS and physical levels of work
Social Security divides types of work by their physical requirements. For people 50 or older, the more physical your past work was, the easier it is for Social Security to apply the GRIDS. The physical categories of work include:
Sedentary – sitting jobs that don’t require lifting more than 10 pounds
Light – usually require more standing and walking and don’t require lifting more than 20 pounds
Medium – requires lifting between 25-50 pounds
Heavy – requires lifting more than 50 pounds
SSDI GRIDS and job skills
Social Security looks at any skills required to perform your past work. Sometimes, skills from your past work can be used to do different types of jobs. Generally, these skills can be used in other jobs with little or no additional training. Social Security refers to these skills as “transferable skills”. If Social Security finds that you have transferable skills to other work, the GRIDS may be harder to apply.
SSDI GRIDS and getting around transferable skills
However, there can be ways around transferable skills. Typically, this can be done if you have a mental health impairment. Mental health impairments include conditions such as depression or anxiety. However, they can also include side effects from medications or the impact pain has on mental functioning. When a person has medical evidence documenting mental health impairment, Social Security must evaluate their ability to perform the mental demands of work. Usually, Social Security concludes a person can only perform simple, routine tasks when there is evidence of mental health impairment. This limitation eliminates transferable skills.
SSDI GRIDS and your RFC
Social Security defines residual functional capacity (RFC) as what you can do despite your limitations. An RFC includes both physical and mental limitations. Social Security determines your RFC based on your medical records. They can also consider opinions from your treating doctors. Social Security cannot determine your RFC from a diagnosis alone. Therefore, you must see your doctors regularly. You should see specialists if you can.
Applying SSDI GRIDS
Once Social Security figures out your RFC and your work history, they will look at the GRIDS. Social Security has separate GRIDS for sedentary, light and medium work. For people over 50, the more physically limited you are and the more physically demanding your past work was, the more likely the GRIDS show you should be found disabled.
Example 1: SSDI GRIDS over 50
For example, Janet, a 52 year old woman previously worked as an office manager. Janet completed high school. She filed for SSDI because she was having worsening anxiety and osteoarthritis in her knees. Janet has difficulty standing and walking for long periods. Her doctors prescribed her a cane. Despite medication and therapy, Janet has difficulty managing her anxiety symptoms. Social Security found that Janet could not perform her past work. They also found that she could not do any other light jobs. She also was limited to simple and routine tasks. Therefore, the GRIDS applied and Janet was approved for disability.
Example 2: SSDI GRIDS over 55
In another example, Jose filed for SSDI after injuring his back. He is 57 years old and has a high school education. Jose worked for many years as a dishwasher. Since his injury, he has difficulty sitting and standing for long periods. He can’t lift or carry more than 10 pounds. Social Security found that he could do light work. His job as a dishwasher doesn’t have any transferable skills. Therefore, the GRIDS allowed social Security to approve Jose’s case.
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Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.
