Brain Injury

Definition

Brain injuries can cause a wide range of symptoms of variable intensity. For example, concussions, which are considered mild traumatic brain injuries (TBIs), can cause headaches and dizziness for a few days, to three months, or even up to a year. More severe brain injuries can cause lifelong cognitive deficits, difficulty speaking and understanding, emotional lability, depression, aggression, seizures, and many other physical, neurological, or psychological symptoms.

General Information

Brain injury can occur as the result of physical trauma to the brain. Trauma to the head, such as falls or motor vehicle accidents, can cause injury to the brain. Other mechanisms include CVA (stroke), infections such as encephalitis or meningitis, hypoxia (lack of oxygen), or chemical exposure such as carbon monoxide or lead.

Treatment following the original injury typically involves a multidisciplinary approach. Consults with neurologists, speech and language therapists, cognitive rehabilitation therapists, and occupational therapists are essential in assessing an individual’s functional ability and putting together a recovery program. Mental health professionals such as therapists, psychologists, psychiatrists, and neuropsychologists are often involved in the care of individuals with brain injuries.

Brain injury and its symptoms have been documented as far back as 1650 BC. However, medical advancements needed in order to more effectively treat acute brain injuries did not come until the 1950s. It was not until the 1990s that standard guidelines for treating brain injuries were developed and disseminated.

Social Security Medical Listing 11.18 – Cerebral Trauma 

Potentially disabling brain injuries are evaluated following the guidelines of Medical Listing 11.18. Listing 11.18 states that cerebral trauma is to be evaluated under 11.02, 11.03, 11.04, and 12.02, as applicable. Medical Listings 11.02 and 11.03 are regarding Epilepsy, so if your brain injury causes seizures, these listings would apply. Medical Listing 11.04 is regarding central nervous system vascular accidents, which are more commonly called strokes. If your brain injury has caused sensory or motor aphasia resulting in ineffective speech, you may be found disabled based on this listing. Listing 11.04 also directs for a finding of disabled for individuals with loss of motor function in two extremities, as long as it results in the inability to perform gross and dexterous movements, or prevents you from ambulating effectively (walking independent of a two-handed assistive device). Perhaps more pertinent to many individuals with brain injuries is Medical Listing 12.02 regarding organic mental disorders. The criterion in this listing discusses “loss of specific cognitive abilities or affective changes.” This listing is satisfied when there are marked restrictions in at least two of the following: activities of daily living, maintaining social functioning, maintaining concentration, persistence, or pace, and repeated episodes of decompensation of extended duration. Listing 12.02 also can be satisfied if you have at least a two-year history of brain injury that causes more than a minimal limitation to your ability to work and you have adjusted so marginally that even a minimal increase in mental demands or change in environment would be predicted to cause you to decompensate or have a current history of at least one year’s inability to function outside a highly supportive living arrangement with an indication of continued need for this arrangement.

Your representative can help you determine whether your brain injury is severe enough for you to qualify for disability benefits under the Social Security Administration.