Social Security and Epilepsy: In Order to Get Benefits, You Must Try to Treat the Condition - Shakespear v. Astrue
Epilepsy is a neurological disorder that often results in seizures. It occurs when brain tissue changes cause the brain to send out abnormal signals, resulting in repeated, unpredictable seizures. While persons who suffer from this serious condition may be eligible for Social Security disability benefits, the Eastern District of Arkansas' ruling in Shakespear v. Astrue makes clear that a claimant must try to treat the condition in order to receive benefits based on it.
Plaintiff Thomas Shakespear - apparently no relation to the Bard (nor to Edward de Vere) - filed a claim with the Social Security Administration (SSA) seeking disability benefits based on epilepsy, lumbar degenerative disc disease, headaches, bilateral wrist pain, breathing problems, depression and anxiety. The SSA denied the claim and an Administrative Law Judge (ALJ) upheld the decision. The ALJ determine that Plaintiff: 1) did not meet the requirements for any of the SSA's listings of impairments, including the epilepsy listing; 2) retained the residual functional capacity to perform medium unskilled work activity with certain restrictions; and 3) could perform previous jobs as well as others currently available in the national economy.
On appeal before the district court, Plaintiff argued that the ALJ incorrectly found that he did not meet the requirements for the SSA's "convulsive epilepsy" listing. The listings describe medical conditions that are so severe that the SSA presumes that any person who satisfies the criteria of a particular listing is unable to perform any gainful activity and therefore eligible for benefits. The convulsive epilepsy listing provides that the condition must be "documented by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once a month, in spite of at least 3 months of prescribed treatment."
The court rejected Plaintiff's argument, finding that, because he hasn't not complied with the prescribed treatment for the condition, Plaintiff does not satisfy the listing. The evidence produced, according to the court, showed that when Plaintiff takes his prescribed medication, his epileptic seizures are well controlled. On the other hand, Plaintiff suffers seizures more frequently when he does not take his medication. As a result, the court upheld the decision denying Plaintiff's claim for disability benefits.
A person whose impairments do not meet one or more of the listings may nevertheless be eligible for Social Security disability benefits if the person is unable to work for at least a year and can document the severity of his or her condition. In order to get benefits, you must submit an application or claim, which can be done by telephone, mail or online. In addition to other background information, the applicant is asked to describe the impairment and any treatment of it. This is the most difficult and confusing part of the process and the point at which a good attorney's help can be invaluable. An experienced disability lawyer knows what information must be included in the initial application and an excellent one will not only guide his or her client through the process but file the application for the client as well.
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