How does Social Security look at children’s disability cases based on epilepsy or other seizure disorders?
First, Social Security considers the Listing of Impairments.
The Listings are a set of descriptions of medical conditions which can be disabling. The Listings tell you the what kind medical evidence you need and the medical findings to prove that the condition is disabling. While the Listings are not the only way to be found disabled, they are very important in children’s disability cases.
For seizure disorders, there are two critical Listings.
Listing 111.02 Major motor seizure disorder
This Listing primarily applies in convulsive seizure disorder cases.
A. Convulsive epilepsy. In a child with an established diagnosis of epilepsy, the occurrence of more than one major motor seizure per month despite at least three months of prescribed treatment. With:
1. Daytime episodes (loss of consciousness and convulsive seizures); or
2. Nocturnal episodes manifesting residuals which interfere with activity during the day.
B. Convulsive epilepsy syndrome. In a child with an established diagnosis of epilepsy, the occurrence of at least one major motor seizure in the year prior to application despite at least three months of prescribed treatment. And one of the following:
1. IQ of 70 or less; or
2. Significant interference with communication due to speech, hearing, or visual defect; or
3. Significant mental disorder; or
4. Where significant adverse effects of medication interfere with major daily activities.
To be found disabled under this Listing, you must show be able to prove either the
- “A” criteria: 2 or more convulsive seizures per month with loss of consciousness, during the day, or at night with side effects (residuals) that last into the daytime hours; or the
- “B” criteria: 1 convulsive in the last year and one of the 4 subparts.
111.03 Nonconvulsive epilepsy
This listing deals with non-convulsive seizures which may or may not include loss of consciousness.
In a child with an established seizure disorder, the occurrence of more than one minor motor seizure per week, with alteration of awareness or loss of consciousness, despite at least 3 months of prescribed treatment.
In both of these Listing, there has to be a well-established diagnosis, and the seizures have to continue despite 3 or more months of treatment.
If Social Security cannot find a child disabled for “meeting” the listing requirements, Social Security then looks for “functional equivalence” (which is the subject of its own post). For an overview of how Social Security decides if a child is disabled, read this.