Does Disability Insurance Cover Head Injuries?

Accidents can happen in the workplace, and these can impair employees’ ability to perform their duties. One of the common results of such incidents is a head injury. It can be caused by a fall, vehicular accident, or physical violence, depending on the industry and specific job tasks.

An occupational head injury often leads to blurred vision, memory loss, or speech problems, undermining a person’s ability to work. As such, it’s common for sufferers tofiledisabilityclaims to secure their financial disposition during recovery and beyond.

However, the process of acquiring disability benefits is a rather meticulous affair. Insurers will naturally probe into the validity of disability insurance claims for head injuries. In this regard, this article will discuss the important details to help you gain a clearer picture of the entire process.

Does your condition make you eligible for disability benefits?

Head injuries can vary in severity. Thus, the Social Security Administration (SSA) will thoroughly assess any disability claim to determine if the head injury makes you eligible for disability insurance.

The steps used to assess the disability claim are the following:

1. Are you engaged in substantial gainful activity?

The first step in the assessment is determining if you’re engaged in substantial gainful activity (SGA). The SSA sets a specific monthly income threshold that serves as the SGA limit. If your income doesn’t go over the stipulated amount, your case may be more likely to proceed to the next step.

2. Is your condition severe?

The SSA has to qualify your condition as ‘severe’ to improve your eligibility. Severe conditions significantly diminish your ability to stand, lift, understand, remember, or carry out simple instructions.

The SSA has a list of medical conditions they consider severe(also known as the Blue Book). Head injuries are assessed under the neurological section 11.18. If your condition meets the criteria of severity, you must present medical proof to substantiate your claim, such as a medical record of any physical or mental impairment that has lasted or is expected to last for more than a year.

3. Can you perform the work you’ve done in the past 15 years?

In this step, the SSA determines if you’re capable of performing past relevant work, which refers to the work you’ve done in the past 15 years before incurring the disability. If the SSA determines that you can’t perform the said work, then you’ll qualify for disability insurance. To increase your chances of approval, present compelling medical records and official doctor’s statements.

4. Can you do other work?

If you can no longer perform your past relevant work, the SSA will determine your residual functional capacity (RFC). It refers to an assessment of your ability to do sustained work-related activities. Your medical condition, experience, education, and skills are under examination. If the SSA determines your RFC is so low that you cannot do any SGA, you will be eligible for disability benefits.

Sidenote

The evaluation process can be complex, and eligibility decisions are made on a case-by-case basis. Even if you meet only one of the criteria, such as having a severe condition, you may still qualify for disability benefits. Each criterion is evaluated independently, and meeting any one of them can only increase your chances of approval.

How to improve your chances of approval

Getting disability insurance for head injuries largely depends on the evidence you provide to the SSA. Some of the factors that can improve your chances of approval include the following:

1. Working with a disability insurance lawyer

Working with a disability insurance lawyer can increase your chances of getting your claim approved. They will help you understand the criteria and gather all the evidence needed for the claim. They can also represent you in any hearing or appeals.

2. Present proof that you are receiving appropriate treatment

You can increase your chances of getting approved if you prove you follow your doctor’s recommendations and work to improve the condition. If there’s proof of appropriate treatment, your claim will be considered credible. Therefore, you should see specialists and get their opinion on the injury.

Conclusion

Head injuries can cause serious damage to your brain and body, affecting your ability to work. It could lead to a loss of income. To offset this, you can apply for disability insurance.

The journey to securing disability benefits for head injuries can be complex and challenging, but it is important to remember that you have rights. By understanding the eligibility criteria and seeking the guidance of a disability insurance lawyer, you can increase your chances of approval and ensure your financial stability during the recovery process.