When is a stroke disabling?

When someone has suffered a stroke, a disability claim may be granted if  the ongoing symptoms make sustained work activity impossible. Or, the claim record may “meet the listings” of impairment, the technical part of Social Security’s regulations which demonstrate the presumption of total disability. However, it is not the fact of a stroke that leads to total disability – it is the symptoms resulting from the occurrence that actually prevent working.

There must be medical evidence of sensory or motor aphasia resulting in ineffective speech or communication for at least 3 consecutive months after the stroke.  Another factor requires an “extreme limitation” in the ability stand from a seated position, balance, or use the upper extremities for at least 3 months after the stroke. “Extreme” for this purpose is defined as needing a walker, two crutches, two canes or the inability to perform both fine and gross motor movements with either arm. 

The third way to meet the listing  requires a “marked limitation” in physical functioning (walker, one cane or one crutch) along with a marked limitation in mental functioning such as: 

  1. Understanding, remembering or applying information;
  2. Interacting with others; 
  3. Concentrating, persisting, or maintaining pace; or 
  4. Adapting or managing oneself.

“Marked” for this section means a serious limitation that has lasted at least 3 consecutive months after the insult. Here, it is the combination of impairments that creates the total disability.  IF the patient can’t meet these strict definitions, there is still room to argue that fatigue, weakness, and impaired concentration prevent the ability to work full-time. As always, documentation from each treating provider needs to be minutely and consistently complete,