Epilepsy

Social Security evaluates Epilepsy in two different categories in Sections 11.02 and 11.03 of the Regulations:

Convulsive Epilepsy — (grand mal or psychomotor), 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. With a daytime episodes (loss of consciousness and convulsive seizures); or night time episodes manifesting residuals which interfere significantly with activity during the day.

Nonconvulsive Epilepsy — (petit mat, psychomotor, or focal), documented by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once weekly in spite of at least 3 months of prescribed treatment. With alteration of awareness or loss of consciousness and transient postictal manifestations of unconventional behavior or significant interference with activity during the day.

When I was in law school, I had a brilliant law professor who always said: “Here’s what they want me to teach you and here’s what happens in the real world”. Applying that principal to all that language above; in the real world I tell my clients to prepare a journal documenting their seizures. I have my clients record how they were feeling before, during and after each episode. Some journals are very interesting reading as some epileptics have absolutely no recollection of having a seizure. They simply wake up on the floor. Other journals are completed by family or friends because the person experiencing the seizure is in no shape to write in a journal. As with pain, I have learned that seizures affect everyone differently. Some clients have warning signs or auras, others have none. Some require an extensive recovery period where they need to lie down and rest to recover their mind and body. Others may only need a few minutes to regain composure. I also recommend that the journal be given to your Doctor so that it can be made a part of your medical record.

One of the interesting things that is often overlooked in these types of claims, is the amount of injuries that epileptics suffer. I had a client that had broken multiple bones in his body due to the frequency and intensity of his seizures. Also, the side effects of the medication can sometimes be more disabling than the seizures themselves. I often hear how sleepy or drowsy the medication makes the person feel; however, there are no other choices because of the frequency of the seizures without the medication. While the frequency of the seizures is an important factor in evaluating these claims, it is also equally important to consider the impact and side effects from treatment. Any and all side effects from medications should be reported to your doctor so that it may become a part of your medical record.

Disclaimer: These pages are only observations from my point of view of some of the factors that are present in the diagnosis. I am not a doctor, I am a lawyer and I am only providing observations of various signs and symptoms that I have seen during my practice and/or the signs and symptoms that I evaluate when taking a client in front of an Administrative Law Judge.