What is Cerebral Palsy?
Cerebral Palsy is a neurological disorder that is caused by brain damage when the brain is injured or develops incorrectly before, during, or right after birth. This damage is not repairable and will leave you with a lifelong disability. Cerebral Palsy results in the loss of motor function, including muscle movement, balance, posture, control of muscles. Cognitive function, including the ability to think critically, solve problems, and learn new skills in extremely limited. The ability to speak and see is also affected.
Types of Cerebral Palsy
There are several types of Cerebral Palsy:
- Ataxic – poor balance, coordination, tremors, and low muscle tone
- Spastic – jerking or stiff muscles
- Athetoid – slow writhing muscles
- Mixed – a combination of any of the above categories
Because there is no cure for cerebral palsy, therapy, and other treatments can help by treating the symptoms as much as possible to improve the quality of life. The severity of this disability will qualify you for disability benefits, but consulting with a disability attorney is always recommended.
How Do You Qualify for Long Term Disability with Cerebral Palsy?
When your cerebral palsy is so severe that you can no longer work, you need to consider applying for long-term disability insurance benefits.
Check Your Policy
Although the Americans with Disabilities Act classifies cerebral palsy as a disability, you need to check your long-term disability policy to see if it’s covered. If you are part of a group policy through your employer, you need to obtain a copy from your human resources department. If you have an individual policy, request a copy from your provider. When asking your HR department for a copy of your policy, it’s best to do so in writing. Employers who suspect that you are planning to file a claim commonly delay giving employees the documents they need. This delay can mean you miss time-sensitive deadlines. By requesting in writing, you have documentation of the date requested, and your employer must respond in a timely manner. Likewise, do not ask your employer if they think you would qualify for long-term disability with cerebral palsy. They are likely to say no, but they are not experts in disability policy, so don’t let this deter you from filing.
Provide Supporting Medical Evidence
When applying for long-term disability, your claim will rely heavily on medical evidence. For your claim to be approved, you will need to prove:
- You have an official cerebral palsy diagnosis from your doctor.
- Your symptoms are so severe that they are impairing your ability to work.
When pursuing an insurance claim for cerebral palsy treatment, it’s essential to inform your insurance company about any medical professionals who have provided care for your condition. The company will need to access your medical records from those physicians in order to properly evaluate your claim. Typically, it is the claimant’s responsibility to acquire them from your doctors and submit them to the insurer.
The insurer will require evidence of your diagnosis, ongoing symptoms, and the manner in which those symptoms influence your daily life. Thorough documentation is crucial to the success of your claim. The Residual Functional Capacity (RFC) assessment, in particular, plays a vital role in this process. It evaluates how your condition impacts your abilities and identifies the range of jobs for which you may still be qualified, despite your limitations.
Accuracy and honesty with your healthcare providers are crucial, especially when it comes to the RFC assessment. Make sure to provide them with complete and truthful information so they can accurately determine your capabilities and limitations.
How Do You Qualify for Social Security Disability with Cerebral Palsy?
All qualified disabilities are listed in the Social Security “Blue Book”. The Social Security Disability Administration has CP as a disability, and to qualify your disability must fit into this definition:
11.07 Cerebral palsy, characterized by A, B, or C:
A. Disorganization of motor function in two extremities (see 11.00D1), resulting in an extreme limitation (see 11.00D2) in the ability to stand up from a seated position, balance while standing or walking or use the upper extremities.
OR
B. Marked limitation (see 11.00G2) in physical functioning (see 11.00G3a), and in one of the following:
- Understanding, remembering, or applying information (see 11.00G3b(i)); or
- Interacting with others (see 11.00G3b(ii)); or
- Concentrating, persisting, or maintaining pace (see 11.00G3b(iii)); or
- Adapting or managing oneself (see 11.00G3b(iv)).
OR
C. Significant interference in communication due to speech, hearing, or visual deficit (see 11.00E2).
Disorganized Motor Function
SSD defines disorganized motor function as the extreme impairment of two extremities (arms or legs) that cause the inability to stand up from a seated position, balance themselves while walking or standing, or the use of the upper extremities.
Marked Physical and Mental Limitations
An individual must suffer from one marked physical limitation as it would relate to working like standing, balancing, or using the extremities AND must suffer from mental limitations that affect their ability to concentrate on work-related tasks, interact with others, or control emotions or behavior while working.
Communication Limitations
An individual with Cerebral Palsy could also qualify for disability benefits if they suffer from significant communication limitations. Examples are:
- Apraxia – where the brain cannot signal to the rest of your body correctly how to form the correct sound that collates to the words you are trying to say.
- Dysarthria – when brain damage causes the muscles used for communication to become weak, the sounds cannot come out correctly. Speech may be slurred or mumbling, low, or too slow.
Assessment of Your Residual Functional Capacity
You may be denied disability benefits if you do not meet the criteria outlined in the Social Security Blue Book, even if you are unable to work. However, it is also possible to be approved based on a medical-vocational allowance. This approach requires careful evaluation of your ability to function in daily life and the workplace.
During this assessment process, the applicant must undergo specific testing, supervised by a medical professional, often the individual’s personal physician. This examination will address a series of questions aimed at evaluating physical and mental capabilities, such as:
- How much weight can you lift, and with what frequency?
- How long can you sit or stand?
- How effectively can you reach out or stretch overhead?
- How effectively can you bend, crouch, or stoop?
- How proficiently can you grasp objects or manipulate your hands?
The answers to these questions will determine the rating that classifies your ability to work into one of three categories: sedentary, light, or medium work. Additionally, mental limitations, including factors such as low IQ, education level, and work experience, will be assessed. Consequently, your mental RFC (Residual Functional Capacity) will categorize you as an unskilled, semi-skilled, or skilled worker. A rating of sedentary work combined with the unskilled worker classification could enhance your eligibility for receiving benefits.
Working with a Disability Attorney
If you need help getting your claim approved, you can reach out to an experienced disability attorney that can help you gather the documents you need to prove your case and fight the insurance company for you.
The experienced disability attorneys at the Ortiz Law Firm can help you through every step of the Social Security Disability process and with disability insurance appeals and lawsuits. You can seek help without worrying about upfront costs or unexpected bills. Our law experts will focus on your case so you can focus on your illness. We have successfully represented people in disability cases across the United States. To see how we can help you win your long-term disability case, call us at (888) 321- 8131.