Am I Eligible for Disability Benefits if I Was Assaulted?

The Social Security Administration offers several different benefits programs for people who cannot work because of disabling medical conditions.  Many different illnesses can qualify claimants — but what about injuries?  If you were stabbed, shot, or assaulted, are you considered eligible?  Our New Jersey disability benefits lawyers explore some of the ways your application might be approved if you were hurt in an attack.

How the SSA Decides if You Are Disabled

The SSA wants to be sure that only claimants who genuinely cannot work are approved for assistance.  Therefore, benefits are only granted to people whose impairments are classified as severe.  So how is severity determined?

When the SSA reviews SSI (Supplemental Security Income) and SSDI (Social Security Disability Insurance) claims, examiners weigh them against a document called the Listing of Impairments, or “Blue Book,” in order to make assessments about each claimant’s condition.  In other words, it isn’t enough to simply have Condition X; Condition X must also meet severity requirements A, B, and C in order to prove that it truly prohibits employment.

While you don’t necessarily have to match Blue Book requirements in order to be approved, it can make the process simpler.  If you were assaulted, it is possible that your injuries (or their effects) could satisfy one or more of the medical standards in the Listing.

However, before we explore that possibility in greater detail, you need to be aware of a very important non-medical eligibility requirement: your condition must either last or be expected to last for at least 12 months, or to end in death.  If you are dealing with a short-term impairment which will subside in a matter of weeks or months, other forms of compensation may be more appropriate.

Can an Injury Qualify Me for Disability Benefits in Pennsylvania?

If you were wounded in an accident or attack, the effects of your injuries may be able to fulfill certain SSA listings.

The Listing itself is divided into subcategories for each body system, so first, let’s review the area most likely to have sustained serious damage: the musculoskeletal system (Section 1.00).  Under Section 1.00, you may meet the requirements for:

• Major Dysfunction of a Joint (1.02)
• Reconstructive Surgery — Major Weight-Bearing Joint (1.03)
• Amputation (1.05)
• Fracture — Femur, Tibia, Pelvis, Tarsal Bones (1.06)
• Fracture — Humerus, Radius, Ulna (1.07)
• Soft Tissue Injury, e.g. Burns (1.08)

If your injuries caused a loss of vision, hearing, or speech, Section 2.00 (Special Senses and Speech) may be more appropriate.  Potentially relevant health issues covered by Section 2.00 include:

• Loss of Visual Acuity (2.02)
• Contraction of Visual Fields — Better Eye (2.03)
• Loss of Visual Efficiency (2.04)
• Loss of Speech (2.09)
• Hearing Loss — Cochlear Implant (2.11)
• Hearing Loss — No Cochlear Implant (2.10)

Most of the respiratory conditions under Section 3.00 relate to illness, but if your lungs were damaged so severely you required a lung transplant, you could qualify under Section 3.11.

The same can be said of cardiovascular disease under Section 4.00, but if your injuries led to a heart transplant, you may be eligible under Section 4.09.  If the shock or strain of your incident triggered a heart attack, approval is a possibility — but as the SSA states, “We will wait [to assess your health] when we have information showing that your impairment is not yet stable…  Examples of when we might wait are: (i) If you have had a recent acute event; for example, a myocardial infarction (heart attack).”

While burns are one example of possible soft tissue injuries cited in Section 1.08, they are also covered under Section 8.00 (Skin Disorders), with burn injuries addressed by Section 8.08.  Furthermore, because burns can compromise the immune system and leave victims prone to infection, you may also be eligible under Section 8.04, which deals with chronic infections of the mucous membranes or skin.

If you sustained a traumatic brain injury, or TBI, you may be a strong candidate through Section 11.00, which handles neurological disorders.  As 11.00F states, “TBI may result in neurological and mental impairments with a wide variety of posttraumatic symptoms and signs.”  Some of the conditions which might apply to you under Section 11.00 include:

• Epilepsy — Convulsive, Grand Mal (11.02)
• Epilepsy — Non-Convulsive, Petit Mal (11.03)
• Central Nervous System Vascular Accident, i.e. Stroke (11.04)
• Cerebral Trauma, i.e. Head Trauma (11.18)

Similarly, Section 12.00 (Mental Disorders) states, “In cases involving TBI, follow the documentation and evaluation guidelines in 11.00F.”  Some of the mental disorders included under Section 12.00 are:

• Intellectual Disability (12.05)
• Personality Disorders (12.08)

Furthermore, if chronic pain caused by your incident led to a substance abuse disorder which affects your central nervous system, it is possible you may be considered eligible under Section 12.09.

Pennsylvania Disability Attorneys Offering Free Consultations

If you were seriously injured in an attack or accident, our experienced Bucks County disability lawyer can help you prepare a claim, or appeal a denial if your application has already been rejected.  To schedule a free and confidential consultation, call Young, Marr, Mallis & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania today.