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How are New Jersey SSD benefits eligibility for TBI determined?


New Jersey residents know that a traumatic brain injury (TBI) can wreak havoc on an individual's life. A TBI can suddenly make routine activities a major challenge and strain their emotions and relationships. At times like this, assistance in the form of Social Security disability benefits for mental conditions can be a life-saver for many TBI patients.

However, TBI is not a specific condition under the Social Security Administration's (SSA) listing of disabling conditions but is mentioned in section 11.18 of the disability manual under neurological impairments. To be more specific, TBIs are evaluated under the heading of cerebral trauma. Interestingly, the definition of "cerebral trauma" is quite brief and mainly refers to conditions and provisions mentioned in sections 11.02, 11.03, 11.04 and 12.02 of the SSA's disability evaluation guidelines.

Due to the unclear definitions and the slightly different nature of a TBI, determining disability on the grounds of a TBI is often a difficult task. However, according to the SSA, disability evaluation is always based on "residual functional capacity" or what a TBI victim is able to do at full capacity despite their mental illness. As a result, disability claim requests for TBI are evaluated on measurable and objective indications of a person's functional limitations.

The usual process for determining disability arising from a TBI depends on whether a patient suffers seizures or not. If that patient does suffer seizures or epileptic attacks, the severity of those attacks are studied and a disability determination is made. Additionally, TBI claimants are also evaluated according to the three listings mentioned under section 12.02 of the SSA's disability evaluation guidelines.

Based on the Brain Injury Association of New Jersey's evaluation of disability coverage for mental health issues arising from a TBI, establishing a TBI patient's disability is not an easy task. There may be denials and appeals and family members may benefit from the assistance provided by an experienced legal practitioner.

Source: BIANJ.org, "Social Security Disability: Determination and Review Regarding TBI," accessed on Dec. 12, 2014

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