Alaska Sleep Education Center

How to Qualify for Social Security Disability Benefits with Narcolepsy

Posted by Eric Minghella on Nov 14, 2018 12:05:00 PM

When you get diagnosed with narcolepsy, you could be facing some difficult changes down the road, especially regarding your employment and other financial-related needs.

If your narcolepsy hinders your ability to be able to work a full-time job and live a normal life, then there may be help available for you in terms of Social Security benefits. The Social Security Administration (SSA) gives monthly benefits to individuals with disabilities who can no longer work full time. Here is
how one can qualify for Social Security disability benefits with narcolepsy.

The Social Security administration offers to programs to individuals with disabilities. The two programs are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Medical qualifications for each program are exactly the same, but SSDI and SSI each have their own technical eligibility criteria that need to be met.

What is Social Security Disability Insurance (SSDI)?

SSDI benefits are paid out to those who can no longer work full time because of a disability. In order to qualify for SSDI benefits you need to be deemed disabled by the Social Security Administration.

Another important factor that goes into qualifying for Social Security disability benefits is the amount of work credits you have by earning taxable income. Work credits are calculated by your age and how many years you’ve worked. It’s actually pretty easy to earn work credits; for example, if you’ve made
$5,280 in 2018, you’ll earn 4 work credits, which is the maximum amount you can earn per year.

What is Supplemental Security Income (SSI)?

Image result for narcolepsySSI benefits are paid out to those with a disability and with very little income. Like SSDI, you must also be deemed disabled by the SSA. You are able to qualify for SSI benefits regardless of any prior work history, but you’ll only be approved if you have a severe financial need. You cannot have more than $2,000 in your savings account or earn more than $750/month in 2018 to qualify for SSI benefits.

Other assets that may disqualify you from SSI include a second home, a second car, or other non-personal valuable items like a snowmobile or vacation cabin. It’s also important to note
that if you’re married, your spouse’s income will disqualify you from SSI benefits regardless of the severity of your narcolepsy.

Narcolepsy and Social Security Disability Benefits

In order to qualify for Social Security benefits, you need to meet the SSA’s criteria for
disability approval. When you send in your application to the SSA, the SSA will consult its own medical guide of qualifying conditions, known colloquially as the Blue Book.

The Blue Book lists specific criteria that under which those who suffer from a
disabling condition, such as narcolepsy, can qualify for Social Security disability benefits.

What’s unfortunate is that there is no exact listing for narcolepsy in the Blue Book. However, those suffering from narcolepsy don’t have to worry about the lack of a narcolepsy listing leading to an automatic SSDI or SSI denial. The SSA states that you may be able to be approved for narcolepsy if you can meet the Blue Book’s epilepsy listing.

Meeting the Epilepsy Listing

Even though epilepsy and narcolepsy are of course two completely different conditions, you can still “meet” the epilepsy listing if your inability to stay awake is as frequent as the listing for those with seizures. Because narcolepsy is not convulsive, you’d need to meet one of the two Blue Book listings for dyscognitive seizures.

The first set of qualifying criteria states that dyscognitive seizures will be approve for
disability benefits if you have at least one seizure per week for three consecutive months, despite following your prescribed treatments.

The second set of criteria states that if you have one seizure (or in your case, fall asleep unexpectedly) at least once every other week you may be eligible so long as you have medical documentation proving significant challenges in one of the following areas of daily functioning:Image result for narcolepsy

• Physical functioning, such as walking balancing, performing fine movements, etc.
• Understanding, remembering, and applying learned information
• Interacting with others in a workplace setting
• “Adapting oneself,” which essentially means controlling your emotions while in a     work environment

Essentially, if you’re taking all your prescribed medication and following your doctor’s orders but still falling asleep at least once per week for three months, you could be approved under the epilepsy listing despite never having a seizure. The same is true for people with migraines and cluster headaches. The Blue Book isn’t large enough to contain every single disability, so many people are able to line their symptoms up to a qualifying condition and still be approved.

The Importance of Medical Records

Since there is no exact listing for narcolepsy, it is very important for individuals looking to qualify for Social Security benefits to provide as much medical documentation as possible. The SSA evaluates the severity of narcolepsy after three months of being treated by a doctor. You should have a formal diagnosis from your
doctor of your condition, any sort of tests that you have undergone that have
confirmed your narcolepsy and any sort of prescription medication(s) that you are taking. You should also ask your doctor if he or she can provide a written statement regarding the extant of your disability. Doctor’s recommendations can go a long way with the SSA. Some things for your doctor to note on your evaluation include:

• How long you’ve had narcolepsy
• All medications you’ve taken, plus the side effects of any medication
• How your medication has helped (or not)
• All the physical activities you’re no longer able to do, like driving

The more your doctor can prove your narcolepsy makes it impossible to maintain gainful employment (earning $1,080 or more per month), the better your odds of approval. Best of all, your doctor will not need to mail in any paperwork to the SSA. The SSA contacts all of your doctors on your behalf
to gather medical records when you apply.

Next Steps to Take

There are a couple of things you can do to apply for Social Security disability benefits for Narcolepsy. The easiest thing you can do is to apply online on the SSA’s website. You can only apply for SSDI benefits online. If you wish to apply for SSI benefits, you can apply in person a Social Security office. In Alaska, there are only 3 offices, which are located in Anchorage, Juneau and Fairbanks. If you have any further questions regarding your narcolepsy case and Social Security
benefits, you can call the SSA toll free at 1-800-772-1213.

If you live in Alaska and have been suffering with narcolepsy, call Alaska Sleep Clinic today to speak with one of our board-certified sleep specialists.

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