Understanding SSDI Eligibility for a Brain Injury

To qualify for SSDI, the SSA requires that your condition must prevent you from engaging in substantial work for at least 12 months or be expected to result in death. For brain injuries, this means you must show that your injury prevents you from performing basic work tasks such as concentrating, interacting with others, or physically performing a job.

A brain injury can include:

• Traumatic brain injury (TBI)
• Concussions
• Stroke
• Anoxic brain injury (lack of oxygen to the brain)
• Brain tumors or lesions
• Infections or conditions affecting the brain

Each type of injury can have different symptoms and impact the brain differently. However, for all brain injuries, the SSA will need detailed medical documentation to evaluate the extent of your disability.

Medical Documentation Required for SSDI with a Brain Injury

The most critical aspect of your SSDI application is the medical evidence you provide. The SSA requires you to show that your brain injury significantly limits your ability to perform work-related tasks. Here’s what you should gather:

A. Doctor’s Diagnosis and Medical Records

• Clear Diagnosis: A formal diagnosis from a neurologist or another medical specialist is essential. The diagnosis should include details about the type of brain injury, the severity of your condition, and any treatments you’ve undergone.
• Medical History: Detailed records of any hospitalizations, surgeries, and treatment plans you’ve followed will help establish the severity of your condition.

B. Functional Limitations

The SSA will want to know how your brain injury affects your daily life. This includes limitations such as:

• Difficulty with memory or concentration.
• Inability to complete tasks at work due to cognitive impairment.
• Trouble interacting with others due to emotional or behavioral changes.
• Physical limitations, such as difficulty with mobility or coordination.

You’ll need to provide documentation that supports these limitations, ideally from a treating physician who understands how your brain injury affects your ability to function.

C. Neuropsychological Evaluation

A neuropsychological evaluation can be incredibly helpful in providing an in-depth look at how your brain injury impacts your cognitive functions, such as memory, concentration, and processing speed. This type of evaluation helps establish the severity of your impairment and is often necessary for proving eligibility for SSDI.

SSA’s Evaluation of Brain Injury for SSDI

When the SSA reviews your application for SSDI, they will follow a five-step process to determine if you qualify. Here's how they will evaluate your brain injury:

Step 1: Substantial Gainful Activity (SGA)

The SSA will first determine if you are engaging in substantial gainful activity. If you are working and earning above the SGA threshold, your application will likely be denied. As of 2025, the SGA threshold is $1,470 per month for non-blind individuals. If you are earning more than this amount, the SSA may conclude that you are not disabled.

Step 2: Severe Condition

Your brain injury must be severe enough to limit your ability to perform basic work activities. If your condition does not significantly impair your ability to perform tasks such as understanding or applying information, interacting with others, or maintaining concentration, it may not be considered severe enough for SSDI.

Step 3: Meet a Listing Impairment

The SSA has a Listing of Impairments (also called the “Blue Book”), which includes conditions that qualify for SSDI. Traumatic brain injury (TBI) is specifically listed in the SSA’s Blue Book under Neurological Disorders. To meet the SSA’s criteria for TBI, you must provide evidence that your condition is severe and causes persistent cognitive, motor, or emotional limitations.

Step 4: Past Work

The SSA will determine whether you are able to perform your previous work. If your brain injury prevents you from performing your past job, the process moves on to the next step.

Step 5: Other Work

If you cannot perform your past work, the SSA will look to see if you can adjust to other types of work, based on your age, education, and skills. If you are unable to perform other work due to your brain injury, you may be approved for SSDI.

How to Improve Your Chances of Approval

To improve your chances of being approved for SSDI with a brain injury, take the following steps:

• Provide Detailed Medical Records: Ensure that all medical records, diagnostic tests, and treatments are submitted.
• Get a Detailed Report from Your Doctor: Your doctor should provide a detailed explanation of your brain injury, including how it impacts your ability to function and work.
• Include Statements from Family and Friends: Statements from family members or friends who observe how your brain injury affects your daily life can be helpful.
• Consider a Lawyer or Advocate: If you’re having difficulty navigating the application process or if your claim is denied, consider consulting with an SSDI lawyer or advocate who can assist in gathering evidence, filing paperwork, and representing you in hearings.