Pseudobulbar Affect and Social Security Disability

Pseudobulbar affect, or PBA, is a neurological disorder often seen in combination with other serious medical conditions, including multiple sclerosis (MS), Amyotrophic lateral sclerosis (ALS), stroke, traumatic brain injury, and dementia, among others. The condition causes inappropriate and uncontrollable emotional outbursts, like laughing or crying at the wrong time or to a more pronounced extent than circumstances warrant.

Notably, the underlying medical condition doesn’t determine the severity of PBA. For example, even someone that suffers few other complications from a stroke may have very severe and pronounced PBA.

The condition is difficult to treat and can cause serious disruptions in everyday life, including social interactions and as well as your ability to maintain gainful employment. PBA can qualify you for Social Security Disability (SSD) benefits, though you may have an uphill battle ahead of you in getting approved for benefits.

Medically Qualifying with Pseudobulbar Affect

If you are applying for SSD based on your PBA alone, then the Social Security Administration (SSA) must look at the manner in which you are affected by your symptoms. To determine how severely your PBA impacts your ability to work, the SSA will conduct residual functional capacity (RFC) analyses, which simply means they look at your:

  • symptoms,
  • medical history,
  • education,
  • work experience,
  • and age.

The goal is to determine if you’re truly unable to hold a job. RFC analyses may include a review of your activities of daily living, including how your mental and physical abilities are affected.

An RFC analysis is the final step in a disability review. Typically, the process starts with a comparison of your medical records to Blue Book listings. The Blue Book is a manual of impairments that lists the medical evidence and severity level required for receiving disability benefits under each listing. There is no listing for PBA in the Blue Book though, which is why an RFC analysis is required.

Many of the conditions associated with PBA are listed in the Blue Book, so if your underlying medical condition is severe enough to win a disability claim, you may be approved for benefits without undergoing an RFC analysis.

Several PBA-related conditions appear in Section 11.00, which covers neurological ailments. Here are just a few of the listings you and your physician will want to review before you apply for SSD:

  • Central nervous system vascular event (stroke)
  • MS
  • ALS
  • Parkinson’s
  • Cerebral trauma (brain injury)

Many with PBA also have severe anxiety and depression problems. These conditions also appear in the Blue Book under Section 12.00

Because PBA can be very severe even when the underlying medical condition is not, it can be difficult to qualify for benefits under a Blue Book listing. This is why many applicants that receive benefits for PBA qualify through an RFC analysis instead.

Regardless of how the SSA determines you’re disabled though, the key to approval is a well constructed application and thorough medical records. Your application and medical documentation should leave no doubt about the severity and extent of your PBA’s affects on your everyday abilities, including your ability to work.

Getting Help with Your Claim

Getting SSD for pseudobulbar affect is always challenging. If your symptoms are severe enough though they can certainly qualify you for benefits. Your doctor can help you document your limitations and will be expected to provide the SSA detailed information in an RFC report form as well. A Social Security advocate or attorney can also assist with your claim. They can help you build a strong application, ensure all your forms are filed correctly, and help you file an appeal, if the SSA initially makes a determination that is not in your favor.