Non-Epileptic Seizures (NES) are episodes that resemble epileptic seizures but arise from different origins, not involving abnormal electrical activity in the brain. These events can significantly affect an individual’s daily life, sometimes leading to substantial limitations. This article clarifies whether NES can be recognized as a disability under established legal frameworks.
Understanding Non-Epileptic Seizures
Non-Epileptic Seizures (NES) are sudden, temporary changes in movement, sensation, or awareness that can manifest in various ways, often mimicking epileptic seizures. Unlike epilepsy, which involves uncontrolled electrical discharges in the brain, NES do not show this characteristic electrical activity on an electroencephalogram (EEG) during an episode. These seizures are involuntary and not consciously controlled by the individual experiencing them.
NES can be categorized into those with psychological causes, often called psychogenic non-epileptic seizures (PNES), and those with organic physical causes. PNES are believed to be physical reactions to psychological distress, unresolved emotions, or trauma. Common triggers include severe stress, anxiety, depression, PTSD, and a history of childhood trauma.
Physical causes of NES can include conditions affecting blood sugar levels, such as diabetes, or cardiovascular issues like sudden drops in blood pressure that lead to fainting. Sleep problems, certain medications, and alcohol use can also act as triggers. While NES can present with symptoms similar to generalized convulsive seizures, they may also involve more subtle manifestations like staring, confusion, altered senses, or changes in emotional states.
Legal Definitions of Disability
The legal frameworks defining disability are primarily set by the Americans with Disabilities Act (ADA) and the Social Security Administration (SSA). The ADA defines a person with a disability as someone who has a physical or mental impairment that substantially limits one or more major life activities. It also protects individuals with a history of such an impairment or those regarded as having an impairment.
Major life activities are broadly defined and include everyday functions like caring for oneself, eating, sleeping, walking, seeing, hearing, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working. The ADA also includes the operation of major bodily functions, such as neurological, circulatory, and immune systems. An impairment does not need to be severe or permanent, and episodic conditions that would substantially limit a major life activity when active are also covered.
The Social Security Administration has a distinct definition of disability, focusing on an individual’s ability to engage in substantial gainful activity (SGA). To qualify for SSA disability benefits, an individual must have a medically determinable physical or mental impairment that prevents them from engaging in SGA. This impairment must be expected to result in death or have lasted, or be expected to last, for a continuous period of at least 12 months. SGA refers to a level of work activity and earnings, with specific monthly income thresholds set by the SSA.
Criteria for NES as a Disability
Non-Epileptic Seizures can meet the legal definitions of disability, not necessarily because of the diagnosis itself, but due to the functional limitations they impose. Under both the ADA and SSA, the key consideration is how the condition impacts an individual’s ability to perform major life activities or engage in substantial gainful activity. The unpredictable nature of NES, with symptoms like convulsions, loss of awareness, or altered movement patterns, can significantly disrupt daily routines.
These limitations can affect various aspects of life, including employment, social interactions, and personal safety. For example, frequent or severe NES episodes can make it difficult to maintain a consistent work schedule or perform job duties, potentially preventing an individual from engaging in SGA. Driving may become unsafe, limiting independence and access to employment or community activities. Socially, individuals might withdraw due to the fear of having an episode in public or experiencing stigma.
Establishing NES as a disability requires comprehensive medical evidence. A diagnosis typically involves video-EEG monitoring to differentiate NES from epileptic seizures by confirming the absence of abnormal electrical brain activity during an event. Documentation should detail the severity, frequency, and persistence of the seizures, along with how they specifically limit major life activities. This evidence substantiates the functional impact.
Applying for Disability Benefits and Protections
Individuals with Non-Epileptic Seizures seeking disability benefits from the Social Security Administration (SSA) must follow a structured application process. The initial step involves gathering all relevant medical records, including diagnostic reports and notes from neurologists, psychiatrists, or therapists that document the NES diagnosis and its impact. This medical evidence is essential to demonstrate that the impairment meets the SSA’s duration requirement of lasting or being expected to last for at least 12 months.
Applicants then submit a detailed application outlining their medical conditions and how these conditions prevent them from performing substantial gainful activity. The SSA evaluates the claim based on the severity of the impairment and its effect on the individual’s ability to work. If the initial application is denied, individuals have the right to appeal the decision through several stages, including reconsideration and hearings before an administrative law judge.
Beyond financial benefits, individuals with NES may also be entitled to protections and reasonable accommodations under the Americans with Disabilities Act (ADA). The ADA prohibits discrimination in employment, state and local government services, and public accommodations. In the workplace, employers must provide reasonable accommodations to enable an employee with NES to perform their job duties, unless doing so would cause undue hardship.
Examples of accommodations might include flexible scheduling to manage triggers, a quiet space for recovery after an episode, or modifications to job tasks if certain activities induce seizures. These protections aim to ensure equal opportunities for individuals whose NES substantially limits their major life activities.