Can you get disability for a TBI?

By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.

What Social Security looks for in a TBI claim

Social Security pays only for long-term disability. Its rule is that you cannot do the work you did before or adjust to other work, and the condition is expected to last at least one year or result in death. It does not pay for partial or short-term disability (SSA, Disability Benefits).

Listing 11.18 in SSA’s Blue Book can be met in two ways, each lasting at least three consecutive months after the injury:

1. Disorganized motor function in two arms or legs, causing extreme limitation in standing up from a seated position, balancing while standing or walking, or using the arms.
2. A marked limitation in physical functioning plus a marked limitation in one area of mental functioning: understanding, remembering or applying information; interacting with others; concentrating, persisting or maintaining pace; or adapting or managing oneself.

“Marked” is the fourth point on SSA’s five-point scale, meaning you are seriously limited in doing the activity on your own and on a sustained basis. If the injury causes only mental limits, SSA evaluates it under the mental disorders listings in section 12.00. Meeting a listing is one route. SSA’s basic test still asks whether you can do the work you did before or adjust to other work.

Why SSA waits after a brain injury

SSA’s TBI section says it generally needs evidence from at least three months after the injury. If it cannot decide then, it defers the decision until it has evidence from at least six months after the injury. The agency also says processing a disability application takes on average six to eight months, and for SSDI there is generally a five-month waiting period, with the first payment for the sixth full month after the date SSA finds your disability began (SSA). Applying early starts the clock.

SSDI and SSI compared

Sources: SSA blog on SSDI and SSI, SSA SSI booklet, SSA Disability Benefits.

Short-term state benefits in California and Washington

SSDI generally does not pay for the first five months, but two of the three states where we practice have their own wage programs.

• California State Disability Insurance pays partial wage replacement to eligible workers who cannot work because of an illness or injury that is not work-related. Benefits are 70% to 90% of the wages earned 5 to 18 months before the claim start date, for up to 52 weeks. You must have had at least $300 in wages with SDI withheld, be unable to do your regular work for at least eight days and have a physician or practitioner certify the disability (EDD).
• Washington Paid Family and Medical Leave covers your own serious health condition that prevents you from working. You need 820 hours worked in the qualifying period. Medical leave is up to 12 weeks in a claim year, paying up to 90% of weekly pay subject to a cap of $1,647 a week in 2026, and there may be an unpaid waiting week (Washington Paid Leave).

If the brain injury happened at work, workers’ compensation rules apply instead; see our guides on Washington work injuries and Texas employers without workers’ comp. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou.

How disability benefits and an injury claim affect each other

The answer runs in both directions.

Your benefits and the injury case. SSI is need-based, so a settlement can affect it. SSA’s operations manual treats an award as unearned income in the month received, deducts amounts such as medical expenses needed to obtain the award, and counts what is left as a resource starting the next month (POMS SI 00830.515). SSA disregards up to $100,000 in an ABLE account for SSI (SSA), and special needs trusts under Section 1917(d)(4)(A) of the Social Security Act are outside the usual SSI trust rules (SSA). SSDI is different. SSA says workers’ compensation and other public disability benefits, including state temporary disability benefits, may reduce SSDI so that the total does not exceed 80% of your average current earnings, while disability payments from private sources do not (SSA).

The injury case and your benefits. Each state has a collateral source rule that generally keeps benefits from an independent source from shrinking what the at-fault party owes, with exceptions set by statute. California applies it to payments “from a source wholly independent of the tortfeasor” (Helfend, 1970). The Texas Supreme Court describes it as precluding any reduction in a tortfeasor’s liability because of benefits the plaintiff received from someone else (Haygood, 2011). Washington applies it to payments whose origin is independent of the wrongdoer (Ciminski v. SCI Corp., 1978).

What this means for your case

If you cannot work, apply for the benefits you may qualify for now and keep the claim against the at-fault party moving on its own track. Tell your injury lawyer about every benefit you receive, because SSI rules and repayment questions shape how a settlement should be structured. Keep pay stubs and the records SSA asks for, since the same documents support a lost wages claim. For timing, see how long brain injury cases take, and for value, how much a brain injury case is worth. More answers are in our injury FAQs.

Common questions

Related pages

Injury law FAQs

Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.