TIA (Transient Ischemic Attack)
What is a TIA?
A TIA, or "transient ischemic attack," is sometimes referred to as a "mini-stroke," because the symptoms of a TIA are often similar to those of a stroke. However, with a TIA, the symptoms are transient. They usually disappear within an hour or so and do not last more than 24 hours. An MRI does not show neurological damage to the brain from a TIA.
TIA or CVA
The National Institutes of Health tells us that a TIA is a transient stroke that lasts only a few minutes. It occurs when the blood supply to part of the brain is briefly interrupted (by a clot or vascular obstruction). TIA symptoms, which usually occur suddenly, are similar to those of stroke but do not last as long. Most symptoms of a TIA disappear within an hour, although they may persist for up to 24 hours. Symptoms can include: numbness or weakness in the face, arm, or leg, especially on one side of the body; confusion or difficulty in talking or understanding speech; trouble seeing in one or both eyes; and difficulty with walking, dizziness, or loss of balance and coordination.
Treatment and Prognosis
Because there is no way to tell whether symptoms are from a TIA or an acute stroke, patients should assume that all stroke-like symptoms signal an emergency and should not wait to see if they go away. A prompt evaluation (within 60 minutes) is necessary to identify the cause of the TIA and determine appropriate therapy. Depending on a patient's medical history and the results of a medical examination, the doctor may recommend drug therapy or surgery to reduce the risk of stroke in people who have had a TIA. The use of antiplatelet agents, particularly aspirin, is a standard treatment for patients at risk for stroke. People with atrial fibrillation (irregular beating of the heart) may be prescribed anticoagulants.
TIAs are often warning signs that a person is at risk for a more serious and debilitating stroke. About one-third of those who have a TIA will have an acute stroke some time in the future. Many strokes can be prevented by heeding the warning signs of TIAs and treating underlying risk factors. The most important treatable factors linked to TIAs and stroke are high blood pressure, cigarette smoking, heart disease, carotid artery disease, diabetes, and heavy use of alcohol.. Lifestyle changes such as eating a balanced diet, maintaining healthy weight, exercising, and enrolling in smoking and alcohol cessation programs can also reduce these factors.
Other Conditions That Mimic a TIA
There are several neurological conditions that may cause symptoms similar to a TIA. They include "small strokes," migraine aura, visual migraines, seizures, syncope (fainting), vestibular disorders of the inner ear or the brain, and transient global amnesia. [Reference: Nadarajan V, et al. "Transient ischemic attacks: mimics and chameleons." BMJ 2014, 14:1.]
Disability Benefits for TIA
If you have had a TIA, claims for long-term disability benefits under Social Security (SSDI) and/or employer-sponsored disability plans (ERISA) are difficult to win, because TIA's are considered "transient." Accordingly, long-term neurological impairment from TIA's, such as memory loss or cognitive dysfunction, is generally not accepted by the medical community.
There are a few studies in the medical literature that appear to medically support a cognitive dysfunction claim related to having suffered a TIA. For example, Dr. Maiken Nedergaard, from the University of Rochester Medical Center, has published research in the Journal of Neuroscience suggesting that TIA's can cause cognitive dysfunction and symptoms of dementia. [See: "Science News", Dec. 12, 2012.] However, the "conventional wisdom" is that a claim for long-term disability related to suffering aTIA is not likely to be accepted as medically valid.
Essential Medical Documentation of Stroke Needed for Disability Benefits:
- How long has the condition affected you?
- What medication is prescribed and effects of the medication?
- Do you have difficulty with your memory?
- How does the condition impact you in your daily life? (substantial impact?)
- How does the condition impact your ability to concentrate, follow directions, stay focused and on task? (substantial interference?)
- How does the condition impact your ability to interact with others? (substantial interference?)
- Have you required any hospitalizations for your condition?
- Have you been fired or reprimanded from work for your condition?
SSA utilizes the term "Impairments" (and resulting "limitations" - why you cannot work) are the essential bits of information that must be clearly and consistently documented throughout your medical history by the treating sources (medical doctors, psychologists, psychiatrists).
SSA additionally utilizes the term "Residual Functional Capacity" (RFC); this is a key concept related to the resulting physical and/or mental impairments from conditions for which the disability claim is based upon and the impact upon ability to work.
SSA has its own forms that are used for Physical RFC here and for Mental RFC here. These forms can be filled out by the treating source who has the opportunity to examine the patient and understand the limitations which result from his/her condition and thereby document with specificity in the language of SSA disability.
Your disablity lawyer must work closely with your treating physician to get the proper documentation of your specific findings and impairments into the medical records. At Law Med that's what we