Traumatic Brain Injury Benefits in Virginia

To get federal disability benefits in Virginia, you must meet Social Security’s definition of disability. For SSDI, you need a work history and enough work credits. For SSI, you must have limited income and resources. Both programs require that your disability (including TBI) is expected to last at least 12 months or result in death. The Social Security Administration (SSA) reviews medical records and work history to decide eligibility[1].

• SSDI: You must have worked in jobs covered by Social Security and earned enough work credits. The amount of your monthly payment depends on your earnings record[2].
• SSI: You do not need a work history. Payments are based on financial need. In Virginia, if you qualify for SSI, you also qualify for Medicaid[3].

Both programs have strict rules about income and assets. The SSA uses a list of impairments, including neurological disorders, to help decide if your TBI is severe enough to qualify[1].

In Virginia, people with a Traumatic Brain Injury may qualify for Medicaid through the Aged, Blind, or Disabled (ABD) program if they meet federal disability standards[4]. Virginia also offers Medicaid waivers for people with developmental disabilities, which can include TBI if it causes long-term functional limitations. These waivers provide home and community-based services like personal care, respite, and supported living[5].

There is a waiting list for Medicaid waivers, and slots are assigned based on urgency of need. You must apply through your local Community Services Board (CSB). Virginia does not require work for Medicaid if you receive disability benefits, so people with TBI are not affected by new work requirements for other adults[6].

Virginia also has special programs for brain injury services, including case management and rehabilitation supports[5].

• Check if your TBI meets Social Security’s disability rules.
• Apply for SSI or SSDI online, by phone, or at a local SSA office.
• If approved for SSI, you will automatically qualify for Virginia Medicaid.
• Contact your local Community Services Board (CSB) for Medicaid waiver services.
• Ask about brain injury-specific programs and supports[5].

• Step 1: Gather medical records that show your TBI diagnosis, treatment, and how it affects your daily life.
• Step 2: Apply for Social Security disability benefits (SSDI or SSI) through the SSA website, by phone, or in person at a local office[1].
• Step 3: If you apply for SSI and are approved, you will be enrolled in Virginia Medicaid automatically[3].
• Step 4: Contact your local Community Services Board (CSB) to apply for Medicaid waiver services. The CSB will help you complete the application and determine your eligibility for home and community-based supports[5].
• Step 5: Ask about brain injury-specific programs, such as case management, rehabilitation, and respite care. These may be available through the CSB or other state agencies[5].
• Step 6: Keep all records and report any changes in your income, resources, or living situation to avoid overpayments[7].

• Social Security Disability Insurance (SSDI): Monthly payments based on your work history. You must have worked and paid Social Security taxes.
• Supplemental Security Income (SSI): Monthly payments for people with limited income and resources. In Virginia, SSI eligibility means Medicaid eligibility.
• Medicare: Available after 24 months of SSDI payments.
• Medicaid: Available to most people who get SSI in Virginia.
• Work Incentives: Programs to help you work without losing benefits, such as the Ticket to Work and Plan to Achieve Self-Support (PASS)[8].

• Medicaid Waivers: Virginia offers three waivers for people with developmental disabilities, which can include TBI: Building Independence, Family & Individual Support, and Community Living. These waivers provide home and community-based services like personal care, respite, supported living, and behavioral supports[5].
• Aged, Blind, or Disabled (ABD) Medicaid: For people who meet federal disability standards and have limited income and resources[4].
• Brain Injury Services: Virginia provides case management, rehabilitation, and support services for people with brain injuries through the Department of Behavioral Health and Developmental Services[5].
• ABLE Accounts: Tax-advantaged savings accounts for people with disabilities. Virginia residents can open an ABLE account to save for qualified expenses without losing SSI or Medicaid[9].

Virginia residents with a Traumatic Brain Injury can open an ABLE account to save money for disability-related expenses. These accounts do not count toward SSI or Medicaid asset limits, so you can save up to $100,000 without losing benefits. ABLE accounts can be used for housing, education, transportation, and more[9].

• SSI: In 2025, the federal maximum is $967 per month for an individual, $1,450 for a couple, and $484 for an essential person. Virginia follows these limits[3].
• SSDI: There is no strict income limit, but you cannot earn more than the Substantial Gainful Activity (SGA) limit. In 2025, SGA is expected to be $1,530 per month for non-blind individuals[10].
• Medicaid: Income limits vary by program. For ABD Medicaid, the limit is about $2,742 per month for an individual in 2025[4].

If your income, resources, or living situation changes, you must report it to Social Security and Medicaid. Not reporting changes can lead to overpayments and loss of benefits. Use the SSA’s online portal or call your local office to report changes. For Medicaid, report changes to your local CSB or Medicaid office[7].

• Virginia Department of Behavioral Health and Developmental Services
  Phone: (804) 786-3921

  TTY: (804) 371-8977

  Email: [email protected]

  Website

  For Medicaid waiver questions and brain injury services.

• Can I get Medicaid if I have a Traumatic Brain Injury in Virginia?

  Yes, if your TBI meets federal disability standards, you can qualify for Medicaid through the Aged, Blind, or Disabled (ABD) program. If you get SSI, you will automatically qualify for Medicaid in Virginia[3][4].

• What Medicaid waivers are available for people with TBI in Virginia?

  Virginia offers three Medicaid waivers for people with developmental disabilities, which can include TBI: Building Independence, Family & Individual Support, and Community Living. These waivers provide home and community-based services like personal care and supported living[5].

• How do I apply for Medicaid waiver services in Virginia?

  Contact your local Community Services Board (CSB) to apply for Medicaid waiver services. The CSB will help you complete the application and determine your eligibility for home and community-based supports[5].

• Do I need to meet work requirements for Medicaid in Virginia if I have a TBI?

  No, work requirements for Medicaid do not apply to people with disabilities in Virginia. If you receive disability benefits, you are exempt from work requirements[6].

• Can I work and still get disability benefits in Virginia?

  Yes, Social Security has work incentive programs that let you work and keep your benefits up to a point. In 2025, the SGA limit is expected to be $1,530 per month for non-blind individuals[10].

• What is an ABLE account and can I get one in Virginia?

  An ABLE account is a tax-advantaged savings account for people with disabilities. Virginia residents with a TBI can open an ABLE account to save for disability-related expenses without losing SSI or Medicaid[9].