Mental Disorders and Qualifying for Disability Benefits
Can I get disability benefits if I am suffering from the effects of a Mental Disorder?
Author: Attorney Greg Reed
Qualifying for disability due to mental disorders is certainly possible but difficult. A claimant’s credibility and a record of treatment will be important in gaining approval for benefits.
According to John Hopkins Medicine, 26% of Americans 18 and older suffer from some type of mental disorder in a given year, and many people suffer from more than one mental illness.
Mental illness is a range of mental health conditions that affect mood, thinking and behavior. Mental disorders include illnesses such as schizophrenia, depression, anxiety, addictive behaviors and eating disorders. It’s not uncommon for people to experience some mental health concerns from time to time, but a concern becomes a mental disorder when it impacts an individual’s ability to function, causing problems at home, school or work.
Both Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) provide financial assistance to individuals with mental illness.
SSDI provides monthly income to people who have a limited ability to work because of a physical or mental disability. In order to be eligible for disability benefits, a person must first meet the Social Security Administration’s definition of disability: “the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” Additionally, an individual must have worked a certain number of years and paid Social Security taxes.
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from a Mental Disorder. If you have been denied disability don’t give up!
Does Social Security consider mental illness a disability?
Yes and no. Whether or not an individual with a mental disorder is considered disabled will depend on a variety of factors: severity of symptoms, medical evidence supporting a diagnosis, effectiveness of treatment, the individual’s age and education, and the type of work the person has done in the past.
Social Security recognizes several mental disorders as impairments which may qualify for Social Security Disability benefits in Section 12 Mental Disorders.
The listings are divided into 11 categories:
- Neurocognitive disorders (12.02) – Alzheimer’s, dementia, inability to concentrate, remember or understand
- Schizophrenia spectrum and other psychotic disorders (12.03)
- Depressive, bipolar and related disorders – loss of interest in life, appetite and sleep disturbances, decreased energy, suicidal thoughts
- Intellectual disorder (12.05) – mental retardation, inability to care for personal needs
- Anxiety and obsessive-compulsive disorders (12.06) – panic attacks, paranoia, agoraphobia
- Somatic symptom and related disorders (12.07) – preoccupation with having or acquiring a serious illness that cannot be explained by a medical disorder
- Personality and impulse-control disorders (12.08) – borderline personality disorder, instability in interpersonal relationships
- Autism spectrum disorder (12.10)
- Neurodevelopmental disorders (12.11) – hyperactive and impulsive behavior, difficulty sustaining attention and organizing tasks
- Eating disorders (12.03)– anorexia, bulimia
- Trauma and stressor-related disorders (12.15)– PTSD, experience or exposure to actual or threatened death, serious injury, or violence
Qualifying for Social Security Disability benefits with a mental disorder can be difficult for a variety of reasons.
Much of the medical evidence supporting a diagnosis of mental illness is subjective and can’t be measured. There are no tests to determine most mental disorders; instead medical providers must rely on the history of a patient’s behaviors. Additionally, claims examiners who review cases are not mental health professionals and know little about mental health conditions. A claimant’s credibility and record of treatment will be important in gaining approval of disability benefits. Treatment includes psychiatric counseling, medications, and hospitalizations. The more specialized your doctor is and the more convincing his statements and opinions, the better the chances for approval of your claim.
Social Security considers a variety of factors when granting disability benefits for a mental disorder:
- Does the applicant meet Social Security’s definition of disability?
- Does the applicant’s mental health condition match a Social Security impairment listing and meet its criteria?
- What treatment is the applicant receiving and what is their prognosis? (It should be noted here that applicants with a mental disorder may have difficulty adhering to a treatment plan and making and attending appointments which harms their case).
- Has the applicant been hospitalized for their disorder?
- Can the applicant perform their former job? Can the applicant understand basic instructions? Are they abele to concentrate, maintain pace and interact with co-workers and the public?
- If the applicant is not able to perform their former job, is there other work the applicant is capable of (even if they haven’t performed that job before)?
In determining whether an individual can perform another job, Social Security will look at the applicant’s education and age. Social Security classifies education level in the following manner:
- Illiterate, or unable to communicate in English
- Marginal – 6th grade level or below
- Limited – 7th – 11th grade level
- High School and above
The older you are, the less educated you are, and the fewer transferable skills you have, the more likely Social Security will find you disabled.
As disabling as a mental illness is, it is not easy to prove depression, anxiety or a debilitating compulsion. When applying for Social Security Disability benefits you should:
- Submit accurate and comprehensive health records.
- Keep a journal of how your illness affects your daily activities at home and at work.
- Follow your prescribed treatment plan.
- Ask your medical providers, counselors, family and friends to write letters describing how your mental disorder affects your daily tasks, employment and social life.
- If Social Security has not asked you to submit an ADL questionnaire, request the form or print it out and submit it. An ADL questionnaire is a form that lists common activities that self-sufficient individuals may be expected to perform, such as mowing the lawn, grocery shopping, dressing, and going to work. Social Security uses this questionnaire to gauge how an impairment affects an individual’s behavior and to determine if that individual is capable of earning a minimum amount of income each month (SGA).
If you have a mental disorder, yet your disability does not match a Social Security listing, you may still be eligible for Social Security Disability benefits if you have another impairment; for example, back problems.
Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical-vocational assessment), taking into account whether or not you are able to drive, your age, and level of education.
Because mental disorders are so difficult to assess and Social Security disability claims can be time consuming and confusing, it is a good idea to have an advocate to act on your behalf.
Consulting a qualified disability attorney can make the difference in whether or not you are approved for benefits, especially if your initial application is denied. Between 2007 and 2015, six in ten applicants (or 59%) who listed a mood or anxiety disorder as a primary impairment were approved after a hearing.
In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.
The first category is the Work Requirements which has two tests.
- The Duration of Work test. Whether you have worked long enough to be covered under SSDI.
- The Current Work Test. Whether you worked recently enough for the work to actually count toward coverage.
The second category is the Medical Eligibility Requirement.
- Are you working? Your disability must be “total”.
- Is your medical condition severe? Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
- Is your medical condition on the List of Impairments? The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
- Can you do the work you did before? SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
- Can you do any other type of work? If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.
More details can be found on our Qualifying for Disability page.
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Because of his extensive litigation experience Mr. Roach is board certified from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Mr. Roach is a member of the Texas trial lawyers association, has been active in the Austin Bar Association and is a past Director of the Capital Area Trial Lawyers Association. Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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