Obtaining disability benefits for Bipolar Disorder
Can I qualify for disability benefits if I am suffering from the effects of Bipolar disorder?
Author: Attorney Lonnie Roach
Bipolar disorder is a mental illness that causes drastic shifts in a person’s mood, energy, and ability to think clearly. People with bipolar disorder vacillate between periods of extreme happiness and excitement and episodes of deep depression.
According to the World Health Organization, bipolar disorder is the sixth leading cause of disability in the world.
It affects approximately 5.7 million adults, both men and women and all ethnic and social groups. The median age of onset is 25, but the illness can begin in childhood or even the 40s and 50s.
Bipolar disorder is also known as manic-depressive illness.
There are two “poles” of mood, which is why the illness is called bipolar. Manic refers to periods when the individual feels “up” or excited and happy, while depressive defines the “down” periods when the individual feels hopeless or worthless.
There are four types of bipolar disorder, but each type is characterized by dramatic changes in mood, energy, and activity level, ranging from extremely happy and energized to very depressed.
- Bipolar I Disorder. In this type of bipolar disorder episodes last at least 7 days or periods with manic symptoms are so severe that hospital care is required. Depressive episodes may also occur, usually lasting at least 2 weeks.
- Bipolar II Disorder. This type is characterized by episodes of both depression and manic behavior, but symptoms are not as severe as in Bipolar I Disorder.
- Cyclothymic Disorder (or cyclothymia). This type of bipolar disorder is defined by numerous periods of hypomania (less severe episodes) and depressive symptoms that last at least 2 years (or one year for children and adolescents).
- Other Bipolar Disorders. This type is characterized by bipolar symptoms that don’t match the three categories above.
People with bipolar disorder experience periods of intense emotion, changes in sleep patterns and activity levels, and exhibit unusual behaviors.
These “mood episodes” are radically different from behaviors typical for that person and do not follow a particular pattern. They may occur over weeks, months, or years, but differ from person to person and can become more or less severe.
Typical manic episode symptoms include:
- Excessive excitement or happiness
- Increased energy and less need for sleep
- Sudden changes in mood from being elated to irritable and angry
- Rapid speech and poor concentration
- Impulsiveness and making unrealistic plans
- Displaying poor judgment
- Drug and alcohol abuse
A person experiencing a depressive episode may show:
- Deep sadness
- Feelings of hopelessness or worthlessness
- Loss of energy
- Uncontrollable crying
- Trouble concentrating
- Trouble making decisions
- Lack of enjoyment in events, hobbies, etc. that were previously fun
- A need for more sleep or insomnia
- Changes in appetite resulting in weight loss or weight gain
Researchers are studying the causes of bipolar disorder and believe that genes, brain function and structure, and family history all play a role.
Bipolar disorder tends to run in families. Two thirds of people with bipolar disorder have a close relative with bipolar disorder and children with a parent or sibling who is bipolar are more likely to develop the illness.
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 Bipolar Disorder. If you have been denied disability don’t give up!
If a doctor believes a patient might have bipolar disorder, they will do a complete psychiatric evaluation.
Diagnosis is based on the individual’s symptoms and ruling out other conditions. Speaking to family and friends can help a doctor determine if bipolar disorder or another condition is involved in a patient’s mood changes and behavior.
Successful treatment can stabilize moods and provide symptom relief.
Though psychotherapy is often employed, medication is the main treatment for bipolar disorder. Tegretol, Lamictal, Depakote and lithium are among the most common mood stabilizers prescribed. Ongoing treatment has proven more effective than dealing with problems as they arise.
The Social Security Administration recognizes bipolar disorder as an impairment in its Blue Book under Section 12.04.
12.04 Depressive, bipolar and related disorders (see 12.00B3), satisfied by A and B, or A and C:
A. Medical documentation of the requirements of paragraph 1 or 2:
- Depressive disorder, characterized by five or more of the following:
- Depressed mood;
- Diminished interest in almost all activities;
- Appetite disturbance with change in weight;
- Sleep disturbance;
- Observable psychomotor agitation or retardation;
- Decreased energy;
- Feelings of guilt or worthlessness;
- Difficulty concentrating or thinking; or
- Thoughts of death or suicide.
- Bipolar disorder, characterized by three or more of the following:
- Pressured speech;
- Flight of ideas;
- Inflated self-esteem;
- Decreased need for sleep;
- Involvement in activities that have a high probability of painful consequences that are not recognized; or
- Increase in goal-directed activity or psychomotor agitation.
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
- Understand, remember, or apply information (see 12.00E1).
- Interact with others (see 12.00E2).
- Concentrate, persist, or maintain pace (see 12.00E3).
- Adapt or manage oneself (see 12.00E4).
C. Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 12.00G2b); and
- Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 12.00G2c).
To qualify for SSDI on the basis of bipolar disorder:
- The disorder must have lasted, or be expected to last, at least 1 year
- You must provide more than one diagnosis of bipolar disorder
- You must prove that the disorder prevents you from working and meeting the demands of daily life
Two thirds of applicants are approved for benefits, but many only qualify on appeal.
If your medical records report periods in which you “feel better” be prepared to explain during an administrative hearing that you have periods of feeling good and periods of feeling bad and how frequently they occur.
An Austin client suffered from Bipolar disorder and took lithium and lexapro for this condition.
She was dysphoric and had cognitive deficits secondary to her Bipolar illness. She suffered from decreased memory, poor organizational skills, poor executive functioning, and low frustration and stress tolerance. According to her treating psychiatrist, she was totally disabled from this condition. She had been found totally disabled by the Social Security Administration. Furthermore, because of the significant mental impairments caused by her condition, the Administrative Law Judge who decided our client’s social security disability claim made a finding that the evidence suggested she was not capable of managing her own funds. MetLife withheld payment of her claim after two years based upon the policy’s 24-month mental health limitation. However, we demonstrated that bipolar disorder was not subject to those limitations and we were able to get her benefits reinstated.
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.
If you have bipolar disorder, you may be eligible for Social Security disability or private long-term disability benefits.
Disability benefits are an important source of income for those who are unable to work. If you 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 over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications 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. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) 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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