Obtaining disability benefits for Bipolar Disorder 2023
Can I get disability benefits if I am suffering from the effects of Bipolar Disorder?
Author: Attorney Lonnie Roach
Bipolar disorder affects one in 40 American adults and is the sixth leading cause of disability worldwide. Sometimes called manic depression, bipolar disorder is a mental illness that causes drastic shifts in a person’s mood, energy, and ability to function. Bipolar disorder affects men and women equally and it can take an average of 10 years from the appearance of initial symptoms to diagnosis. If you are suffering from the effects of Bipolar disorder you may qualify for disability benefits.
Can I Get SSDI If I Have Bipolar Disorder?
People with bipolar disorder vacillate between periods of extreme happiness and excitement and episodes of deep depression.
The condition is called bipolar because there are two “poles” of mood. Manic refers to periods when the individual feels excited and happy, while depressive defines the periods when the individual feels hopeless or worthless.
There are four types of bipolar disorder with each type characterized by dramatic changes in mood, energy, and activity level.
- Bipolar I Disorder. This type of bipolar disorder episode lasts at least 7 days with manic symptoms so severe 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.
- 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.
Symptoms vary from person to person and can become more or less severe over time. These “mood episodes” are radically different from behaviors typical for that person; they do not follow a particular pattern and may occur over weeks, months, or years.
Manic episode symptoms typically include:
- Sudden changes in mood from being elated to irritable and angry
- Excessive excitement or happiness
- Increased energy and less need for sleep
- Rapid speech and poor concentration
- Impulsiveness and making unrealistic plans
- Displaying poor judgment
- Drug and alcohol abuse
Symptoms of a depressive episode may include:
- Feelings of hopelessness or worthlessness
- Deep sadness
- Uncontrollable crying
- Loss of energy
- Difficulty concentrating
- Trouble making decisions
- Lack of interest and enjoyment in hobbies and activities that were previously fun
- A need for more sleep or insomnia
- Changes in appetite resulting in weight loss or weight gain
The exact cause of bipolar disorder is unknown, but researchers believe that biological differences in brain function and structure and genetics may be involved.
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.
If you are suffering from Bipolar disorder and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are. Have some questions? just give us a call, we love to help folks just like you!
If a doctor believes a patient might have bipolar disorder, they will do a complete physical and 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. Bipolar disorder is a lifelong condition, but can be managed successfully with a treatment plan that includes medications and psychological counseling.
What do I need to qualify for Social Security Disability Income?
The Social Security Administration recognizes that the symptoms of bipolar disorder can interfere with a person’s daily routine and prevent you from working.
Bipolar disorder is listed in Social Security’s Blue Book as a disabling impairment under Section 12.04 Depressive, bipolar and related disorders; you will likely qualify for disability benefits if your symptoms match the requirements of this listing.
You must have a diagnosis of bipolar disorder and must show at least three of the following symptoms:
- “Pressured speech” – unnaturally fast and frenzied speech
- Increase in physical agitation, such as pacing or restless busyness
- Quickly changing ideas and thought patterns
- Decreased need for sleep
- Inflated self-esteem
- Involvement in risky activities with painful consequences you don’t recognize
Additionally, you must show an extreme limitation of one, or marked limitation of two of the following areas of mental functioning. Keep in mind that “extreme” means debilitating and “marked” means intense.
- Understanding, remembering, or applying information
- Concentrating, persisting, or maintaining pace
- Interacting with others
- Adapting or managing oneself; i.e., your ability to control your behavior, adapt to new situations, and personal skills such as cooking and dressing.
You may also qualify under this listing if you can show you are unable to function without a support system such as social workers, living in a group home, or with help from family or personal caretaker.
You must have a medically documented history of bipolar disorder that has existed for at least two years and evidence of the following:
- Medical treatment, mental health therapy, psychosocial support, or a highly structured setting, such as a group home, that is ongoing and diminishes the symptoms and signs of bipolar disorder; AND
- You have minimal capability to adapt to changes in your environment that are not part of your daily life
If your symptoms aren’t considered extreme or marked, you may be found “vocationally” disabled if you have the right medical evidence.
Social Security will do a Residual Functional Capacity assessment (RFC) to determine if there are any skilled or unskilled jobs you can do given your age, education, and whether or not you can drive. Most jobs, even those with few demands, require employees to be on time and follow instructions. If you have difficulty concentrating and are easily distracted, or call in sick frequently because of depressive episodes, it’s unlikely you can maintain full-time employment.
You will need to provide complete and accurate medical records to Social Security as evidence of your claim, including:
- Names and locations of your doctors and other healthcare professionals
- Dates of doctor visits and hospitalizations
- Doctors’ notes and observations
- Medications you’ve taken, your reactions and any side effects
- Reports of mental status exams showing abnormality in thinking
- Reports from hospitalizations
- Other treatments you have tried
What do I do if my medical records show evidence of drug or alcohol abuse?
A person with bipolar disorder may have struggled with drug or alcohol abuse (DAA) at one time, or continue to struggle with DAA – this is not uncommon. Social Security won’t immediately deny your claim if your medical records show evidence of DAA; instead, the agency will attempt to determine if limitations caused by bipolar disorder would still exist if you hadn’t used drugs or alcohol. Because symptoms of bipolar disorder are similar to DAA, you should establish a period of sobriety while you’re receiving medical treatment to give Social Security an idea of your mental health without the effects of DAA.
Your age or another medical condition may help you get approval.
Though most people with bipolar disorder are diagnosed in their early teens or 20s, bipolar disorder can occur at any age and is often misdiagnosed.
Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job; applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant who has no transferable skills might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.
You may also be eligible for Social Security Disability benefits if you have another impairment, such as high blood pressure.
One disorder by itself may not meet the criteria of an impairment in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues together limit your ability to hold a job and perform necessary daily tasks.
You must also meet Social Security’s basic financial requirements.
You must also meet some basic financial requirements before you are eligible for Social Security disability benefits.
You must: 1) have a disability that has lasted, or is expected to last 12 months; 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,470 per month in 2023 for nonblind applicants and $2,460 per month for blind applicants.
What if I don’t qualify for SSDI?
If you don’t meet Social Security’s financial requirements, you may be eligible for disability benefits through another Social Security program, like Supplemental Security Income (SSI,) or from long-term disability insurance through your employer or a privately purchased policy.
SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury.
I have long-term disability insurance – should I file a claim?
If you have a long-term disability insurance policy, you should definitely file a claim as soon as you become disabled.
Long-term disability insurance (LTD) protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. But, LTD coverage is good only as long as you are employed, so do not quit your job before you file a claim. Be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Note that long-term disability insurance companies can require a claimant to apply for SSDI in addition to filing an LTD claim.
How do I file for Social Security Disability benefits?
You can apply for Social Security Disability benefits online, over the phone, or in person at your local Social Security Administration office.
If your application is denied, do not be discouraged – most initial applications are; you will have the opportunity to appeal. There are four steps to the Social Security appeal process:
- File a Request for Reconsideration with the Social Security Administration to completely review the case.
- If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI and SSI cases and either uphold or overturn decisions to deny SSDI or SSI benefits. If you are not represented by an attorney, you should obtain legal counsel at this critical point to raise your chance for success.
- If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
- Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.
Do I need a disability attorney for SSDI or SSI?
If you have bipolar disorder and cannot maintain full-time employment, you may be eligible for SSDI or SSI benefits.
However, applying for Disability benefits with this medical condition can be tricky, and your chances for approval are increased significantly if you have the guidance of an experienced Social Security Disability attorney who can evaluate your case and file your initial claim. At the request for reconsideration and hearing levels, an attorney can collect and submit relevant medical evidence, obtain doctors’ opinions, draft a brief to the ALJ, and prepare you for questioning by the judge. An attorney can also cross-examine vocational and medical experts to demonstrate your inability to work. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.
Do I need a disability attorney for Long-Term Disability?
Filing a claim for long-term insurance if you become too disabled to work is a complex process, whether you have a long-term insurance policy purchased through a private insurance broker or a group policy purchased with your employer.
The wording of policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in their procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.
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.
The attorneys at Bemis, Roach & Reed have wide experience in representing clients at all levels of the Social Security Disability process and in long-term disability insurance cases.
At The Texas Disability law firm Bemis Roach & Reed, our attorneys are committed to helping injured or disabled clients receive the benefits they deserve. Mr. Roach is AV Preeminent and SuperLawyers rated and has become a recognized leader in the field of Long Term Disability law. Mr Bemis focuses his practice on Social Security disability while Mr Reed handles both LTD and SSDI claims. Both are AV Preeminent and SuperLawyers rated and all our attorneys have been successfully helping people fight for their rights against big insurance companies and the government since 1993. If you have applied for benefits and been denied call 512-454-4000 for a free consultation 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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