Getting approved for disability by the Social Security Administration for a mental illness can be more complex than getting approval for a physically disabling condition. However, it is far from impossible. The primary reason obtaining disability benefits is more complicated for a mental illness is that symptoms of a mental illness are more difficult to evaluate and measure objectively. Yet, according to the National Institute of Mental Health, in 2019, as many as 13.1 million U.S. adults over the age of 18 had at least one major depressive episode with severe impairments.
Qualifying for mental illness disability benefits can feel like an uphill battle. Having an experienced Social Security Disability attorney by your side from start to finish can result in a much higher chance of a positive outcome. The attorneys at Schaffer & Associates can ensure you have the very best chance of being approved for your disability benefits. If your initial application is denied, we can go through the appeal process on your behalf, working hard for approval.
Qualifying for Mental Illness Disability Benefits
If your mental health condition significantly limits your ability to perform your regular tasks at work, you may qualify for Social Security Disability benefits. Just as with disability benefits for a physical impairment, you must have earned sufficient credits and paid enough taxes to be eligible for these benefits. For most people, that translates into having worked the equivalent of five years, full-time, out of the past ten years. This qualifier can be much more complex. You can earn up to four credits per year; in 2021, you receive one credit for each $1,470 in wages or self-employed income. Once you have earned $5,880 in one year, you have earned your four credits for the year.
You must not currently be making more than $1,350 per month, or the SSA will not consider you disabled. Unlike some other programs, there are no benefits for partial or short-term disability. To be considered disabled by the Social Security Administration, your mental condition must prevent you from doing the work you did before. In addition, you must be deemed unable to adjust to other types of work due to your condition, and your disability must have either lasted or is expected to last for a least one year, or result in death.
The SSA uses a medical guide known as the Blue Book when determining whether an applicant qualifies for disability benefits. There is a section in the Blue Book that details many different mental disorders and conditions. If you are applying for SS disability based on cognitive impairment, your symptoms must meet the specific criteria listed in the blue book. You will need evidence to confirm this fact, including your medical records that clearly state your diagnosis, your treatment, and how your mental illness prevents you from doing work you did before or transitioning to another type of work.
What Mental Illnesses Qualify for Disability Benefits?
There are eleven categories of mental illnesses listed in the SSA Blue Book. They are:
- Neurocognitive disorders (12.02) including Alzheimer’s, vascular dementia, dementia due to a medical condition, progressive brain tumor, neurological diseases like Parkinson’s and Huntington’s, traumatic brain injury, or substance-induced cognitive disorders.
- Schizophrenia spectrum (12.03), including a psychotic disorder due to another medical condition, delusional disorder, schizoaffective disorder, and schizophrenia.
- Depressive, bipolar, and related disorders (12.04), including bipolar or depressive disorders due to another medical condition, major depressive disorders, cyclothymic disorders, and bipolar disorder.
- Intellectual disorders (12.05)
- Anxiety and obsessive-compulsive disorders (12.06), including social anxiety disorder, obsessive-compulsive disorder, agoraphobia, panic disorder, and generalized anxiety disorder.
- Somatic symptom and related disorders (12.07) Disorders in this category have physical symptoms or deficits that cannot be clinically explained but are neither feigned nor intentionally produced. Disorders like illness anxiety disorder, conversion disorder, and somatic symptom disorder fall under this category.
- Personality and impulse control disorders (12.08), including intermittent explosive disorder, obsessive-compulsive personality disorder, dependent or avoidant disorders, paranoid, schizoid, schizotypal, and borderline disorders.
- Autism spectrum disorders (12.10), including autism spectrum disorder with or without accompanying language impairments and autism spectrum disorder with or without accompanying intellectual impairments.
- Neurodevelopmental disorders (12.11), including specific learning disorders, borderline intellectual functioning, and tic disorders like Tourette’s syndrome.
- Eating disorders (12.13), including anorexia nervosa, binge-eating disorder, avoidant/restrictive food disorder, and bulimia nervosa.
- Trauma and stress-related disorders (12.15), including PTSD and adjustment disorders with prolonged duration.
Somatic symptom and related disorders, personality and impulse control disorders, autism spectrum disorders, neurodevelopmental disorders, and eating disorders must qualify under paragraphs A and B in their Blue Book descriptions. In contrast, neurocognitive disorders, schizophrenia spectrum, depressive, bipolar, and related disorders, anxiety and obsessive-compulsive disorders, and trauma and stress-related disorders have three paragraphs (A, B, and C).
These five mental illnesses must either satisfy the requirements of paragraphs A and B or A, and C. Listing 12.05 (Intellectual Disorders) has two unique paragraphs; your disorder must satisfy either paragraph A or paragraph B. For example, to satisfy paragraph C for 12.02, 12.03, 12.04, 12.06, and 12.15, there must be a medically documented history of the disorder over at least two years.
What is a Medical-Vocational Allowance?
Suppose your mental illness does not precisely match a listing in the Blue Book, but you are seriously disabled and unable to perform any type of work. In that case, you may still qualify for benefits based on a medical-vocational allowance. Your medical records will be thoroughly reviewed by the SSA. After reviewing your medical records, the Social Security Administration will determine whether you qualify for disability benefits under a medical vocational allowance.
Based on the evidence, the SSA will determine what type of work you can reasonably perform with your mental disability. This is known as Residual Functional Capacity (RFC), which measures your remaining ability to work after consideration of the limitations of your mental illness. In short, how much can you do, and for how long? For mental illnesses, the questions to answer might look like this:
- Are you able to both understand and remember instructions?
- Can you maintain concentration and attention for extended periods?
- Are you able to respond appropriately to normal work conditions, co-workers, and supervisors?
- Can you easily cope with work setting changes?
For the vocational aspect, the SSA will take your age, work history, transferrable skills, and educational background into consideration. Under a medical vocational allowance, you might be approved for SSD benefits you otherwise might not qualify for. It is beneficial to have a highly-skilled Social Security Disability attorney help you prepare your application and be a strong advocate in your corner.
What Medical Evidence is Necessary to Prove Mental Disability?
The Blue Book listings for mental disabilities is crucial to proving your mental illness. You will need solid medical evidence. The SSA disability examiner will obtain your records from all your medical professionals familiar with your diagnosis and treatment. This could include your primary care physician, psychiatrist, psychologist or therapist, mental health facilities, your local hospital, and any other caregivers who have treated your mental disability.
You may be required to see an SSA-authorized physician; you should continue seeing your regular medical professionals as well. All medical documentation, including notes and medical records from treating medical professionals, will become relevant as you seek to show how your mental disability makes it impossible for you to hold down a full-time job. Testimony from family members, friends, social workers, and others you regularly interact with may help you obtain your disability benefits as they can help explain how your mental illness affects your ability to obtain sufficient employment, interact with others, and perform routine functions.
]The medical professionals who have diagnosed and treated your mental condition must include a clinical label (like bipolar disorder, chronic depression, or schizophrenia). Your mental illness must significantly impact at least two of the following four areas (some mental illnesses, such as personality disorders, require three out of four):
- Daily living
- Social interactions
- The ability to focus and complete tasks
- Your reaction to pressure and stress
In the end, SSA will give the most weight to what your treating medical professionals have to say about whether your mental condition severely limits your ability to work.
How Schaffer & Associates Can Help Those Seeking Disability Benefits for a Mental Illness
If you seek mental illness disability benefits, having an experienced Social Security Disability attorney by your side to offer highly experienced legal assistance can be a significant advantage. The SSD attorneys at Schaffer & Associates, LPA, can help you file your initial application for disability benefits or assist you with the appeals process. In fact, according to the Disability Benefits Center, claimants represented by an attorney are three times more likely to have their disability claim approved. Contact a Schaffer & Associates attorney today! Our compassionate, knowledgeable team will guide you through the process, ensuring your application has the very best chance of approval.