How does the SSA evaluate claims based on mental illnesses?When the claims examiner reviews an application for disability benefits, he or she will first check to see if your condition is one of those listed in the Blue Book. This federal guide provides a detailed Listing of Impairments that the SSA deems likely disabling. If your mental illness is on the list and meets the criteria, the SSA will likely accept that you cannot work and determine you as disabled. Section 12 of the Blue Book lists all the mental disorders that the Administration assumes will keep you from working. Below are some of the listed impairments:
- Schizophrenic, paranoid, and other psychotic disorders
- Affective disorders such as bipolar disorder and depressive syndrome
- Intellectual disabilities
- Anxiety-related disorders such as agoraphobia
- Somatoform disorders
- Personality disorders
- Autistic disorder and other pervasive developmental disorders
What criteria are necessary to establish a mental illness?The SSA requires a certain degree of severity to consider a mental illness a qualifying disability. The Administration evaluates each specific type of ailment differently, the details of which are in the Blue Book. For example, to qualify for disability based on a somatoform disorder such as pain disorder or hypochondriasis, you must meet two specific requirements:
- You must have medically documented evidence of one of the following: 1) a history of multiple physical symptoms of several years’ duration, beginning before age 30, that have caused you to take medicine frequently, see a physician often, and alter life patterns significantly; 2) persistent nonorganic disturbance of vision, speech, hearing, use of a limb, control of movement, or sensation; or 3) an unrealistic interpretation of physical signs or sensations associated with the preoccupation or belief that one has a serious disease or injury.
- Your condition has resulted in at least two of the following: marked restriction of activities of daily living; marked difficulties in maintaining social functioning; marked difficulties in maintaining concentration, persistence, or pace; or repeated episodes of decompensation, each of extended duration.
What other criteria does the SSA require for disability benefits?As aforementioned, the first requirement for benefits is to have a disabling condition that is on the Listing of Impairments or a mental illness so severe that it keeps you from working. There are also a few other criteria you must satisfy to collect disability:
- Your condition must have lasted or be expected to last a year or more (or result in death).
- You must have sufficient work credits on your record. Each year that you worked at a job in which you had Social Security taxes withheld, you essentially were buying into the Social Security Disability Insurance (SSDI) program. The number of work credits required depend upon your age. Young workers may only need six credits, for example, whereas older workers may need 40.
- If you haven’t worked long or recent enough to qualify for SSDI, you may instead be able to collect benefits under a different program for disabled persons with limited resources: Supplemental Security Income (SSI).
How to I prove my mental disability to the SSA?You will need to provide substantial medical evidence from your treating physicians, mental health practitioners, counselors, and therapists that proves the severity of your condition to the SSA. This evidence is critical to win your benefits. You can also have your doctor fill out what is called a mental RFC, which assesses your “residual functional capacity.” The SSA will take the input on the form into consideration when deciding whether it thinks you can work. The RFC form assesses your intellectual, memory, concentration, adaptive, and social functioning abilities, and the degree of your limitations. Other evidence that may be useful in demonstrating your disability to the SSA is testimonies from your family, friends, coworkers, employer, social workers, teachers, etc. that illustrate the effect your mental illness is having on your ability to work.
Get Help with Your Disability Claim at Lunn & Forro, PLLCIt is notably challenging to win benefits for mental illnesses, a fact that is frustrating for people who are suffering from mental impairments and are legally entitled to benefits. But rest assured, it can be done so long as you have adequate supportive evidence. Our lawyers at Lunn & Forro, PLLC care deeply about helping people living with disabilities in Raleigh. We can help gather the evidence necessary to support your claim, walk you through the claims process, and appeal a denial if necessary. For questions about disability benefits or for help with your application, call 888-966-6566 and request a free consultation.
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