Mental illness is common in modern American life, but in some cases, mental impairments can be so severe they can impact a person’s ability to work full-time.
Since the Social Security Administration defines a disabling condition as, “by reason of a medically determinable physical or mental condition [expected to last a full year or result in death],” it is clear that mental illness can be disabling.
Some prevalent mental illnesses (especially depression and anxiety) are difficult to define, nebulous, or hard to quantify. The chronic nature of mood disorders (including bipolar disorder and panic attacks) can make it difficult to establish a date of onset, for example.
Some mental impairments are cut and dried, like intellectual deficits that can be measured with IQ tests; most mental impairments require plenty of medical evidence that establishes how the mental illness impacts daily living as well as substantial gainful activity (commonly called work).
This article outlines how SSA categorizes mental impairments, why medical evidence is essential, and how signs and symptoms, such as poor impulse control or even medication side-effects, can be effectively documented.
The SSA and Mental Illness Claims
Mental health disorders are, as a general rule, more difficult to prove with objective medical tests than physical impairments. Even for those with neurocognitive disorders (such as a benign brain tumor, or the effects of Parkinson’s disease) much rests of symptomology. It is often the behavior of the allegedly disabled person that matters, so reports from a treating mental health professional (especially a psychiatrist) as well as a Consultative Exam (CE) can carry a lot of weight.
The bottom line with mental health conditions is the level of functioning, including the ability to complete activities of daily living such as self-care, maintaining relationships, and completing treatment. Family members will often be asked to complete paperwork to help document what daily life is like for a person who has a mental illness.
What Percentage of Mental Health Claims Are Denied?
Mental illness is often accompanied by a physical impairment, so it is impossible to give a straight percentage of how many mental health claims are denied. In a sense, the percentage denied is less important than understanding how to prove mental illness, which rests on demonstrated signs, symptoms, behaviors and functional limitations.
Which Mental Illnesses Qualify for Social Security Benefits?
Social security categorizes mental impairments. In each category, the applicant (known as the “claimant”) can “meet” a listing with certain signs, symptoms and objective medical evidence. The vast majority of claimants do not meet a listing, however, and the severity of their conditions must be evaluated using a form called the “Mental Residual Functional Capacity” (MRFC). The MRFC considers all the medical evidence, including things like IQ tests, suicide attempts, and treatment history. A psychologist or psychiatrist reviews all the evidence in file and completes the MRFC.
The categories established by the SSA and used by the DDS are:
- Affective disorders (bipolar, dysthymia, etc.)
- Anxiety Disorders (panic attacks, PTSD, etc.)
- Autism and related disorders
- Mental retardation (any intellectual deficit, at any age)
- Organic Mental Disorders (Alzheimer’s disease, traumatic brain injury, etc.)
- Personality disorders (Borderline personality, anti-social personality disorder, etc.)
- Schizophrenia, paranoia, and psychotic disorders
- Somatoform disorders (illnesses with little physical evidence)
- Substance addiction (including alcohol)
It is important to remember that diagnosis itself is usually insufficient to establish a disabling mental condition. In order for your mental disorder to quality, you must show signs and symptoms, in addition to functional limitations, that are supported by medical evidence.
Are Any Mental Illnesses Not Covered?
All mental illnesses can result in a finding of disability, but not all mental illnesses have a listing. A listing establishes a near-exact threshold of severity. For example, in the case of mental retardation, a full-scale IQ (FSIQ) below 60 meets the listing. In this case, the psychologist doesn’t fill out an MRFC completely: he (or she) simply checks the box at the top that says, “meets listing X.”
Some mental illnesses, however, fit into multiple categories. For example, an individual may have bipolar disease (an Affective Disorder) with psychosis. In this case, the medical professional will choose the most appropriate category.
The Most Common Mental Health Disorders Covered by Disability?
Disability is a numbers game, which means the most common diagnoses within the general public are also the most frequent disability claims. Common conditions that may result in a finding of mental disability include:
- Depression (particularly with suicide attempts and/or multiple hospitalizations)
- Anxiety-related disorders (including Post-Traumatic Stress Disorder or PTSD)
- Schizophrenia (especially with psychosis and/or multiple hospitalizations)
- Intellectual disorders (including those resulting from DD and dementia)
- Mental impairment due to TBI (traumatic brain injury), dementia, or developmental disorders
Less common disorders include
- Autism (including Asperger’s disease)
- Obsessive-compulsive disorder (OCD)
- Personality disorders
- Somatoform disorders
How To Ensure Your Mental Health Claim Is Accepted
Mental health claims do not pass a harder test, but they do require more thorough documentation. Additionally, if a medication exists to treat the medical condition (whether mental or physical) but the claimant isn’t taking it, the claim may be denied. Unfortunately, in some cases, a symptom of the mental illness is the inability to take meds or willful denial that a condition exists.
Help you or a loved one win the case by doing the following on your social security disability claim:
- Document all allegations thoroughly, including listing them as “alleged impairments”
- Make sure to attend all scheduled appointments
- Include all medical tests (e.g. IQ tests) even if they are out-of-date
- Ensure family members complete requested paperwork
- Ask all treating physicians for therapy notes
- Document any suicide attempts
- Submit school records as requested
- Obtain records from ALL sources, including addiction treatment, alternative therapies, prison records
How A Disability Lawyer Can Help You
If you have a mental illness, the disability process can be even more overwhelming. A disability attorney will offer a free evaluation and can even help you identify your alleged impairments, including whether you meet a blue book listing. Getting a disability evaluation from a disability attorney can help you realistically understand your chances of success. If you are considering at attorney, you can call or use the web to leave your phone number.
If you are an individual without a work history, you will apply for SSI (Title 16 or “Medicaid”) and disability attorneys have the best track records with these types of claims.
Apply For Social Security Disability For Your Mental Illness
We encourage you to consider applying for disability benefits by using a law firm. Disability benefits aren’t difficult to obtain with persistence and the right help. Social Security disability benefits are your right, whether you are taking advantage of an entitlement program (Title 2) or welfare assistance (Title 16). We encourage you to reach out to a qualified law firm for assistance in applying for social security benefits today.