Many people mistakenly believe that a mental or psychological disability does not qualify for disability benefits under Social Security Disability. Nothing could be further from the truth. Severe depression or any other type of mental illness that prevents you from maintaining gainful employment may qualify for mental illness disability benefits. Social Security disability benefits can cover every day living expenses, medical bills, and other financial obligations.
There are nine categories of mental disorders covered in the blue book. Each disorder has its own set of criteria for evaluation. You must be able to show you meet the criteria or that your disabling condition prevents you from working. It is important that you be able to show you are receiving and complying with treatment when you apply for SSD.
Statistics Related to Receiving Disability Benefits for a Mental Disability
Depression and other mental disabilities are more common than you might think in our society. According to the National Institute of Mental Health, as many as 10.3 million adults in the United States suffered a depressive episode in 2016. That being said, in the same year, only about 2 million people were receiving SSDI or SSI benefits for mood disorders—about 14 percent of the total number of beneficiaries. Mood disorders like depression and bipolar disorder ranked high among the primary mental impairments for SSDI or SSI benefits.
In fact, mood disorders are the most common impairment following back problems. When combined with traumatic stress disorder, OCD, and agoraphobia, psychological conditions account for about 16 percent of all SSDI or SSI applicants. Unfortunately, it can sometimes be difficult to convince others who have not experienced a mental disability that it’s not something you can “get over.” The same may also be true when you are applying for mental illness disability benefits.
Eligibility for Mental Disability Benefits
Social Security Disability is available to disabled adult workers who have paid Social Security taxes. If you have never worked due to your mental illness, you will not qualify for SSDI, but could qualify for SSI. You must have worked in jobs covered by SSA and have a medical condition that meets the SS definition of a disability.
Generally speaking, you must have been unable to work for a year or more as a result of your disability. Once you are approved for benefits, they will continue until you are able to return to work on a regular basis. If you are receiving SSDI when you reach full retirement age, your disability benefits will automatically convert, with the amount remaining the same.
Your SS work credits are based on total yearly wages or self-employment income. You can earn up to four work credits each year, although the amount needed per credit changes yearly. In 2021, you earn one credit for each $1,470 in wages or self-employment income. Once you’ve earned $5,880 (in 2021), you’ve earned your four credits for the year.
The number of credits you will need will depend on how old you are when you become disabled. In general, you need 40 credits. Twenty of those 40 credits must have been earned in the past 10 years (up until the year you became disabled). Younger disabled workers may be able to qualify with fewer credits.
What is Considered “Disabled” Under Social Security Rules?
You are considered disabled by SSA if you cannot do work you did prior to your disability and cannot adjust to another type of work. Your disability must have lasted or be expected to last at least a year or result in death.
Social Security does not pay for partial disability or short-term disability—only total disability. SSA determines whether you are disabled by asking the following five questions:
- Are you currently working? If you are working, and you are consistently making more than $1,310 per month, you will probably not be considered disabled.
- Does your disability prevent you from performing basic work-related activities (walking, standing, sitting, remembering)? In short, is your condition considered “severe?”
- Is your disabling condition found in the Blue Book list of medical conditions?
- Are you able to do the work you did prior to your disability?
- Depending on your specific medical condition, education, age, and past work experience, could you potentially do another type of work?
You must also have a formal diagnosis of your disabling condition to be eligible for SSD benefits.
How to Prove Your Mental Disability Case
To prove your mental disability case, you must have extensive medical records that document your mental disability, such as:
- Information from a psychiatrist or psychologist on your diagnosis;
- Documentation such as a brain scan or other type of evidence of your mental disability;
- Records detailing your treatment(s), medications, therapies, and other management related to your mental disability;
- The effects of treatment(s), medications, and therapies on your mental disability;
- Documentation of an increase in symptoms or periods of decompensation related to your mental disability, and
- Effects your mental disability symptoms have on your day-to-day life (“activities of daily living”).
You may wonder what’s covered under “activities of daily living” (ALD). If you can prove that your mental illness makes it nearly impossible for you to function outside of your home, you have a very strong chance of approval for SSD benefits. To qualify for SSD benefits with a mental illness you may have to prove you have taken medication for your condition for at least two years and have seen no improvement.
Which Mental Illnesses are Covered in the Blue Book?
The SSA will conduct a detailed review of your medical records to determine whether you are eligible for mental illness disability benefits. Your medical records will be matched to a disability listing in the Blue Book—the SSA’s medical guide used to evaluate every disability. Mental illnesses appear in Section 12.00 and include the following:
- 04—Affective disorders like bipolar disorder;
- 06—Anxiety-related disorders like PTSD, a severe phobia, or panic disorders, and
- 08—Personality disorders like severe clinical depression.
Some examples of mental disabilities include:
- Depression/Bipolar Disorder
- Anxiety Disorder/Generalized Anxiety Disorder
- Organic Brain Dysfunction/Traumatic Brain Injury
- Personality Disorders
- Impaired IQ/Learning Disorders/Intellectual Disability
- Memory Problems/Cognitive Disorder
- Post-Traumatic Stress Disorder
- Attention Deficit Hyperactivity Disorder
- Asperger’s Syndrome
- Bipolar Disorder
- Eating Disorders
- Mood Disorder
- Drug Addiction
- Obsessive Compulsive Disorder
- Schizoaffective Disorder
- Somatoform Disorders
To qualify with a drug addiction disability, you must have medically document evidence that your substance abuse issue causes you to meet the requirements for one of the other neurological, mental, or digestive disorders. To qualify for a somatoform disorder you must have medical documentation that shows:
- By age 30 you had a history of unexplained physical symptoms;
- These physical symptoms required you to make substantial changes to your lifestyle;
If the symptoms involved loss of movement, loss of sensation, excessive heightening of sensation, loss of one or more limbs, loss of speech, loss of movement, loss of hearing, or loss of sigh, you will likely qualify for SSD benefits.
What is the Process for Applying for Mental Illness Disability Benefits?
You can apply for SSD benefits online, or at the nearest SSA office. You can call 1-800-772-1213 to make an appointment with your local SSA office. You will need the following on hand before applying online, or, if you are applying in person, you will need to take these documents.
- Medical records you have in your possession;
- Any workers’ compensation information (if you’ve filed for WC);
- The names and DOBs for each of your minor children and your spouse;
- Dates of all marriages and divorces;
- Your checking or savings account number, along with your bank’s 9 digit routing number;
- The name and contact information of a person SSA can contact if they are unable to reach you;
- A medical release form SSA-827, and
- A completed medical and job worksheet.
If your initial application is approved, you can expect to have your case reviewed each year. Applicants with a condition that will clearly never improve (i.e., paralysis), are reviewed about every seven years. Mental illnesses can often be treated, therefore you can expect a yearly check-in. If you are not initially approved, you can ask for a reconsideration. If you are not approved at the reconsideration stage, you can ask for a hearing before an Administrative Law Judge. If you are turned down at this stage, you can appeal your case two more times.
How a Social Security Disability Attorney from Carmichael Law Group Can Help
Obtaining mental illness disability benefits can be a long, exhausting process. If your original application is denied, do not give up! Instead, find a highly experienced SSD attorney from the Carmichael Law Group to handle your appeal. You have a much better chance of being approved for the disability benefits you need and deserve when you have the Carmichael Law Group on your side. Aside from having a better chance of approval, the process is simply much less difficult when you have a knowledgeable SSD attorney in your corner. Contact the Carmichael Law Group today.