Individuals who suffer from certain mental illnesses or who have a mental illness in addition to other disabling conditions may qualify for Social Security Disability benefits if the mental illness prevents them from being able to work.
Understanding the different categories of mental illness and the criteria that must be met can help you determine whether benefits may be available.
Our experienced Phoenix Social Security disability attorneys fight every day for our clients to secure the benefits they need and deserve. Contact us today to assess your mental illness claim and to get advice on how to proceed with your claim.
SSD Requirements for Mental Illnesses
In order to qualify for Social Security disability benefits based on mental illness, the individual must provide medical documentation that meets specific criteria based on the specific condition.
Additionally, all of the mental illnesses described below must meet the following criteria:
The condition must cause an extreme limitation or a marked limitation in:
- Understanding, remembering or applying information
- Interacting with others
- Concentrating, persisting or maintaining pace
- Adapting or managing oneself
If this criterion cannot be met, an alternative may be to show that the mental disorder is serious and persistent. This means that the individual has a history of the disorder for a minimum of two years that is medically-documented that has negatively impacted his or her ability to work.
Additionally, the individual must show that the medical condition that he or she suffers from has impaired the individuals' ability to function in the world without a tremendous amount of outside support.
The individual will also have to show that he or she suffers from episodes of decompensation, or situations where the person's mental state deteriorates and his or her ability to function is negatively affected.
The SSA's Categories of Mental Illness
The Social Security's Blue Book includes listings for a variety of mental illnesses, including:
These disorders include various forms of dementia, progressive brain tumor, Parkinsonian syndrome, Huntington disease and other disorders that are characterized by a clinically significant decline in cognitive functioning.
Individuals who suffer from these disorders may suffer from memory loss, difficulty concentrating, inability to make decisions, insensitivity to social standards and problems with perception.
In order to qualify for disability benefits under this category, the individual must have medical documentation that establishes a decline in one of the following areas:
- Complex attention
- Executive function
- Learning and memory
- Social cognition
Schizophrenia Spectrum and Other Psychotic Disorders
This listing includes conditions that are characterized by one or more of the below:
- Disorganized speech
- Catatonic behavior
- Exceptionally disorganized behavior
These symptoms cause a clinically significant decline in functioning. Conditions in this category include schizophrenia, delusional disorder and schizoaffective disorder.
Depressive, Bipolar and Related Disorders
These disorders are associated with symptoms of depression, suicidal ideation, moods based on irritability, depression or elevation, or sleep disturbances.
Claimants who have a depressive order must have medical evidence of five or more of the following:
- Depressed mood
- Reduced interest in nearly all activities
- Weight change caused by a disturbance of their appetite
- Sleep disturbance
- Psychomotor agitation or retardation
- Decreased energy
- Feeling guilty or worthless
- Trouble concentrating or thinking
- Suicidal ideation or thoughts
If the claimant suffers from a bipolar disorder, he or she must have symptoms of at least three of the following:
- Stressed speech
- Flight of ideas
- Inflated ego
- Diminished need for sleep
- Engagement in activities with a higher likelihood of painful repercussions that the claimant does not recognize
- Increase in purposeless or goal-oriented activity
This disorder is characterized by below average general intellectual functioning, significant deficits in current adaptive functioning and the development of the disorder before a person reaches the age of 22.
Claimants with a disorder of this nature must show that their cognitive function is below the ability to participate in standardized testing for intellectual functioning and that they are dependent on others for basic needs like bathing, eating or toileting.
This medical history must be established for before age 22.
Anxiety and Obsessive-Compulsive Disorder (OCD)
These disorders involve a person feeling an excessive amount of worry, fear, anxiety or apprehension. Individuals suffering from these disorders may experience panic attacks, fatigue, compulsions or constant concern about safety.
Individuals who suffer from an anxiety disorder must show at least three of the following:
- Easily fatigued
- Difficulty concentrating
- Muscle tension
- Sleep disturbance
Individuals with a OCD must show that their condition is characterized by involuntary and time-consuming focus on intrusive and unwanted thoughts or repetitive actions that are made to reduce anxiety.
Individuals with a panic disorder must show that they have panic attacks that are followed by persistent concern about additional attacks or anxiety or fear that is disproportionate about two unique situations.
Somatic Symptom and Related Disorders
Individuals with these disorders may suffer from physical manifestations of the disorder that cannot be fully explained by a physical medical condition. Individuals suffering from these disorders may feel pain, preoccupation with having a serious medical condition, gastrointestinal problems or fatigue.
Claimants must show:
- Symptoms of voluntary sensory or motor function that cannot be attributed to another condition
- One or more somatic symptoms that are upsetting and are associated with extreme behaviors, feelings or thoughts
- Obsession with having a serious medical condition while not having any significant symptoms of the condition.
Impulse-Control and Personality Disorders
Individuals suffering from these conditions may have problems with being inflexible and maladaptive. They may experience patterns of distrust, social detachment, hypersensitivity, difficulty making decisions on their own or impulsive anger.
Individuals with a disorder of this nature must show at least one of the following:
- Suspicion or distrust and of others
- Emotional disinterest in social relationships
- Disrespect for and the violation of others' rights
- Instability in interpersonal relationships
- Excessive emotions and attention seeking
- Feelings of inadequacy
- Extreme need to be cared for
- Preoccupation with orderliness and perfectionism
- Recurrent, impulsive and fierce outbursts
Autism Spectrum Disorder
Autism spectrum disorders can cause deficits in the development of social interaction and verbal and nonverbal communication skills and may involve repetitive patterns of behavior.
Claimants with a disorder in this category must show measured shortfalls in verbal and nonverbal communication and social interaction. Additionally, they must show significantly restricted and repetitive patterns in their behavior, activities or interests.
Individuals who suffer from this disorder experience symptoms such as abnormalities in their cognitive processing, deficits in attention, tics or difficulty organizing.
They must show evidence the they experience one or both of the following:
- Frequently distracted, have trouble maintaining attention, struggle with organizing tasks
- Impulsive and hyperactive behavior
Alternatively, the evidence can show significant difficulties in learning and applying academic skills or recurring motor activity or vocalization.
These disorders involve disturbances in eating behavior and a preoccupation with weight and consumption. They may involve binge eating, self-induced vomiting, misusing laxatives or excessive exercise.
Medical documentation must establish a persistent change in eating behavior that damages psychological or physical health.
Trauma- and Stressor-Related Disorders
This category of disorders includes conditions that are caused after witnessing a traumatic event or learning of an event, such as post-traumatic stress disorder (PTSD).
Individuals with these disorders may suffer from flashbacks related to the traumatic event. The condition may cause the person to withdraw socially, to be uninterested in activities or to be unable to experience positive emotions.
To qualify for benefits with a disorder in this category, the individual must have medical evidence:
- Exposure to actual or the threat of death, violence or serious injury
- Unintentionally repeatedly experiencing of the trigger event
- Avoidance of reminders of the event
- Disruption in mood and behavior
- Increases in provocation and reactivity
Contact Our Disability Attorneys for Help with Your Mental Illness Claim
Individuals who suffer from any of the mental disabilities described above can contact an experienced Social Security disability attorney for an evaluation of his or her case. Our attorneys have decades of experience guiding individuals through the application and appeal process.
Your initial consultation with our firm is free and we do not require payment for anything unless we recover compensation for you.
Call 1-800-503-2000 to schedule a free consultation.