Disability Associates discuss what you need to know about mental illness and making a claim for disability benefits.

Those who are applying for Social Security disability often base their claims on a mental illness such as depression or bi-polar disorder. These types of claims can be difficult to substantiate, but the chances of success may increase by learning and understanding what evidence is needed to support your claim.

Basic Requirements for Disability Benefits
In order to be eligible for disability, a person must demonstrate that their mental illness is severe enough that it prohibits them from maintaining a full-time job.

Substantial Activity
Being unable to work means that a person is unable to work at the “Substantial Gainful Activity” (SGA) level for a minimum of one year. The SGA amount is often adjusted annually to correspond with economic change. Reviewing the SGA with an experienced attorney can help you better understand whether your own circumstances fall within the guidelines.

How Social Security Evaluates Mental Illness Claims
If the necessary requirements for disability are met, Social Security will then review a person’s mental illness to find out whether the illness meets or is an equivalent of one of the medical conditions discussed on the Listing of Impairments. The listing outlines conditions that the SSA has deemed severe enough as to automatically be approved for benefits.

It should be noted that having a condition that is on the listing will not necessarily result in an approval; the condition must also meet the specific criteria of that listing.

The Listing of Impairments
The listing contains a full section to what the SSA describes as “Mental Disorders.” Some of the conditions included under the Mental Disorders Listing include:

  • Schizophrenia
  • Affective disorders (like depression or bipolar disorder)
  • Anxiety-related disorders (like obsessive compulsive disorder or PTSD)
  • Autism
  • Mental retardation (intellectual disability)

Each condition listed has a defined set of criteria that must be met. A person not only must be diagnosed with a certain illness, they must also demonstrate that the illness causes functional limitations that prevent full time employment.

If You Don’t Meet the Listing Requirements
If your condition does not meet the requirements, the SSA will then review your symptoms to determine your “mental residual functional capacity” (MRFC). MRFC is the maximum a person can perform of the mental aspects of a full-time job. If SSA decides that a person does not have the MRFC to work a regular and sustained schedule, then it is likely that person will be approved for benefits.

To determine mental capacity, SSA will review all medical records and any opinions submitted by approved medical professionals. The MFRC report must be prepared by a doctor who specializes in mental conditions. It is difficult to win a claim based on a mental illness without a detailed report from an individual’s personal physician detailing the mental illness and how it limits ability. A disability attorney can help to ensure that a person has the correct MRFC form and that it is completed by their physician and submitted to the SSA in a timely manner.

The Importance of Credibility
One of the most critical factors in all disability cases, especially those involving mental illnesses, is the issue of credibility. If an appeal of a claim is necessary, then an Administrative Law Judge (ALJ) will hear the case and have an opportunity to question an individual about their disability. ALJs hear hundreds of cases every year and are well trained at recognizing untruthful and embellished testimony. It is also important that any medical records submitted do not contradict the personal testimony provided.

Navigating the Social Security Disability claim landscape can be difficult. The combination of the complexities of the process and the impairments that result from mental illness leaves many people without the help and benefits they need. Learning about the different procedures and speaking with the appropriate professionals may help ease some of the stress associated with the claims process.

If you or a family member have questions concerning mental illness and Social Security benefits please contact Disability Associates for more information.