Although winning Social Security disability insurance (SSDI) benefits for any disabling condition can be difficult, obtaining an award for a mental condition can be especially challenging. Sadly, there continues to be a bit of discrimination in society against victims of mental illness, and that attitude is sometimes carried over by psychologists, psychiatrists, judges and other individuals who make recommendations or determinations for the Social Security Administration in disability cases. And since the evidence surrounding mental illness is often more subjective than that of a physical condition, proving this type of disability can be tough.
Eligibility Requirements for SSDI and the Challenges they Present for Victims of Mental IllnessFortunately, the Social Security Administration (SSA) does not discriminate against mental impairments when it comes to eligibility requirements for benefits. Whether the victim suffers from a physical impairment or a mental illness, the criteria is the same. Meeting the criteria, however, can be more difficult for mental illness sufferers.
- To be awarded SSDI benefits, a disabled victim must show that he or she suffers from a mental or physical condition (or combination of conditions) that significantly impairs the person's ability to perform gainful work for a period of at least one year or that is expected to end in death. Temporary disability benefits are not available through Social Security.
Unfortunately, many mental health conditions like anxiety or depression are believed to be curable or significantly improved with treatment. Even though society and the mental health industry has become more aware in recent years of the lasting effects and periods of decomposition that often accompany mental illness, this type of condition is frequently viewed as non-permanent.
- The mental or physical condition, or combination of impairments) must be severe. There are no benefits through the SSA for partial disability. To simplify the severity requirement, the SSA offers a list (Blue Book) of disabling conditions and the criteria needed to qualify for each. Even when a victim does not meet the criteria of a listed condition, however, he or she can still qualify if suffering from another impairment or combination of impairments that causes equal limitations.
Since the SSA workers who approve or deny SSDI benefits are not typically trained in mental illness, they often do not fully understand the impact such conditions can have on a person's ability to consistently perform substantial gainful activity (SGA). And since many mental illnesses are cyclical, the challenges faced can be even more difficult for victims to prove.
- Disabled claimants must meet the work credits requirement except under certain circumstances. The number of work credits required to qualify for SSDI benefits varies with age. A victim who is 31, for example, will typically need 20 work credits over the past 10 years to maintain SSDI coverage.
As a result of their struggle with a severe mental illness, many disabled victims have worked at very low paying jobs, have a sketchy work history, or have not worked at all. Unfortunately, little to know work history can disqualify even the most severely impaired claimant from being able to obtain SSDI benefits.
Subjective Evidence in a Mental Disability CaseDue to the sheer nature of mental illnesses, much of the evidence used to make a disability determination is subjective. Unlike with physical disabilities, after all, there are very few testing procedures or clinical methods to document the severity of a mental disorder. Because subjective evidence submitted by doctors, caregivers, former co-workers, friends and family members and even disabled individuals themselves plays such a significant role in the evaluation of a claim, it is extremely important for victims to be open, honest and thorough when discussing the impact of their disorders.
What the Statistics Say
According to the National Institute of Mental Health (NIMH) approximately 43.7 million adult Americans experience mental illness in a given year. About 13.6 million experience a condition so severe that it significantly interferes with or limits the victim's ability to engage in major life activities. In fact, mental disorder was the second leading diagnostic group for individuals receiving SSDI in 2013, with about 27.3 percent of recipients having such a condition. Mood disorders appear to be the most common mental conditions suffered by SSDI recipients.
Improving the Chances of Obtaining SSDI benefits for Mental Health Conditions
Many victims who suffer from a mental health condition are denied SSDI benefits. Fortunately, there are a number of things a claimant and his or her social security disability lawyer can do to improve the chances of a successful claim. Following the advice of mental health professionals, obtaining and submitting evidence to support a claim, being honest and thorough in all reports, and keeping up with letters, notices and important dates can significantly increase the claimant's chances for being awarded benefits.