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Disability benefits for short-term conditions

Monday, March 5th, 2012

How can I get help for a short-term health condition?

One of the most common questions on our forum is, “Can I get SSDI or SSI benefits for a short-term disabling health condition?” Unfortunately, SSI or SSDI are offered to claimants whose condition is not expected to last for at least 12 continuous months. So the Social Security Administration does not offer any type of short-term disability benefits to injured or sick claimants.

Why doesn’t the government offer any types of short-term disability benefits for short-term conditions? Honestly, the inefficiency of the government would not even allow for the distribution of short-term disability benefits for short-term conditions. Most claimants would be healed and back to work before they would most likely receive their first short-term disability benefit payment.

What is another reason? The expectation is that most American workers understand they need to save and prepare for the possibility that they could experience some interruption in their employment. So whether there is an economic downturn, a loss of job or a short-term sickness, it is expected that you should have some type of emergency fund to support yourself and would not need short-term disability benefits from the Federal Government.

Other options available for short-term Disabilities health

Sick Leave

Most employers offer full-time workers some type of paid leave. It may be called sick pay or paid time off but this short-term disability benefit is generally the best option for workers who are sick and cannot work. Some employers will also allow workers to take vacation pay if their sick leave is exhausted.

Personal injury Lawsuit Awards

Other individuals who have been injured due to the negligence of another person may be able to file a personal injury claim and win compensation for their injuries. The most common example of personal injury claims results from serious car accidents. Although not all states allow a driver to file a lawsuit against another driver, if you have been injured in a car accident which was not your fault you may be able to get compensation either from your own insurance (in a no-fault state) or through the insurance of the other driver.

Compensation for personal injury claims should provide the injured party (who is injured from the negligence of another person) with compensation for their medical bills, lost wages and pain and suffering.

Worker’s Compensation Benefits

Workers compensation is available to covered workers who are injured during the course of their normal employment. Workers compensation, unlike a personal injury case, does not require the worker to prove that their employer was negligent for their work injuries only that the injuries were a direct result of their work duties. Workers compensation will cover the cost of medical bills, wage replacement, funeral expenses, and job retraining costs (if necessary).  For many injured workers, worker’s compensation will be their best chance to get short-term disability benefits.

Family and Medical Leave Act (FMLA)

FMLA was created in 1993 to provide time-off from work for sick employees or employees who had family members who needed assistance. FMLA does not provide any type of wage replacement for the worker, but it will protect the employee from being fired if they have to miss work due to specific reasons.

After reviewing this list you might be even more discouraged, especially if you are a part-time worker or you work for an employer who does not provide any of these benefits. In this case you may have to get a bit more creative if you need to generate cash while you are unable to work. You may have to rely more heavily on friends and family, consider selling your assets or taking out a temporary loan to meet your daily expenses.

So what is the bottom line? Do not rely on SSDI or SSI benefits if you have a short-term health condition. SSDI and SSI can be necessary for claimants with a severe long-term health condition, but it can takes months to get SSDI and SSI and if your condition is short-term, they are not the right disability benefits for you.

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If I Cannot get SSDI, Can I get SSI?

Thursday, March 1st, 2012

If you have not worked, have worked but not paid taxes or have worked in the past but waited too many years to file for disability you might not qualify for Social Security Disability Insurance. Maybe you are wondering, “If I cannot get Social Security Disability Insurance, can I get Supplemental Security Income?”

How does the SSA award benefits?

Most claimants do not realize that the disability determination process is the same for SSI and SSDI. The only difference is the nonmedical criteria for each program. For instance, if you apply for Social Security Disability Insurance (SSDI) but you are denied, the SSA will examine whether or not your income and resources are low enough for SSI benefits.

If you meet the resource and income limitations and other requirements of the SSI program the SSA will pull your medical records and determine whether or not you can receive Supplemental Security Income benefits.

If you do not meet the income and resource limitations for the SSI program the SSA does not pull your medical records and will not evaluate your disability status.

Does everyone who apply win disability?

Unfortunately, many claimants assume that the disability programs offered by the Social Security Administration are similar to the retirement programs: you decide you cannot work, you contact the SSA and they mail you a check.

It is not this simple. In fact, there are over 2 million claimants who apply for SSI or SSDI each year and over 70% are denied. Some of these claimants appeal their claims and go on to win benefits; other are never approved for SSDI or SSI benefits.

What reasons can the SSA deny my SSDI benefits?

To win SSDI benefits you will have to prove that you have a very severe health condition which does not allow you to perform substantial gainful activity. Your condition must also be expected to last for at least 12 continuous months. Additionally, you must have accumulated work credits by working and paying employment taxes for a specific number of years. Even more confusing is that a specific number of your accumulated work credits must have been earned in the 10 years before your date of disability.

So why are claimants denied SSDI benefits? You can be denied for any of the reasons listed above: your condition is not severe, your condition is not expected to last 12 continuous months, you do not have enough work credits, you have work credits but they were not earned close enough your date of disability.

So, no, not all claimants who apply for disability will win benefits.

What reasons can the SSA deny my SSI benefits?

As mentioned above, if you do not qualify for SSDI, it may be possible to win SSI benefits, assuming you meet the criteria for the SSI program. Many claimants may be severely disabled and not have enough work credits for SSDI but have too much income or resources for SSI.

This occurs frequently for spouses who have been homemakers but who now find themselves seriously disabled but their spouses work and make too much money for them to qualify for Supplemental Security Income.

If you have not worked, have worked but not paid taxes or have worked in the past but waited too many years to file for disability you might not qualify for Social Security Disability Insurance. Maybe you are wondering, “If I cannot get Social Security Disability Insurance, can I get Supplemental Security Income?”

 

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SSDI Hearing – No medical evidence

Thursday, March 1st, 2012

Recently on our forum we had a disability applicant ask what would happen at their administrative hearing if they did not have any medical evidence to support their Social Security Disability Insurance (SSDI) claim and they had not seen a doctor in several years.

We get stories like this all the time and frankly it is rather baffling. This claimant has probably waited months, maybe even years, to see the administrative law judge, who by the way has the power to decide whether or not the claimant is disabled, and the claimant has failed to study the disability process and understand, even at the most basic level, what they need to win their SSDI claim.

What are my chances of winning Social Security Disability Insurance (SSDI) without medical evidence?

This question is easy. I would put the percentage at almost zero percent. The Social Security Administration makes their disability determination decision based on a claimant’s medical records from valid medical sources (medical doctors, nurses, therapists, psychiatrists, psychologists, etc.). The Social Security Administration is looking for a diagnosis and verifiable signs and symptoms that the claimant’s condition is severe, expected to last for 12 continuous months and does not leave the claimant with the residual functional capacity to work.

If you have not gone to the doctor and you have no evidence of your disability how is the Social Security Administration supposed to decide if you can work?

My disability hearing is scheduled. What do I do next?

Disability hearings are handled by the Office of Disability Adjudication and Review (ODAR) and the claimant’s disability case is assigned to the regional office which services their area. Within this system there are 1,300 Administrative Law Judges who hear thousands of disability cases each year.

Given that millions of individuals apply for disability each year and thousands are denied and have to appeal to the administrative law judge, it is not unusual for claimants to wait up to two years to have their case heard by the judge at a disability hearing.

Even one year should be adequate time for a disability applicant to find a disability lawyer. Thoroughly review their Social Security Disability Insurance (SSDI) case and determine if they have enough medical documentation to prove they are disabled and if not, go to the proper medical doctors.

Steps to win an administrative hearing

At the disability hearing there will be a judge, a court reporter, the disability applicant and potentially a job expert or medical expert. Claimants can also hire a disability lawyer to attend the hearing with them and argue their SSDI case.

Step 1: Do not wait until a few days before your disability hearing to hire a disability lawyer. Disability lawyers need at least 3 to 4 weeks to review your SSDI case and make sure you have enough evidence to prove you are disabled.

Step 2: Do not wait until a few days before your disability hearing to evaluate your medical evidence. You should have been building your case months and years before you ever were scheduled for the disability hearing. Many claimants do not have insurance and this is a valid issue, but you MUST find a way to document your condition and the limitations you have to work or you will not win SSDI benefits.

What is the bottom line? I feel bad for this claimant, but I know that they probably had months or years to address this problem and for whatever reason they did not, but it is unlikely they will win Social Security Administration disability benefits without any medical proof they are disabled.

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SSDI – 5 Steps to Make your Disability Case

Friday, February 24th, 2012
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The most common question asked on our Social Security Disability benefits forum is, “How do I know if I have a case?” or “Do I qualify for benefits?” This is basically the same question. Everyone wants to know, before they go through the hassle of filing a Social Security Disability Insurance (SSDI) claim and fighting with the Social Security Administration whether or not they are wasting their time.

There are five very important things to review prior to filing a Social Security Disability Insurance claim.

1.    Identify your current work status.

We get questions everyday about whether or not you can work and draw SSDI or whether or not you can work until you win your Social Security Disability Insurance claim. I am not sure why this is so confusing, but if you can work (i.e. perform substantial gainful activity) or if you are working at a substantial level you will be AUTOMATICALLY denied. The SSA defines disabled as the inability to perform substantial gainful activity. If you are working, you are not disabled (according to the Social Security Administration).

2.    Be realistic about how long your disabling condition will last.

If you have just had a major car accident or difficult surgery you may be VERY sick and disabled. Does this mean you will get Social Security Disability Insurance? No, SSDI is only for claimants who have a long-term health condition. No short-term SSDI benefits are awarded, regardless if you are very disabled right now. If your condition will not last for at least 12 continuous months you will be denied benefits.

3.    Evaluate your work history.

This is another point that seems VERY confusing to claimants. Social Security Disability Insurance is only awarded to claimants who have worked, paid employment taxes and earned sufficient work credits.

What if you have worked but have NOT paid taxes? What if you have not worked? What if you have worked as a homemaker? What if you are 2 credits short? None of this will matter; if you have not worked enough, paid employment taxes and earned enough work credits on your own work record you will not get Social Security Disability Insurance.

The Social Security Administration sends a report to workers each year called the Statement of Earnings. You can either review this report to see your estimated payment or you can use their estimator calculator on their website. The Social Security Administration no longer provides additional copies of statements to workers.

4.    Is your condition on the SSA Listing of Impairments?

If you meet all the above conditions and your condition is listed on the SSA Listing of Impairments (also known as the Blue book) and you are able to prove that your condition “meets or exceeds” the listing, you have a good case.

5.    Do you have enough medical evidence to prove you cannot work?

The Social Security Administration has another method called the medical vocational allowance that they use to determine a claimant’s disability status and whether or not the claimant has sufficient residual capacity to work. If your condition does not meet or exceed a listing in their Blue Book it may be possible, with the right type of medical evidence, to prove that you cannot work.

Contact a disability lawyer if you have additional questions about your Social Security Disability Insurance case and what medical evidence you need to win Social Security Disability Insurance through a medical vocational allowance.

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Disability Lawyer and Disability Advocate – What is an Authorized Representative?

Wednesday, February 22nd, 2012

If you have applied for Social Security Disability Insurance or Supplemental Security Income and you are one of the 70% who have been denied disability benefits, you might have considered hiring a professional to help you get benefits. You may have also heard you can either hire a disability advocate, who is a non-attorney representative, or you can hire a disability lawyer.

What does an Authorized Representative do?

Many claimants ask if they can represent themselves when they apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) or if they have to hire a disability lawyer or non-attorney representative. All claimants have the option of representing themselves in the disability process, but whether or not this is a good idea will depend on several factors:

  1. Does your condition automatically meet a listing on the Social Security Administration’s listing of impairments?
  2. Do you have the time to review the process and understand how the SSA makes their disability determination for Social Security Disability Insurance and Supplemental Security Income?
  3. Do you have difficulty communicating in English or do you have a limited education?
  4. Do you understand what medical conditions and symptoms are considered disabling?
  5. Are you too sick to manage the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) process?

If you are denied the first time you apply for Supplemental Security Income or Social Security Disability Insurance you have 60 days to appeal your denial decision. Most claimants, if they are considering legal assistance, will talk to a either a non-attorney representative or disability lawyer at this point so they can get help with the appeal’s process.

So how do you decide if you should hire a non-attorney representative or a disability lawyer?

How are Disability Lawyers and Non-attorney Representatives paid?

Non-attorney representatives and disability lawyers are both paid on a contingency fee basis. This means that they are only paid if they win your claim. If you win they are paid 25% of the back pay up to a maximum of $6,000. It is unlikely that you will save any money by hiring a non-attorney representative.

Non-Attorney Representative

A non-attorney representative can actually be anyone you want to appoint to help you with your disability claim. The Social Security Administration simply states that they must be of “good character and reputation,” and they must not have been barred or prohibited from providing this service. Most likely you would hire a disability advocate who has helped other claimants win benefits and who has the appropriate professional skills and expertise.

Disability advocates can be extremely good. They may be someone who has worked for the Social Security Administration in the past or who has taken courses and classes to understand the process.

One benefit that is sited from some claimants is that a disability advocate may be able to provide more specialized, focused help and attention than a disability lawyer, who may have too many cases to focus their time and efforts on your case.

Disability Lawyer

A disability lawyer can also be an authorized representative. A disability lawyer is someone who is licensed to practice in the United States and has not been barred by the Social Security Administration from handling Social Security Administration (SSA) disability cases.

Disability lawyers specialize in disability law and understand the Social Security Administration (SSA) processes and disability determination process. The main complaint claimants make about disability lawyers is that they have too many cases or they do not do enough to expedite the disability claim. The first complaint may be valid; the second generally is not.

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Volunteer Work and SSA Disability Benefits

Tuesday, February 21st, 2012

Many Social Security Disability Insurance and Supplemental Security Income claimants want to know if they can volunteer when they are receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits. This is a great question and sounds like a good idea, especially if the severity of your condition varies and you have “good days and bad days,” but the answer to the question goes to the fundamental definition of disability according to the Social Security Administration: If you can work you are not disabled.

So, what does this really mean? It means that the Social Security Administration considers that a disability, by its very definition, means you do not have the capability to perform what they call “substantial gainful activity” for at least 12 continuous months due to a severe mental or physical health condition.

So is voluntary work considered “work”? Let’s take a look at what the SSA considers work for more information. The SSA considers work as working too many hours or making too much money. They call this performing substantial gainful activity. If the Social Security Administration believes you are performing substantial gainful activity they will automatically consider you not disabled and will deny your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) case. They will do this without ever requesting your medical records or evaluating the severity of your health condition.

Volunteer work does not generate a profit

It is true that volunteer work does not generate a profit so it would pass the first test for work which determines if the work is gainful. Gainful work is work that produces an income of higher than a specific monthly amount. In 2012, the amount a non-blind claimant can make is $1,010 per month and a statutorily blind individual can make $1,690.

BUT the Social Security Administration (SSA) is also interested in whether or not the work is substantial. To determine if you are performing substantial work the SSA will look at the amount of time you are working and the physical and mental exertion.

So, consider the types of volunteer work you are performing and the amount of hours spent engaging in these activities. Depending on the complexity of the tasks and the amount of time you are dedicating to the activities, the SSA may determine that if you are able to perform the volunteer work than you could also engage in substantial gainful activity.

For example, if you are delivering meals for The Meals on Wheels program one time per week this might not be considered substantial, and the Social Security Administration (SSA) is unlikely to assume that one hour per week of driving a car would compare in complexity or  effort to maintaining full-time employment. But what if you were volunteering at a soup kitchen for 30 hours per week? It is not a stretch to assume that the Social Security Administration (SSA) may decide that if you could volunteer your time for this many hours each week you may be able to work a job.

What’s the Bottom Line?

When the Social Security Administration is evaluating your activities, such as volunteer work, they are evaluating not only your earnings but also whether or not the exertion (either mental or physical) is comparable to work. Keep in mind, your work may be substantial even if it is done on a part-time basis or if you do less, get paid less, or have less responsibility than when you worked before. If you are working too much when you apply for Supplemental Security Income or Social Security Disability Insurance the SSA will deny your claim, regardless of the severity of your health conditions.

 

 

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Social Security Disability – Why won’t my doctor help me?

Monday, February 20th, 2012

One of the most common questions we get from Social Security disability claimants is, “Why won’t my doctor help me with my Social Security disability application?” Although this is a common question, it is unlikely that you will find a doctor who will complete a Social Security disability application for you, nor is it expected by the Social Security Administration.

How does the Social Security Administration Make the Disability Determination?

The Social Security Administration will request your most recent medical records, evaluate the records and determine if your conditions either meet a listing on the SSA Listing of Impairments or are so severe that they do not allow you to perform substantial gainful activity.

The Social Security Administration (SSA) will request information from your doctors, caseworkers, therapists, counselors, psychologists, and hospitals. If you have any recent records and you can make copies and give them to the Social Security Administration (SSA) this can expedite the decision making process. Waiting for medical records to be sent by the treating doctors is one of the main reasons the disability decision process takes so long.

Who completes the Social Security disability application?

If you want to apply for either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), it is up to YOU to complete the SSI or SSDI disability application. Can you hire a disability lawyer? Yes, you can and you can request help from friends or family, but the Social Security Administration (SSA) will not send the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) paperwork to your doctors and they do not expect your doctors to complete the application.

Activities of Daily Living- Do I need to provide this information to the SSA?

Some claimants refuse to answer questions or put “not applicable” on all the questions they do not want to complete, than they complain that they keep getting denied. If there is any advice that claimants should heed it is this, “The Social Security Administration will not do the work for you. You will have to take a proactive approach to getting SSI or SSDI benefits.”

The Social Security Administration receives millions of applications each year. If you do not answer questions on your application this can add processing time to your application or can be viewed as “uncooperative” by the SSA.

For example, if the SSA asks what you do during the day and you answer not applicable, the SSA knows this cannot be true because everyone does something. If you sit in a chair all day because you do not have the physical capacity to go to the store or pay your bills or the mental capacity to “deal with other people,” this can be relevant to your Supplemental Security Income and Social Security Disability Insurance case.

What do doctors do to help you get Social Security Disability?

Do your doctors have a role in the disability decision at all? They will not be asked to make a disability decision. In fact, if they state you are disabled this will not guarantee you will receive benefits. The information they provide, however, is given considerable weight in the decision, especially if there is additional medical evidence to support their claims (laboratory findings, blood reports, MRIs, X-rays, etc.).

The most important thing your doctor can do is provide clear medical evidence in your medical files which states how your ability to work is severely limited due to your physical or mental health conditions.

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Social Security Disability – What changes do I report?

Saturday, February 18th, 2012

Some Social Security Disability claimants want very little to do with the Social Security Administration (SSA) after the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefit have been awarded. This is understandable, especially if you fought months to win your SSI or SSDI benefits, but under some conditions, you must contact the Social Security Administration (SSA) and report changes to your living situation or you may either miss out on SSI or SSDI benefits you are entitled to receive or worse, end up repaying money in which you were not entitled.

In the worst situations, if you continue to receive Social Security Disability Insurance or Supplemental Security income payments that you are not entitled to receive you could be prosecuted for disability fraud.

When do I contact the Social Security Administration?

1.    You move to a new address

Moving is stressful but if you are receiving a check from the Social Security Administration you need to contact them and give them your new address and phone number. Some claimants who receive a direct deposit for their Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)  into their bank account may not think this is necessary, but the SSA will periodically need to send you information and all changes in address must be reported to them.

2.    Your medical health condition changes

If your medical health condition changes and you are able to return to work you are expected to notify the Social Security Administration. If you do not do this and you are paid money you are not entitled to receive, you may be forced to repay the Social Security Administration (SSA).

3.    You return to work

Many workers return to work and do not notify the Social Security Administration. This is a mistake. The SSA has programs to help workers make work attempts for a specified time period without losing their medical insurance or disability benefits (the process of SSDI and SSI vary).  Claimants who attempt to work and are unable will continue to receive their benefits. Claimants who return to work for more than nine months but later determine they cannot work may, under certain conditions, be able to quickly reinstate their benefits.

4.    When you leave the United States

Claimants who are United States citizens who reside outside the United States can generally continue to receive benefits with little difficulty. Claimants who are not United States citizens but are considered “aliens” may have more difficulty keeping their benefits and may have to either return to the U.S. every 30 days or for 30 consecutive days in a 6 month period. For questions concerning your right to continue receiving disability benefits when you travel abroad it is best to contact the Social Security Administration. There are various treaties and international agreements which may affect your right to disability payments.

5.    When you get married or divorced

Marriage and divorce can affect disability payments, especially for claimants receiving Supplemental Security Income benefits. For children receiving an auxiliary benefit, their payments may be terminated when they marry. If you are married and receiving SSI benefits and you divorce, your payments may go up (if your SSI payments were less than the full Federal Benefit Rate because of your spouse’s income). If you did not qualify for SSI benefits due to your spouse’s income, you may qualify if you divorce if you can prove that you are disabled and have limited income and resources.

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Social Security Disability – Denied for not following treatment plan

Friday, February 17th, 2012

Many Social Security disability claimants want to know if they can be denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) if they refuse to go to their consultative examination, cannot see a doctor or they refuse to follow their doctors prescribed treatment plan due to lack of funds. This blog will address how the Social Security Administrations (SSA) views lack of cooperation and refusing appropriate medical care.

Denied Social Security Disability for Refusing to Release medical records or see a Consultative Examiner

The Social Security Administration (SSA) makes their disability determination based on a claimant’s medical records. Claimants who have insufficient medical records, who have not seen the appropriate doctors or who refuse to release their medical records to the SSA may be required to see a consultative examiner.

The consultative examiner is not a “SSA doctor.” They do not work for the Social Security Administration (SSA), but they are merely contracted to evaluate a claimant’s health condition and provide information to the SSA about the claimant’s functional capacity to work.

Claimants who consistently refuse to see a consultative examiner, who refuse to give the SSA the authority to request their medical records, or who repeatedly do not show up for an examination will have their Social Security application denied.

Denied Social Security Disability for Refusing proper medical treatment

Many claimants want to know if they can be denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits if they refuse to follow their doctor’s treatment plan or if they are not seeing a doctor. Yes, the Social Security Administration (SSA) can deny benefits if you are not following your doctor’s orders AND the SSA decides that following the prescribed treatment plan could restore you to a level that would allow you to perform substantial gainful activity.

If, however, there is medical evidence that following your doctor’s prescribed treatment plan would not restore you to a functional level then they may find you disabled. Consider also, if your doctor makes medical statements or provides medical evidence which is contrary to what is considered “standard medical opinion” the Social Security Administration (SSA) is likely to disregard their opinion.

Valid Reasons to refuse medical care for Social Security Disability

The Social Security Administration understands there may be valid reasons for refusing medical treatment: limited I.Q., severe phobia of surgery, severe mental illness, repetitive surgeries for similar conditions when surgery has been unsuccessful in the past, the treatment plan is too risky, the medical opinions vary on the treatment plan, you have a lack of funds and the SSA cannot find an acceptable alternative or you have religious objections to treatment.

Consider, if you state that you do not have sufficient funds to either see a doctor or follow their treatment plan but you purchase luxury items (beer, wine, cigarettes) the SSA is likely to conclude that you could use this money for medications and medical care.

Hiring a Social Security Disability Lawyer

The Social Security Disability process can be complicated. If you have questions and need assistance, talk to a disability lawyer. Whether you applied for Social Security Disability Insurance (SSSDI) or Supplemental Security Income (SSI), disability attorneys can help. They understand Supplemental Security Income and Social Security Disability Insurance (SSDI) laws and can make sure you get the benefits you need to support yourself while you are unable to work.

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Anxiety and Social Security Administration Disability

Wednesday, February 15th, 2012

Everyone experiences some degree of anxiety in life, which can be heightened if a claimant does not have a job or income. Anxiety, which the Social Security Administration considers disabling, however, would be much more profound and severe.

The Social Security Administration has two methods they use to determine if a claimant is disabled for mental health disorders and qualifies for either Supplemental Security Income or Social Security Disability Insurance.

First, the Social Security Administration (SSA) will determine if the claimant’s condition is severe enough to meet or exceed a listing on the Social Security Administration’s Listing of Impairments (also informally known as the Blue Book) or if the claimant’s condition does not meet a listing whether or not the claimant has the residual functional capacity to work.

Meeting a Listing in the SSA Blue Book for Anxiety Disorders

Anxiety is a listed disorder found in the Social Security Administration’s Listing of Impairments under 12.00 Mental Disorders, Section 112.06 Anxiety-related disorders. To meet a listing the SSA is first looking for medical evidence of the disorder: signs, symptoms, psychological testing, clinical notes or laboratory testing. Claimants who have not seen a doctor or followed a doctor’s treatment plan will have difficulty proving they are disabled.

Next, the SSA will evaluate whether or not a claimant’s condition meets or exceeds the listing. Anxiety related disorders generally fall into severe phobias or obsessive compulsive disorders. According to the SSA, they would expect to see, “anxiety as either the predominant disturbance or experienced as the individual attempts to master symptoms; for example, confronting the dreaded object or situation in a phobic disorder or resisting the obsessions or compulsions in obsessive compulsive disorders.”

First the Social Security Administration is looking for three of the four signs of symptoms:

  • Motor tension – defined as trembling or the inability to sit still.
  • Autonomic hyperactivity – defined as sweating, increased heart rate, dry mouth
  • Apprehensive expectation – focusing on all possible negative outcomes and excessive worry
  • Vigilance and scanning- obsession with the environment and heightened fear above what the circumstance warrants

The SSA will also determine if the claimant has an “irrational fear of a specific object, activity, or situation which results in a compelling desire to avoid the dreaded object, activity, or situation” or “recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week” or “recurrent obsessions or compulsions which are a source of marked distress” or “recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress.”

All the symptoms and signs listed above must lead also to the marked restrictions in at least two of the following: daily activities, social functioning, difficulty maintaining concentration, persistence or pace and repeated episodes of decompensation.

The claimant can also have all the symptoms listed above and prove that they do not have the ability to function outside of their home.

What if I do not meet a listing for anxiety?

Many claimants will not have all the evidence listed above to prove their anxiety disorder meets or exceeds the listing, but they can prove that their disorder, plus potentially other disorders, does not leave them enough residual capacity to work.

Most claimants who do not meet a listing should contact a disability lawyer and have them review their medical files. Disability lawyers help hundreds of claimants each year and they understand how to win disability benefits for anxiety disorders.

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