Tag Archives: disability and depression

Supplemental Security Income (SSI) and Depression

Supplemental Security Income is awarded to the aged (65 years or older), blind or disabled who have not worked or who have not paid enough employment taxes and are not considered “insured” by the SSA but they need a monthly cash assistance to pay for their monthly expenses because they are unable to work for at least 12 continuous months. Not all claimants will qualify for SSI. It is a “needs” based program and is only provided to claimants who have VERY limited income and resources.

Winning SSI for Depression

Although most people struggle with feelings of sadness or a loss of self-esteem periodically, prolonged periods of depression with feelings such has helplessness, hopelessness, insomnia, fatigue or significant changes in appetite can be signs of clinical depression. Depression, which is the opposite of mania (elevated mood, euphoric, grandiose ideas), can have a severe impact on a claimant’s life and in the most severe cases can lead to attempts of suicide.

Meeting or Exceeding a Listing for Depression

The Social Security Administration has two methods they use to determine if a claimant is disabled and unable to work. First, they will evaluate the claimant’s condition and determine if it “meets or equals a listing” on their SSA Medical Listing of Impairments (also known as the Blue Book).

If the claimant’s condition is not listed or does not meet a listing in the Blue Book, the SSA will determine how much residual capacity the claimant has to perform substantial gainful activity. This is done through the medical vocational allowance process.

The Social Security Administration (SSA) will evaluate depression under the Listing 12.00 for Mental Disorders, specifically 12.04 Affective Disorders. The following information can be found in the SSA Blue Book under Affective Disorders.

12.04 Affective Disorders

According to the SSA, affective disorders are “characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves either depression or elation.”

First the SSA will be evaluating whether the claimant has at least four of the following symptoms (symptoms provided from the SSA Blue Book):

• Anhedonia or pervasive loss of interest in almost all activities; or
• Appetite disturbance with change in weight; or
• Sleep disturbance; or
• Psychomotor agitation or retardation; or
• Decreased energy; or
• Feelings of guilt or worthlessness; or
• Difficulty concentrating or thinking; or
• Thoughts of suicide; or
• Hallucinations, delusions, or paranoid thinking; or

2. Manic syndrome characterized by at least three of the following:

• Hyperactivity; or
• Pressure of speech; or
• Flight of ideas; or
• Inflated self-esteem; or
• Decreased need for sleep; or
• Easy distractibility; or
• Involvement in activities that have a high probability of painful consequences which are not recognized; or
• Hallucinations, delusions or paranoid thinking; or

3. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes);

AND

B. Resulting in at least two of the following:

1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Marked difficulties in maintaining concentration, persistence, or pace; or
4. Repeated episodes of decompensation, each of extended duration;

OR

C. Medically documented history of a chronic affective disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:

1. Repeated episodes of decompensation, each of extended duration; or
2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
3. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Proving Depression through Medical Records

The Social Security Administration will request copies of the claimant’s medical records. They will also assume that if the mental health disorder is severe, the claimant will be under the care of a psychiatrist or psychologist. Records from the claimant’s treating sources such as psychiatrists, psychologists, counselors, mental health clinics, hospitals, and family doctors will be reviewed. Additionally, the SSA will request information from the family and friends of the claimant.

The SSA is attempting to determine how depression affects their ability to perform substantial gainful activity. Can they carry out directions and maintain a persistent work pace, can they get along with a supervisor or coworkers, and can they maintain a consistent work schedule?

What if the claimant has not been seen by a doctor or they are not following their specified treatment plan? The SSA may deny SSI benefits, assuming that if they were following their medical treatment plan they may improve to such a degree that they could work.

Can I get Social Security Disability with a Mental Illness?

There are a variety of mental health disorders that the Social Security Administration will consider disabling. Claimants may be able to win Social Security Disability benefits either by “meeting a listing”, which means their condition is listed in the Social Security Administration’s Listing of Impairment or Blue Book (a list of conditions the SSA automatically considers disabling) or by proving their mental health condition is so severe they are unable to perform substantial gainful activity for at least 12 continuous months through a medical vocational allowance.

So what types of mental health disorders does the Social Security Administration have listed in their SSA Listing of Impairments or Blue Book?

Common disabling mental health conditions and their corresponding listing number are below.

  • Organic mental disorders (12.02)
  • Schizophrenic
  • Paranoid and other psychotic disorders (12.03)
  •  Affective disorders (12.04)
  • Mental retardation (12.05)
  • Anxiety-related disorders (12.06)
  • Somatoform disorders (12.07)
  • Personality disorders (12.08)
  • Substance addiction disorders (12.09)
  • Autistic disorder and other pervasive developmental disorders (12.10)

Keep in mind, to meet a listing your condition not only has to be listed, you also have to have symptoms or limitations which are as severe as the ones listed in the Blue Book. Having the condition may be insufficient if your condition is not serious. For instance, claimants who claim to be “depressed” may experience mild mood swings or loss of interest in activities or they may be suicidal.

So what types of issues does the Social Security Administration assess for a mental health disorder? The SSA will review a variety of factors including how the mental health disorder affects the following:

  • The impact on the claimant’s daily living and social functioning
  • The ability of the claimant to maintain concentration, pace, persistence in a work environment
  • The amount and duration of their episodes of decompensation, including increases in the claimant’s medications or psychological support system or increased hospitalizations. (Episodes of decompensation generally are three episodes within 1 year, or an average of once every 4 months, each lasting for at least 2 weeks).

If your condition does not meet a listing, you may be able to qualify for SSDI or SSI benefits, but it will be more difficult.  The Social Security Administration may concede you have a serious health condition but you will have to work a little harder to convince them that you are unable to work due to your mental health condition.

So, how do you prove that you cannot work? First it is important to understand what you need to prove. If you have been seeing a mental health specialist your medical records probably prove that you have a mental health disorder, but do they prove that you cannot work (perform substantial activity) or explicitly outline your residual functional capacity to work?

If your condition does not meet a listing, the SSA will complete several additional disability evaluation steps (which are part of their Five Step Sequential Evaluation) and see if you can qualify for disability under a medical vocational allowance. The SSA will answer two questions. 

  • Can you perform the work you performed in the past?

Many claimants can prove that their condition is so severe that they cannot work their current job, unfortunately, this will not be enough to win SSD benefits. If you cannot work your previous job, the SSA proceeds to the next question.  

  • Can you be retrained for new work?

Under this step the SSA will determine if you could be retrained for new work. To make this determination, the SSA will review your education, work history and transferable work skills, your age, and your residual capacity to work. If the SSA determines you could not retrain or adjust to other work, they will award SSD benefits. If they determine you could retrain for new employment, they will deny SSD benefits.

What does the SSA need to find you disabled?

The Social Security Administration asks claimants to list the names of their doctor’s addresses, phone numbers and dates of treatment. This information is used to gather medical evidence from all of your medical sources. Make sure this information is complete or this could add weeks to the disability evaluation process.

After the SSA has gathered all of your medical records the Disability of Determination Services (DDS) Offices will evaluate your medical record. The DDS will review your medical files, your diagnosis, your residual functional capacity to work, and determine if you meet mental or physical health condition meets their definition of disabled as determined by the sequential evaluation process.

Hiring a Disability Lawyer

What is the most important thing you can do to improve your chances of winning disability for a mental health condition? Get great medical help, consistently see a doctor, take your medication and make sure your medical file clearly states why you cannot work.

If you would like a disability attorney to review your claim you can fill out the FREE evaluation form and a disability advocate will call you to review your claim or you can call our office at 1-800-641-3759 to talk to someone now.