Mental illnesses can be just as disabling as physical ones. Yet, patients often find it hard to claim disability for mental illness. In fact, mental disability claims tend to get denied more often than other types of disability claims.
According to the National Institute of Mental Health, only 2 out of 10 people suffering from mood disorders are receiving disability benefits. Though inconclusive, this illustrates how hard it is to get disability benefits for mental disorders.
So, why is it so hard to claim social security benefits for mental disabilities in the US? There are actually a variety of reasons. To fully understand this, let’s first take a look at the SSA’s disability claims process for mental disorders.
Claiming Disability Benefits for Mental Illness
As mentioned, applying for mental disability benefits isn’t exactly a walk in the park. You must meet the SSA’s eligibility requirements and prove that your condition is disabling enough.
Types of Disability Benefits You Can Apply For
Before you apply for disability benefits, you first need to determine which type of benefit you should apply for.
1. Social Security Disability Benefits (SSDI). This is for those who have paid social security taxes and have enough work credits.
2. Supplemental Security Income (SSI). If you don’t have enough work credits and have a limited income, you’ll have a much better chance of getting approved for SSI.
As with other disability claims, you’ll be eligible for social security benefits if your mental illness:
- affects your ability to work or do any type of gainful employment
- is expected to last for more than a year
The SSA also keeps a list of mental disabilities that can qualify for benefits. If your condition is not on this list, applications are usually denied right off the bat.
What Mental Disorders Qualify For Disability?
Also known as the “blue book”, the SSA’s disability evaluation handbook lists the criteria for mental disorders to be considered a disability. If your condition meets all the criteria laid therein, you’ll most likely qualify for disability benefits.
Here are the mental disorders included in the list:
- Neurocognitive disorders. This type of disorder is characterized by a significant decline in cognitive functioning. It includes dementia, progressive brain tumor, and neurological diseases.
- Schizophrenia spectrum and other psychotic disorders. Patients who suffer from hallucinations or catatonia fall into this list.
- Depression, bipolar and related disorders. Aside from bipolar disorders, this category also includes dysthymia and major depressive disorders.
- Intellectual Disorder. As the name suggests, this category refers to conditions where patients have a significant sub-average general intellectual functioning. It includes intellectual disabilities and “mental retardation”.
- Anxiety and Obsessive-Compulsive Disorders. This includes social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder.
- Somatic symptom and related disorders. Examples of conditions under this are illness anxiety disorder and conversion disorder.
- Personality and impulse control disorders. Some of the conditions under this are paranoia, schizophrenia, and intermittent explosive disorder.
- Autism Spectrum Disorder. This includes autism disorders with or without accompanying language and intellectual impairment.
- Neurodevelopmental disorders. Disabling conditions under this category include specific learning disorders, borderline intellectual functioning, and tic disorders (like Tourette’s).
- Eating Disorders. This includes anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food disorder.
- Trauma and stressor-related disorders. Examples of trauma disorders under this are post-traumatic stress disorder (PTSD) and other specified trauma.
But remember that having your mental disorder on the above list isn’t exactly a guarantee that you’ll get approved for benefits. It will just increase your chances. The SSA will still evaluate your residual functional capacity (RFC). This refers to your maximum functional ability in spite of your psychological condition/s. In short, if your condition does not prevent you from working, your claim will probably be denied.
For instance, anxiety is one of the most common mental health issues. But for most people, it doesn’t significantly affect their ability to work. Severe cases of anxiety, however, can cause some people to totally withdraw from society. This, obviously, prevents them from working or and can have a significant impact on their daily living.
Common Reasons Why Mental Disability Claims Are Denied
If your mental condition is on the list but your application still got denied, here are some things you could be doing wrong:
1. Lack of Strong Clinical Evidence
Unlike other disabilities, mental disorders don’t manifest physically. This makes it harder to prove.
Physical impairments can easily be proven with x-ray or blood test results. But diagnostic tests for mental disorders can be subjective. The findings are based mostly on the observations of the medical personnel based on the behavior of the patient. This is why the SSA is more strict in accepting medical evidence for mental disorders.
2. No History of Psychological Treatments
Most mental disability claimants fail to provide a treatment history for the disorder they are applying for. This is especially true for depression-related cases. Because of lack of access to mental health resources, most patients deal with depression on their own without seeing a psychiatrist.
Without the applicant’s medical records and treatment history, the SSA will have a hard time evaluating their condition and how likely it is to affect their work.
3. Scant Supporting Evidence
Memory impairment testing, IQ tests, and reports from mental health professionals are just some of the evidence you need to include in your application. But most of the time, the SSA will also require other evidence to support your claim. This can include written testimonies of the people you interact with regularly and case files from a social worker (if any). If your supporting evidence is not enough to back your claim, chances are it will get denied.
4. Non-Compliance With Prescribed Treatments
The SSA can outright deny your claim if they determine that you are not following the prescribed treatments for your mental illness.
Remember, the SSA will want to make sure that you are really disabled and not just using your condition as an excuse to receive free welfare. One way to prove that is your willingness to get better so you can get back to the workforce sooner. If you aren’t willing to comply with the prescribed treatments, then that means you don’t want to improve your condition.
5. Social and Cultural Bias
The lack of understanding on the nature of mental disorders has built a cultural and social bias towards people suffering from it. Other people will just tell them to “get over it” or that “it’s all in your head”. Unfortunately, this kind of attitude permeates all levels of society including some SSA employees. This makes it all the more difficult to prove that you deserve disability benefits.
6. Lack of Duration
One fundamental criterion the SSA uses to gauge disability is that it must be expected to last for at least a year or can lead to death. But most mental disorders don’t have a definite duration. With proper treatments, some conditions can improve in a matter of months. While others may last throughout the patient’s lifetime.
How To Increase Your Chances of Getting Approved
If you want your claim to get approved faster, here are some steps you can take:
- Gather as much supporting evidence as you can. As with most disability claims, the more evidence you have the higher your chances of convincing the SSA that you really are disabled.
- Follow your mental health specialist’s prescriptions. If you want to prove to the SSA that you’re working towards getting better, you need to follow your prescribed treatments diligently.
- Consult an experienced disability lawyer like Victor Malca. His more than 25 years of experience helping injured workers in Florida makes him the best person to help you with your claim. He can help you get the social security disability benefits you rightfully deserve. Contact us now for a free consultation.
VICTOR MALCA LAW – A TRUSTED NAME IN FLORIDA
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success in fighting for his clients puts among the most trusted workers’ compensation lawyers in Florida. Our area of expertise is in representing injured workers on compensation benefit cases and disabled individuals claim social security disability benefits.
Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. Book a free consultation today.
ABOUT THE AUTHOR
Judy Ponio is a writer for Victor Malca Law P.A. and enjoys helping people with questions about social security, workers compensation, and other serious matters involving people’s livelihood. She is not an attorney and her writing should not be considered legal advice.