Does your mental disorder qualify for disability benefits?

Written by TC Newlin

TC is a disability litigator and one of the managing partners in the Social Security Disability Department at Fleschner, Stark, Tanoos & Newlin. He has had the pleasure of helping thousands of people obtain the benefits they so desperately need.

October 24, 2021

What Is Considered a Mental Health Disorder?

Mental health disorder is a term used to refer to a wide range of mental health conditions.  These illnesses can affect mood, thinking and behavior.  Mental health disorders are extremely common among the pool of disability applicants.  Specific disorders like; anxiety, bipolar disorder, depression, PTSD and schizophrenia are issues disability lawyers and judges see on a weekly basis.  

How to Seek Disability Benefits

A diagnosis of a mental health disorder is frightening, but you are not alone. 

  • 1 in 5 adults experiences mental illness in their lifetime. 
  • 1 in 20 experiences serious mental illness.

If you are in that 1 out of 20 people where your occasional issues turn into common issues, you need to seek help.

In a majority of cases, these symptoms can be controlled with therapy and/or medication.  If therapy and/or medication fail to help and mental illness begins to cause problems to a degree that you are no longer able to maintain employment, it could be time to seek disability benefits. 

These benefits can help you with everyday living expenses, medical bills, and other bills that have been piling up.  The monthly cash benefit can make it possible for you to live your life without income from work.

Applying for disability benefits can be daunting.

The process is long and mental health cases can be harder to win than physical cases.  You cannot present your case in the form of x-ray or MRI therefore it is imperative that you have established ongoing mental health treatment from a doctor, preferably a psychologist or a psychiatrist. 

Regular treatment from a specialist shows your condition is beyond the help that can be provided by a primary care physician.  

Non-Medical Eligibility for SSDI and SSI

The first hurdle a disability applicant must get over is the Non-Medical eligibility criteria.  SSDI and SSI have two separate eligibility requirements.  

SSDI

SSDI is insurance. 

In order to be eligible, you need to pay the ‘premiums’. 

SSDI ‘premiums’ come in the form of work credits.  An individual typically needs to accumulate 40 work credits over their lifetime to be insured under the SSDI program, 20 of which were accumulated over the last 5 years. 

In 2021, a work credit is awarded after a worker has earnings of $1,470.  An individual can only accumulate 4 credits in a calendar year.  Thus, in order to get the maximum of 4 work credits in 2021, a worker needs to earn $5,880.  

Younger individuals, who as a result of lack of years in the workforce, do not have to accumulate the full 40 work credits to be insured under the system.  The closer an individual is to 18 years of age, the fewer credits they need to accumulate.  

SSI

SSI is a needs-based program. 

Whether or not an individual has worked is not relevant to eligibility for SSI benefits. 

I routinely tell people that if they are eligible for food stamps, they are likely to be eligible for SSI benefits.  The rules state that you cannot have more than $2,000 in assets to be eligible for SSI benefits.  

Medical Eligibility for SSDI and SSI

After getting over the non-medical hurdle, an applicant needs to be found medically eligible for SSDI and SSI.  The medical requirements for both programs are exactly the same.  

Mental Ailments Listings

A judge will need to determine whether or not your mental ailment meets a listing. 

The listings are broken into 14 different categories.  The particular category we are interested in is #12, Mental Disorders.  The mental disorder section is broken down again into 15 subsections.  Of those 15 subsections, we can find a particular listing for anxiety, bipolar disorder, depression, PTSD, and schizophrenia.  The judge will compare the requirements of the listing to the medical records in the file. 

If the facts of your case meet or equal a listing, you will be awarded disability benefits at step 3 of the 5-step disability process.  

Mental Ailments and an Inability to Do Any Work 

If the facts and circumstances of your case do not meet or equal a disability listing, the judge will need to make a determination as to whether or not there are any jobs in the regional or national economies that you could perform. 

The common ways to eliminate the ability to perform any work from a pure mental ailment perspective is to prove that you would have issues like; excessive absenteeism, would show up late or leave early, have an inability to concentrate on simple/routine type tasks, or have an inability to be around people. 

These types of examples can be proven with medical records, including hospitalizations and therapy notes.  Additionally, opinion evidence from your medical care provider(s) can be persuasive.  These opinions can be made in actual medical records, in written statements, or by asking your doctor to complete a Mental RFC.

If a decisionmaker determines that you are unable to perform any work on a full-time sustained basis, you will be deemed disabled under the rules and regulations of the Social Security Administration. 

Do I Qualify for SSD Benefits?

Browse our SSDI resource library to find clear answers and determine if you qualify for up to $3,148/month in SSD benefits.

Do I Qualify for Social Security Disability?

Browse our SSDI resource library to find clear answers and determine if you qualify for up to $3,148/month in SSD benefits.

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