Medical Documentation Needed to File For Disability for Mental Illness?

Although a mental illness can significantly affect your job performance, it can be difficult to prove that your condition warrants medical disability benefits.  If you believe that your illness prevents you from working because of the day-to-day challenges that you face, then it is important to know the medical documentation needed to file for disability for mental illness.  Understanding what will be required for your claim can make the difference in whether your request is accepted or denied. 

Qualifying for Disability Benefits

According to the U.S. Social Security Administration (SSA), a person must be medically diagnosed to have serious problems in at least three of the following areas of functioning to be considered for benefits:

• Daily living—includes the ability to engage in activities such as cooking, maintaining personal hygiene and paying bills;
• Social functioning—includes the ability to communicate and to interact with others;
• Concentration persistence—includes the ability to stay on task and to complete activities; and
• Decompensation—includes the ability to respond appropriately in stressful situations.

The SSA Web page lists all of the medical conditions that may be eligible for benefits compensation.  These include, for example, psychotic disorders, personality disorders and mental retardation.  An individual who seeks disability benefits for a mental illness must have documentation that describes his impairment, how it imposes on his ability to work and whether his condition is expected to last for at least 12 consecutive months.  To begin the claims process, SSA will need to review materials that support your request.  

The Process of Applying For Disability

• First, you must submit medical evidence about your disability, including any records of examinations, testing, hospitalizations and treatment.  Your doctor will need to submit a letter that thoroughly outlines and explains the difficulties that you experience and the severity thereof.  He will need to cite specific examples of your disability.
• Second, SSA will review any statement that you submit on your own behalf about your functional limitations to determine if your description corresponds with the medical evidence. 
• Third, SSA will consider any additional information submitted by other health care providers, e.g., a psychiatric nurse and/or a psychiatric social worker, which supports your claim.  As part of this additional information, non-medical sources such as family members, colleagues and friends can also submit statements that describe your condition in consistency with the medical evidence. 

The majority of disability claims are initially processed through local SSA offices and State agencies referred to as disability determination services (DDSs).  On verification and review of the evidence, the DDS makes the disability determination, a two-part decision that involves a medical/psychological consultant and a disability examiner.  If you are dissatisfied with the decision made about your claim, you can file an appeal that will be decided by a judge after hearing and receiving evidence from your medical sources.  

Getting Help

It is a good idea to work with an experienced disability rights attorney when you are filing a claim for mental illness with the SSA. Because of the difficulty of proving such a case, the advice of an experienced attorney can prove invaluable.