Agoraphobia can be a crippling anxiety disorder, one that prevents people from being around crowds, going into public spaces, or even from leaving their homes. If the agoraphobia is well-documented and makes full-time employment impossible, Social Security Disability benefits may be available.
What Is Agoraphobia?
Agoraphobia is the fear of public places. It is caused by panic attacks and the fear of panic attacks, which are sudden and unexplained waves of anxiety, terror, or apprehension. Panic attacks can also manifest themselves in physical symptoms, such as shortness of breath, lightheadedness, racing heartbeat, sweating, and trembling. People with agoraphobia generally seek to avoid situations that trigger panic attacks, so they are often reluctant to be around large groups of people or people they don't know. Everyday tasks like shopping, working, and visiting with friends can become virtually impossible. In severe cases of agoraphobia people will withdraw entirely from society, refusing to leave their own homes. Many others are in fact able to appear in public, but only for short periods of time and accompanied by friends or family for support.
Agoraphobia is diagnosed using a psychological evaluation, a physical exam, and the patient’s own descriptions of her limitations. Agoraphobia can treated with anti-anxiety or antidepressant medications, which are sometimes combined with sessions of cognitive behavioral therapy (CBT) with a mental health professional. CBT is a type of therapy which focuses on understanding one's illness and its symptoms, and it often tries to "desensitize" those with anxiety disorders by gradually and safely exposing them to situations which can cause them anxiety. As with most mental disorders, the earlier agoraphobia is diagnosed and treated, the greater the chances for improvement.
Agoraphobia affects an estimated 3.2 million people in the United States between 18 and 54, and it is about two times more common in women than in men.
Agoraphobia and Social Security Law
The easiest way for a person with agoraphobia to qualify for Social Security Disability benefits is to meet Listing 12.06 for anxiety disorders in SSA's "blue book." (For more on the blue book, see our article "Social Security Disability List of Impairments.") In order to meet the listing, a person with agoraphobia must satisfy the requirements of both A and B, or both A and C, listed below:
A. Medical evidence showing at least one of the following:
1. Long-lasting anxiety characterized by motor tension, hyperactivity, apprehensiveness, or hypervigilance
2. An irrational fear and avoidance of a particular activity or situation
3. Severe and recurring panic attacks occurring an average of once a week
4. Distress resulting from irrational obsessions or compulsions
5. Persistent stress caused by a past trauma
B. The above symptoms cause problems performing daily activities, interacting socially, or maintaining focus and concentration
C. A total inability to function independently outside the home.
If your agoraphobia meets the requirements of the above listing, you should qualify for Social Security Disability benefits. If your symptoms do not meet the listing, you may still qualify for benefits depending on the limitations caused by your anxiety. For example, if you only rarely leave the home and experience persistent fear of panic attacks when in public, the SSA may decide that you are incapable of working.
How Can I Prove My Agoraphobia Leaves Me Unable To Work?
The opinion of your mental health provider is very important in your Social Security case, as SSA is required to give special consideration to your treating doctor. One of the easiest ways for your doctor to give his or her opinion on your work-related limitations is by filling out a Residual Functional Capacity (RFC) form. In cases of agoraphobia, this form should state your diagnosis and address your ability to:
- Interact appropriately with the public and supervisors
- Maintain appropriate attendance (missing more than two days of work per month is usually held to prevent full-time employment)
- Handle stressful situations
- Make work-related decisions
- Maintain attention and concentration
- Follow either simple instructions and complex instructions
If agoraphobia is not your only diagnosis, your doctor should take into account the combined affect of all your impairments on your ability to perform the above tasks. Note that it is not necessary for your doctor to state whether or not you are “disabled,” as that as a determination made by Social Security.
In order to bolster the opinions of your mental health provider, or in cases of untreated agoraphobia, reports from friends and family members may be helpful. These reports should focus on first-hand observations of the claimant’s behavior, especially the ability to appear in public and interact with others, rather than on discussing his or her particular medical diagnosis.
Finally, it can frequently be helpful for the Social Security applicant to submit a “statement of claimant” regarding her condition to the SSA. This statement can be short – a page or two is fine – and should describe the person’s struggles with agoraphobia in her own words, focusing on the ability to go out in public and interact in social situations.