Can You Get Disability Coverage for Depression?

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Depression can be so disruptive to a person’s life that it interferes with everyday life and makes it impossible to work. If your depression is so severe, even with anti-depressive medication, that you can’t work any type of job, you may be able to qualify for Social Security disability benefits. Your condition will have to be well documented as well as severely debilitating -- it must affect your ability to function socially, concentrate, and/or manage the tasks of daily living. And you must have been diagnosed with depression that is persistent (that is, it has lasted at least one year or is expected to last at least one year), even though you may not be continuously depressed (that is, you may have depressive episodes that are intermittent).

To qualify for disability benefits for depression, your condition must be severe enough to meet requirements the Social Security Administration (SSA) has set out in its impairment listing on affective (mood) disorders (listing 12.04), OR it must interfere with your functioning to such an extent that the SSA agrees that there are no jobs that you can do.

Qualifying for Disability Benefits Based on Depression Listing

To qualify under the SSA’s official listing for depression, your depression must be characterized by at least four of the following:

  • decreased energy
  • difficulty concentrating or thinking
  • loss of interest in most activities (or anhedonia, the loss of ability to enjoy previously enjoyed activities)
  • lack of physical movement, difficulty doing routine physical activities
  • appetite disturbance with weight gain or loss
  • disturbance of sleep
  • feelings of worthlessness or guilt
  • suicidal thoughts, or
  • paranoid thinking, delusions, or hallucinations.

The SSA also requires that your depression cause any two of the four of the following problems:

  • severe restriction of activities of daily living (ADLs)
  • severe difficulties in maintaining social functioning
  • severe difficulties in maintaining concentration, persistence, or pace, or
  • repeated, extended episodes of decompensation (worsening symptoms).

Alternatively, you might be able to qualify without fulfilling the above requirements if your depression has improved with medication or psychosocial support, but your recovery is tenuous and you could experience a setback if you go back to work. Specifically, to qualify under this alternative, your depression must be medically documented as having lasted at least two years, must significantly limit your ability to do basic work activities, and must include one of the following:

  • repeated episodes of decompensation, each of extended duration
  • the risk that even a minimal increase in mental demands or change in your environment is predicted to cause you to decompensate, or
  • inability to function outside a highly supportive living arrangement for at least the past 12 months, and this need is likely to continue.

Qualifying for Disability Based on Reduced Functional Capacity

If you don’t qualify under the SSA’s requirements for major depression, above, the SSA will next consider your depression symptoms and to what extent they impair your ability to do the usual activities of daily living, and if there is any kind of work you can be expected to do. The SSA will give you a rating of the type of work it thinks you can do (skilled work, semi-skilled work, or unskilled work). This is called your residual functional capacity (RFC), and in the case of depression, it’s called a mental RFC rather than a physical RFC.

If the SSA finds that you can do at least unskilled work, as is likely if you didn’t meet the official listing above, you won’t be granted benefits. But if the SSA finds that you cannot perform even unskilled work (which might be true, for instance, if your concentration is markedly limited or you cannot sustain an ordinary routine), the SSA might grant you benefits under a “medical-vocational allowance.” However, most claimants applying for disability benefits for depression either qualify under the official listing (rather than a RFC) or don’t qualify at all.

But if you have any type of physical impairment in addition to depression, this can change. For example, if you get a mental RFC for unskilled work and a physical RFC for sedentary work, there might be few jobs you can do in this category, and you might be able to qualify for benefits under a medical-vocational allowance.

Medical Evidence Required for Disability Based on Depression

Your treating doctor should be able to submit a comprehensive psychiatric report and a well-documented psychiatric medical record showing the history of your depression to the SSA. Your psychiatric record should include all treatments attempted, including the types of medication and therapy, and the efficacy and side effects of each treatment. Your doctor should also include detailed examples of how your depression affects your daily activities and your ability to hold a job.

Starting a Disability Claim

Call the SSA at 800-772-1213 to set up an appointment to fill out an application for SSDI or SSI disability benefits. When you fill out your application, include a detailed description of how your depression affects your daily life, your social functioning, and your ability to concentrate and complete tasks quickly, follow directions, and function, and how often you have episodes of worsening symptoms. If you have both depression and a physical impairment that makes it impossible for you to work, consider hiring a disability lawyer to help you file your Social Security claim, or if your initial claim gets denied, to file an appeal with the SSA.

This article is provided for informational purposes only. If you need legal advice or representation,
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LA-NOLO4:DRU.1.6.3.20141021.28794