Social Security Benefits for Mental Illness

Mental illness consists of a wide range of mental disorders that affect your mood, social skills, thought processes, and ability to engage in daily activities. Either your primary doctor or a psychiatrist or psychologist can diagnose you with a mental illness. If your symptoms are severe and have prevented you from being able to perform work for at least 12 months (and you expect not to be able to work for at least 12 months), then you may be eligible to receive disability benefits from the Social Security Administration (SSA).

Qualifying for a Disability Listing With a Mental Illness

One way to receive Social Security Disability (SSD) benefits or Supplemental Security Income (SSI) benefits is to meet the requirements of an official SSA disability listing. The SSA has devoted an entire section of its disability listings book (the "blue book") to the topic of mental illness. Section 12.00, Mental Disorders, contains nine categories of mental disorders. They include the following:

  • organic mental illness
  • schizophrenia and other paranoid disorders
  • mental retardation
  • anxiety or obsessive-compulsive disorders
  • somatoform disorders (have physical symptoms but no known psychological condition)
  • personality disorders
  • autistic disorders and other developmental disorders

To qualify for one of the impairment listings, you must present medical evidence to the SSA showing that you have the required symptoms for the particular mental disorder. For example, to meet the disability listing for depression (12.04), you must have evidence indicating at least four of the following symptoms: a persistent loss of interest in activities, difficulty eating with a change in your weight, difficulty sleeping, psychomotor agitation or retardation, low energy, feeling worthless or guilty, problems thinking or focusing, suicidal thoughts, or delusional thinking.

In addition, you will also need to show that your symptoms of mental illness result in at least two of the following factors:

  • a  severe limitation in your ability to perform daily tasks
  • a  severe  limitation in your ability to relate well to others, such as the general public
  • a  severe  limitation in your ability to concentrate and focus on tasks
  • continuing episodes of decompensation (a repeated increase in your symptoms of mental illness that result in the need for additional treatment)

Evaluating Your Residual Functional Capacity

When you don't meet the severity requirements for a disability listing, the SSA will decide whether you are disabled based upon your residual functional capacity (RFC). Your RFC is the most that you could do physically and mentally if you had to work a full-time job. For instance, if you have been diagnosed with depression, your RFC might look like the following: You can work in a position that requires only minimal interaction with others, you are unable to focus on tasks that demand even short-term concentration, and your current medication makes you groggy on occasion. Since most positions require some type of concentration, this RFC might likely make you unable to perform most types of work.

If your RFC shows that you cannot perform your past work, you could  be found disabled.  Learn more about how the SSA does its RFC analysis.

If your RFC also shows that you cannot perform any job available in the U.S., you should be found disabled.  Learn more about getting disability benefits through a medical-vocational allowance.

Sources of Medical Evidence

Upon receipt of your disability claim, the SSA will review your medical history to determine the severity of your mental illness. The agency will consider chart notes, medical opinions concerning how your mental illness limits your ability to work, psychological tests, intelligence tests, hospitalizations, and mental status examinations. The SSA generally will place greater weight upon a psychiatrist's opinion than upon the opinion of a nurse practitioner.

If you are taking medication to treat your mental illness, the SSA will consider whether you are experiencing side effects from your prescriptions. Possible side effects of medications can include drowsiness, nausea, headaches, and fatigue. If your current medication causes side effects, the SSA will determine whether you have tried other medications that do not produce side effects. Further, the SSA will evaluate whether your medication treats all or just some of your symptoms.  

If you are not being medical treated for mental illness, Social Security Rulings state that the SSA must consider your explanation for why you are not able to visit a doctor, such as not being able to afford it. If you haven't seen a doctor for your mental illness, or your medical record is otherwise incomplete, the SSA might send you out for a consultative examination with a psychologist so that the SSA has enough evidence to properly consider your disability claim.

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