What Are Mental Health Disability Benefits?

What Are Mental Health Disability Benefits?

If you suffer from a debilitating condition that is the result of a mental illness, you may still apply for Social Security Disability (SSD) benefits. As we will explain in a later article, proving a mental health disability is more difficult than proving a physical condition, but the process involved in applying for benefits is the same.

In order to qualify for mental health disability benefits, you must suffer from a condition that has been diagnosed by a doctor, usually a psychiatrist or psychologist, and you need to meet the standard disability criteria: 1) your disorder prevents you from doing the work you did up until the time of your disability; 2) your disorder makes it unreasonable for you to be trained for other work available at the time of your disability; and 3) your disorder is expected to be long-term or last for at least one year.

The Social Security Administration (SSA) has an official listing of impairments in what’s called the blue book. In the blue book, SSA lists conditions that it deems inherently disabling. In the realm of mental health, they include affective disorders (bipolar disorder and depression), disorders related to anxiety (panic attacks and abnormal fears), mental retardation (learning disorders), somatoform disorders (illness or injuries have no discernible cause), pervasive developmental disorders (autism), psychotic disorders (paranoia and schizophrenia), personality disorders (obsessive-compulsive and passive-aggressive disorders), and organic disorders (Alzheimer’s and dementia). SSA also considers post-traumatic stress disorder and eating disorders to be debilitating. Each one of these classifications has its own specific set of requirements.

If you are interested in applying for mental health disability benefits, consider hiring a trusted SSD attorney to represent your mental disability claim because he or she will be well-versed in the deadlines and requirements to prove your claim. Then, complete the application. A claims examiner will review your application and any supporting documents as part of your mental status examination and render a decision.

The claims examiner will first look to see if you meet one of the blue book listings. If not, he or she will look at your symptoms to determine your mental residual functional capacity (MRFC). If the examiner determines that you do not have the MRFC to work on a sustained and regular basis, your claim will be approved. SSA will review any medical records and, possibly, the opinions of employers or friends submitted on your behalf to determine your mental capacity. In fact, it’s a good idea to ask your doctor to prepare an MRFC report for you to save time. You will also likely need to submit an activity of daily living (ADL) questionnaire to explain how your mental health disability affects your daily life.

Specifically, the claims examiner will look closely to determine the following in your mental status examination: 1) your ability to follow directions and control behavior; 2) your ability to get along with others; 3) your ability to handle stress; 4) your ability to understand and remember information; 5) your ability to concentrate, complete tasks, and get work done in an appropriate amount of time; and 6) your ability to adapt to changes.

Approximately two-thirds of all applications are denied. If you receive a denial letter from SSA, you can either drop your claim or go on to appeal it. At this point, you’ll have an opportunity to make your case directly to an administrative law judge (ALJ) who is more knowledgeable about mental health disabilities than the claims examiners. Also, if he or she wishes, the ALJ can interview your doctors before making a decision.

Should you decide to appeal the decision, you are strongly encouraged to hire an attorney to represent you if you do not have one already. It is crucial that you present yourself accurately and thoroughly at this stage, and an attorney can go a long way in assisting you. He or she will be familiar with SSA’s disability criteria for your specific mental health disability and will ensure your forms are completed in a way that makes your disability—and how it affects you—clear. Because the initial denial rate is so high, especially when it comes to mental health disability claims, having an attorney can boost your chances of a favorable decision.