Obsessive compulsive disorder (OCD) can be so disruptive to a person’s life that it becomes impossible to work. Obsessive-compulsive disorder is characterized by repeated unwanted thoughts that compel a person to try to relieve them by perform repetitive tasks or rituals, such as constantly checking or counting things or cleaning. Attempts to resist these obsessive, compulsive urges may lead to anxiety. The repetitive, involuntary thoughts can be about contamination by violence, sex, religion, or germs. For instance, someone who is obsessed with contamination and fear of germs may have the compulsion to wash their hands repeatedly to prevent infection. Not all patients with OCD have both obsessions and compulsions.
Most people with OCD develop it by age 30. About 20% of people who have OCD also have nervous tics, involuntary muscle contractions such as blinking or grimacing.
You may be able to qualify for Social Security disability benefits based on OCD if your condition is well documented and severely debilitating. OCD is evaluated by the Social Security Administration (SSA) as an anxiety-related disorder. For you to get benefits for OCD, you must first have a diagnosis of OCD characterized by either an involuntary, time-consuming preoccupation with intrusive, unwanted thoughts or by repetitive behaviors aimed at reducing anxiety. Second, you must show that you have an extreme limitation one of the following areas or a "marked” limitation in two or more of the following areas:
Note that "marked" is worse than moderate but less than extreme—you can think of it as seriously limiting.
There are alternate criteria for those whose OCD is under control because they have been living in a highly structured or protected situation or undergoing intense therapy. These individuals may be able to get benefits if they have had OCD for at least two years and their OCD is being managed by treatment. They must also show that they have minimal capacity to adapt to demands that are not already part of their daily life or to changes in their environment.
If you don’t qualify under the SSA’s OCD listing because your limitations are more moderate, as part of the disability determination process, the SSA will consider if there is any kind of work you can be expected to do with moderate limitations. The SSA will give you a rating of the type of work it thinks you can do (skilled work, semi-skilled work, unskilled work, or less than unskilled work). This is called your mental residual functional capacity (MRFC).
If the SSA finds you can do any type of work, skilled or unskilled, you won’t be granted disability benefits. If you don't meet the listing requirements, it's likely the SSA will find some type of unskilled work you can do. However, if you also have any type of physical impairment, you might be able to qualify for disability benefits under what’s called a “medical-vocational allowance.”
You’ll need to present to the SSA a comprehensive report from your psychiatrist and a well-documented psychiatric medical record showing the history of your OCD. Your record should include all treatments tried, include the types of medication and therapy, and the efficacy and side effects of each treatment. Your doctor should include detailed information on how your OCD affects your daily activities and your ability to work. If your psychiatrist has given you a diagnostic questionnaire, such as the Yale-Brown Obsessive Compulsive Scale (YBOCS), this can help show the SSA the severity of your OCD.
Call the SSA at 800-772-1213 to set up an appointment to fill out an application for SSI and/or SSDI disability, or go online to www.ssa.gov/disabilityonline. When you fill out your application, include a detailed description of how your OCD affects your behavior; how it affects your ability to concentrate and complete tasks quickly, follow directions, and function; how it affects your social functioning; and how often you have episodes of worsening symptoms.