Social Security Disability Benefits for Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental impairment characterized by repeated, unwanted thoughts as well as attempts to relieve them by performing repetitive tasks or rituals. According to the National Institute of Mental Health, an estimated 1.2% of American adults have had OCD in the past year, with approximately half of those cases considered "serious."

OCD generally comes on gradually, and symptoms can go away for a while or worsen in response to stress. Most people with OCD develop the disorder during childhood and are diagnosed as young adults. A sizable percentage of people who have OCD also experience "tics" (brief, involuntary muscle contractions such as grimacing or jerking or compulsions like touching and retouching objects). Other anxiety or mood disorders, such as depression, often occur at the same time as OCD.

Is OCD a Disability?

Symptoms of obsessive-compulsive disorder may become so intense that they interfere with the ability to work. And if you have OCD symptoms that keep you from working full-time for at least one year, you may qualify for Social Security disability benefits.

Qualifying for Benefits by Meeting a Mental Disability Listing

The Social Security Administration (SSA) maintains a list of disorders, physical and mental, that the agency has determined to be especially severe. This "listing of impairments" (or "Blue Book") contains information about what evidence the SSA needs to see in your medical record before the agency can find that you "meet a listing" and award you disability benefits.

Social Security evaluates claims for disability based on OCD using listing 12.06, Anxiety and obsessive-compulsive disorders. To qualify for benefits under this listing, you'll need to have doctors' notes and tests demonstrating that you have an "involuntary, time-consuming preoccupation with intrusive, unwanted thoughts" or "repetitive behaviors aimed at reducing anxiety." Additionally, you'll need to show that your OCD causes an "extreme" limitation in one, or a "marked" limitation in two, of the following areas:

• understanding, remembering, and applying information (such as following directions)
• interacting with others in socially appropriate ways
• concentrating, persisting, or maintaining pace (finishing tasks on time), and
• adapting or managing oneself (like recognizing and avoiding danger).

Your limitations are "marked" if your OCD symptoms manifest strongly, but you're able to pull through with help. Your limitations are "extreme" if your symptoms keep you from doing anything else until the compulsion is satisfied.

If your limitations are milder, but only because you're keeping your OCD symptoms under control in a "highly structured setting," you can still qualify for benefits under listing 12.06 provided you have significant difficulty adapting to changes in your environment.

Qualifying for Benefits by Having a Reduced Functional Capacity

You can still get benefits with OCD even if your symptoms aren't severe enough to meet a mental disability listing if your limitations prevent you from performing any full-time work. The process by which Social Security determines what kinds of jobs, if any, you can do is called assessing your residual functional capacity.

Your residual functional capacity, or RFC, is a set of restrictions on the types of tasks you can do in a work environment. Somebody with obsessive-compulsive disorder might be restricted from skilled jobs that require extensive focus and concentration, for example. The more severe your symptoms are, the greater the restrictions in your RFC will be. If your combined limitations rule out all jobs, the SSA will award you disability benefits.

For applicants under the age of 50, this generally means having an RFC that eliminates even the easiest, sit-down jobs (unskilled, sedentary work). Too much time spent "off-task" due to engaging in repetitive behaviors or focusing on intrusive thoughts, for example, is often what the SSA calls "inconsistent with competitive employment" and therefore disabling.

Applicants 50 years of age and older with additional physical disabilities may be able to qualify for benefits using the medical-vocational grid rules if they have physical limitations in addition to OCD.

Getting Medical Evidence to Prove Disability for OCD

Whether you think you meet the listing for obsessive-compulsive disorder or you want to show that your OCD symptoms keep you from doing all work, you'll need to have medical records to back up your claim. You should submit the following documents to the SSA for claims examiners to review:

• a comprehensive mental health report from your psychiatrist or psychologist
• clinical notes from your doctors or therapists showing how your treatment is progressing
• a list of all medications you're currently taking, including side effects, and
• your activities of daily living questionnaire.

Your doctor's notes should include detailed information on how your OCD affects your daily activities and your ability to work. Specialized diagnostic tests, such as the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), can help establish the severity of your symptoms. If your treating doctor is willing to write a medical source opinion detailing your limitations, that can be very helpful to your claim.

What Disability Benefits Can I Claim for OCD?

The Social Security Administration provides two types of disability benefits, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). While most people use the terms SSDI and SSI interchangeably, they are different benefits with different preliminary eligibility rules.

SSDI eligibility is determined by how much you've worked and contributed to the program in payroll taxes (or self-employment taxes). You become "insured" for SSDI by earning work credits based on your earnings history.

SSI, on the other hand, is needs-based and not tied to your employment history. You're eligible for SSI if you have income and assets below a certain low threshold.

When you file for disability, Social Security will determine whether you qualify for SSDI, SSI, or both programs. If you aren't legally eligible to receive at least one type of benefit, you can't receive disability payments from Social Security, no matter how debilitating your OCD symptoms are.

How Do I Start a Disability Claim for OCD?

You can apply by calling the SSA at 800-772-1213 from 8 a.m. to 7 p.m., Monday through Friday, or go online and use the agency's application web portal. If you want help completing the application, you can also visit your local Social Security field office and speak with a representative in person.

You aren't required to hire an attorney at any stage of the disability determination process, but it can be a very good idea, especially if you've already received a denial letter. An experienced disability lawyer can help you submit helpful medical evidence proving that your OCD is disabling, handle correspondence with Social Security on your behalf, and—perhaps most importantly, given how many disability claims are denied at the initial and reconsideration levels—represent you at a hearing with an administrative law judge.