How Can I Document My PTSD in Order to Get Social Security Benefits?

Post-traumatic stress disorder (PTSD) can be the basis for a successful Social Security disability claim, but it must be properly medically documented. In deciding whether you are disabled, the Social Security Administration (SSA) will consider your medical records, including hospital records and clinic notes from physicians, therapists, and counselors. You should ask your treating mental health provider to complete a Residual Functional Capacity (RFC) form for you, which will address the work-related limitations caused by your PTSD. Social Security generally gives special consideration to the opinions of treating doctors, and an RFC form can make the difference between an approval and a denial of your disability claim.

PTSD Symptoms and Treatment

Post-traumatic stress disorder (PTSD), or post-traumatic stress injury (PTSI), is an anxiety disorder that usually occurs after a person has been involved in a traumatic event, such as military combat, sexual assault, childhood abuse, severe car accident, or a natural disaster. Those with PTSD commonly experience nightmares, flashbacks, or panic attacks that seriously interfere with everyday life. Some people will think obsessively about their past trauma, while others will become emotionally numb and avoid thinking about it at all costs. PTSD is also commonly characterized by:

• feelings of hopelessness, guilt, or shame
• difficulty concentrating or remembering things
• anger and irritability
• trouble sleeping, and
• excessive anxiety or fear.

While almost all people who live through a trauma will experience some degree of shock or fear as a result, those with PTSD have long-lasting, severe symptoms that tend to worsen over time if left untreated. Treatment for PTSD often includes some combination of medication, counseling, cognitive-behavioral therapy, or psychotherapy.

Social Security's Disability Listing for PTSD

There are two ways for Social Security to find you disabled based on PTSD. The first is for you to satisfy the requirements of Social Security's new disability listing for PTSD. The second way is to receive a "medical-vocational allowance" by showing that your impairments prevent you from working full-time.)

The disability listing for PTSD was added in 2017 as listing 12.15, Trauma- and stressor-related disorders. To fulfill the criteria for the listing, you must have medically documented evidence of all of the following:

• exposure to a death or threatened death, serious injury, or violence
• subsequent involuntary re-experiencing of the traumatic event (for example, intrusive memories, dreams, or flashbacks)
• avoidance of external reminders of the event
• disturbance in mood and behavior, and
• increases in "arousal and reactivity" (for example, exaggerated startle response, sleep disturbance).

In addition to proving the above, you must show that you have severe or extreme limitations in certain areas. You must have either an extreme limitation in one of the following areas or a "marked" (severe) limitation in two of the following areas:

• adapting or managing oneself (regulating one's emotions, adapting to changes, having practical personal skills like cooking, cleaning, and wearing appropriate attire)
• interacting with others (in socially appropriate ways)
• concentrating on tasks (being able to finish work at a reasonable pace)
• learning, understanding, and remembering information (including following instructions and applying new knowledge to tasks).

If you don't currently suffer from any extreme or severe limitations in the above areas because you are living in a highly protected or supervised situation or you are undergoing intense therapy, you can provide certain documentation to fulfill the listing. You must show that:

• Your PTSD has been serious and persistent over a period of at least two years.
• You are undergoing ongoing medical treatment, mental health therapy, or living in a highly structured or protected setting, and
• Your adaptation is fragile, meaning that you have minimal capacity to adapt to changes or new demands.

If you do not meet the requirements of the listing, you can still receive benefits through a medical-vocational allowance, a type of approval that considers your work history, age, education, and Residual Functional Capacity, which is what you can do despite all of your impairments.

Documenting Your PTSD for Social Security

It is important to make sure that Social Security has all the medical evidence related to your PTSD and all your other impairments, including records of inpatient or outpatient psychiatric treatment and clinic notes from counseling and therapy. While Social Security will usually request your treatment records from the previous year when you file your disability application, you should provide Social Security with all relevant records from the last several years, if not more.

In addition, if your treating mental health provider is willing to complete an RFC form or write a letter on your behalf, this could give you a much better chance of being approved. The RFC form should ask for your diagnosis and symptoms, and it should address your ability to:

• sustain a routine without special supervision
• maintain attention and concentration
• understand, remember, and carry out simple and complex instructions
• avoid excessive absences from work (more than two days per month)
• make simple work-related decisions
• interact appropriately with supervisors, coworkers, and the general public, and
• be on time to work and avoid taking unscheduled breaks from the job.

Your doctor should also state the medical basis for his or her opinions, and address whether you meet the above listing for PTSD.

"Third-party statements" written by friends, family, and former bosses and co-workers can also be helpful in demonstrating that you're not able to work. The statements should focus on the third party's observations of you and their interactions with you, rather than your medical issues.