Social Security administers two types of benefits for disabled people—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). You can receive these disability benefits if symptoms from your PTSD prevent you from working full-time for at least twelve months.
Each program has its own legal eligibility criteria that you’ll need to meet before you can collect that type of benefit. SSDI eligibility is determined by your work history, while SSI is needs-based and requires that you meet a low income and asset threshold. It’s possible to be eligible to receive both SSDI and SSI, but you won’t receive more than the maximum amount you’d get from SSDI alone.
You can qualify for disability benefits in one of two ways—by satisfying the requirements of the Blue Book listing for trauma-related disorders, or under a medical-vocational allowance because your PTSD symptoms rule out all jobs. Either way, you’ll need to show that your PTSD has a significant impact on your ability to complete your daily activities.
PTSD symptoms can be as specific to each person as the trauma-causing event (“stressor”). Some people will think obsessively about their stressor, while others will become emotionally numb and avoid thinking about it at all costs. However, there are some symptoms that are common to many people diagnosed with PTSD, such as:
While almost everybody who has lived through a traumatic event will feel some degree of shock or fear as a result, people with PTSD have long-lasting, intense symptoms that, when left untreated, tend to get worse over time. Treatment for PTSD often includes some combination of medication, counseling, cognitive-behavioral therapy, or psychotherapy.
One method of getting benefits for PTSD is called “meeting a listing.” Disability listings are disorders that Social Security considers especially serious. Each numbered listing has a set of requirements that you need to fulfill in order to “meet the listing” and receive benefits.
The disability listing for PTSD is found under Blue Book section 12.00 for mental impairments. Listing 12.15 concerns trauma- and stressor-related disorders (such as PTSD) specifically. You can meet the listing criteria with medically documentation of all of the following:
In addition to having evidence of all of the above symptoms , you’ll need to show that you have “marked” limitations in two, or an “extreme” limitation in one, of the following functional areas:
“Extreme” limitations are worse than “marked” limitations—you can think of a marked limitation as being able to function independently in an area (but with significant difficulty), while an extreme limitation means you can’t function on your own in that area for any meaningful period of time.
You can also meet listing 12.15 if you don’t currently have any extreme or marked limitations because you’re living in a highly structured or protected setting (such as a group home) and you have limited capacity to adapt to changes outside of that environment.
Even if you don’t meet the requirements of listing 12.15, you can still collect benefits through what’s called a “medical-vocational allowance.” A medical-vocational allowance is based on how much your functional limitations restrict your ability to work, taking into consideration factors such as your age, education, skills, and residual functional capacity (RFC).
Your RFC is a set of limitations, physical and mental, on what you can and can’t do at work. Social Security looks at your medical records and function reports to determine how much your symptoms interfere with the types of jobs you can do. For example, somebody with fairly well controlled PTSD may have an RFC prohibiting loud work environments that could trigger flashbacks, while another applicant struggling with constant intrusive thoughts might have an RFC restricting them from performing even simple, repetitive tasks.
Social Security compares your RFC with your past work to see if you could return to those jobs today. If not, the agency then determines whether any other jobs exist that you could do, despite the restrictions in your RFC. People who are unable to perform any other full-time work (or who aren’t expected to learn) will receive disability benefits.
With proper medical documentation, qualifying for disability based on PTSD doesn’t have to be a challenge. The disorder is probably one of the more familiar mental impairments seen by Social Security claims examiners and disability judges, so it’s less likely that your symptoms will be misunderstood. However, you’ll still need to be on top of your game when it comes to gathering and submitting your medical evidence.
Make sure that Social Security has all the medical records related to your PTSD, including inpatient or outpatient psychiatric treatment records and clinical notes from counseling and therapy. The agency will usually request treatment records from the previous year when you file your disability application, but you should provide Social Security with all relevant records from the last several years, if not more.
You should also ask your regular mental health provider if they’d be willing to complete an RFC form or write a letter that addresses 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 your disability claim being approved or denied. A helpful RFC form should address your ability to:
Your doctor should also state the medical basis for your limitations, and discuss whether these limitations meet the requirements of the PTSD listing. 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.
When you’re ready to begin your application for SSDI or SSI, check out our article on filing for Social Security disability benefits. If you’re a veteran who is thinking about applying for disability compensation from the VA, we have many articles discussing issues related to PTSD in veterans and military service members. And if you’re unsure whether you want to go through the application process alone, review our article on when to talk to a Social Security disability lawyer.
Updated March 8, 2024
]]>Yes, mental illness can qualify as a disability if your symptoms keep you from working full-time for at least twelve months, despite medical treatment. Full-time work is defined as earning enough money (in 2024, $1,550 per month) to qualify as substantial gainful activity.
According to a survey conducted by the Social Security Administration (SSA) of people receiving disability benefits, about 40% reported a mental health condition or intellectual disability as their reason for their limitations.
While only about one-third of all disability applications are approved at the first stage of review, applicants (“claimants”) who see their application through to the hearing level have a greater chance of success. About one-half of Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claims are awarded after a hearing with an administrative law judge.
When you submit your application for SSDI or SSI, a claims examiner at your state Disability Determination Services office will first review your file to make sure that you meet the financial eligibility requirements for the type of benefit you’re applying for. If you’ve worked long enough to qualify for SSDI, or have assets below the threshold limit for SSI, the examiner will request medical records from the providers you listed in your application.
Your medical records are the foundation of your disability claim. Social Security will want to see that you’ve been getting regular treatment for your mental health symptoms. Your records should contain most, if not all, of the following:
If you have trouble getting consistent mental health treatment because you don’t have health insurance or can’t get any affordable treatment options, the SSA can send you to a consultative examination on the agency’s dime. During a consultative exam, a psychologist or psychiatrist asks you questions about your daily life and your medical history. Based on the exam, the doctor will provide Social Security with an opinion about how serious your mental health symptoms are.
Claimants whose medical records contain evidence of particularly intense mental illness symptoms can qualify for disability benefits without having to go through the added step of showing that they can’t do any job. In Social Security lingo, this is called “meeting a listed impairment.”
Listed impairments are conditions that the SSA has already determined to be disabling, provided that specific criteria are met. Mental illnesses have their own category (Section 12.00) in Social Security’s “Blue Book” list of disabling impairments. Disorders specifically listed include:
Each listed condition has a specific set of requirements that must be documented in your medical records. You need to have been diagnosed with one of the above disorders, but you also need to show that you have very significant (“marked” or “extreme”) limitations in areas of mental functioning like interacting with others or remembering tasks.
Showing that you meet the complicated listing criteria can be difficult. Ask your regular psychiatrist, psychologist, or therapist to determine whether you may qualify for disability under a mental disorder listing.
Most disability claimants don’t have medical records that meet the strict requirements of the mental illness listings. But Social Security can still award you disability benefits if you can show that your residual functional capacity (RFC) rules out all available jobs.
Your RFC is a set of restrictions that reflects the most that you’re able to do, mentally and physically, in a work environment. If you have a mental disorder, the SSA will review your medical records to determine the extent of any limitations you have in the following areas:
The more restrictions your mental condition causes, or the more severe your limitations are, the more likely no jobs will exist that you can do with your RFC. For example, if your depression interferes with your concentration to the extent that you’re leaving basic work tasks unfinished, it’s unlikely that any employer would hire you for even an easy, low-stress job.
You can learn more about what types of mental limitations qualify you for disability in our article about getting disability when you can't do a simple, unskilled job.
Social Security provides several ways that you can file your application for disability benefits:
Keep in mind that the disability determination process can be extremely lengthy. While claims for benefits due to mental illness can often be successful, the time between filing your initial application and when your claim is approved is likely to take several years.
Consider getting help from an experienced disability attorney or advocate to help take some of the stress out of the process. Your lawyer can help you explain in clear, convincing terms how your mental health has an impact on your abilities, whether in your function report or when testifying in front of a judge at a disability hearing. Your lawyer can also help put any less-than-glowing parts of your application, such as evidence of drug or alcohol abuse, into context so that they don’t sink your claim. And if you’re awarded benefits, your attorney can help you keep them during a continuing disability review.
You can find a lawyer near you using our attorney directory tool here.
Updated December 20, 2023
]]>If your child has been diagnosed with ADHD or ADD they may qualify for SSI disability benefits—but it’s not easy. You’ll need to show that the severity of the child’s ADHD symptoms meets or functionally equals the Social Security Administration’s childhood impairment listing for neurodevelopmental disorders (listing 112.11).
The name of Social Security's listing 112.11, which used to be Attention Deficit Hyperactivity Disorder, is now Neurodevelopmental Disorders, and it encompasses more medical conditions. Under the current listing, you must show evidence that your child’s ADHD or ADD is characterized by at least one of the following:
You also need to show that your child's ADHD or ADD causes a high degree of limitations in certain areas of functioning. Your child must have either an “extreme” limitation in one of the following areas or a “marked” limitation in two of the following areas:
Extreme limitations are more severe than marked limitations. For example, if your child needs extra guidance and time in order to complete homework assignments—but does eventually complete them—Social Security is likely to find that they have a marked limitation in concentration. But if your child is unable to finish their homework at all, the agency will likely consider that to be an extreme limitation.
Even if your child doesn’t meet the specific requirements of listing 112.11, they can still qualify for SSI benefits if you can show that their symptoms are severe enough to be functionally equivalent to the listings. Children with ADHD that functionally "equals" a listing are just as disabled as children whose symptoms meet the requirements exactly, but their disability manifests itself in a different way.
To functionally equal a listing, you’ll still need to show that your child has an extreme limitation in one, or marked limitations in two, functional areas. However, Social Security uses slightly different functional areas, called domains, to decide if your child’s ADHD is functionally equivalent to the listings. The six domains encompass a broader range of behaviors, both mental and physical:
For more information, see our article on how your child can qualify for Social Security disability benefits.
Make sure to include all of the medical evidence and psychological test results you have that demonstrate any abnormalities in your child's behavior. Standardized tests are generally preferred to other evidence, but they aren’t always available for every set of symptoms or for every age. If you can have your child take a standardized test, make sure the person who administers any standardized test is properly qualified and licensed to do so.
Be sure to provide Social Security with the names, addresses, and phone numbers of every doctor, psychologist, therapist, or clinic that has seen the child for ADHD-related reasons. Let the agency know about any medications your child is taking, including whether they’re effective in controlling ADHD symptoms and if they cause any side effects. School records and teachers' observations can be a good source of evidence and can show the consistency or progression of your child’s symptoms over time.
You can also document your own observations, along with those of anyone else who knows your child and has seen them struggle with ADHD—for example, teachers or coaches. Your own observations should include any difficulties your child has with daily functioning and social interactions, such as picking up after themselves or making friends. The medical records you submit should support your observations as well as those from your child’s relatives and teachers.
You can call the Social Security Administration (SSA) at 800-772-1213 or contact your local SSA office to submit an application (“claim”) for SSI. Your child’s claim for benefits—including all of the information and records you provide—will be evaluated by a claims examiner, who will request any further information or records they may need to help decide your claim.
The longer the SSA has to wait for medical or school records, the longer it will take the agency to make a decision, so it’s in your interest to keep the SSA in the loop about your child’s treatment.
The SSA will then make a determination on your child's case. If your child’s claim is denied, as most initial claims for ADHD are, you have the right to an appeal. If your appeal goes to a hearing in front of an administrative law judge, consider bringing a disability lawyer to the hearing who can help explain to the judge how your child’s functional limitations from ADHD are disabling.
Updated August 3, 2023
]]>To receive disability benefits, you will need to show proof of more than just a diagnosis of depression or bipolar disorder. You will need to present evidence that your depression or bipolar disorder is so severe that you are unable to work or function well. According to Social Security statistics, about two-thirds of applicants who apply for disability on the basis of major clinical depression or bipolar disorder end up getting approved (many only after having to request an appeal hearing).
Following is a list of important issues the Social Security Administration (SSA) will consider when evaluating your claim, and tips for how you can increase your chances of obtaining benefits.
Your depression or bipolar disorder must have lasted or be expected to last for at least a year, and must be at a level at which you would be unable to perform a job on a consistent and regular basis. The SSA does not require that you be depressed every day of the month, but you must show your depressive symptoms occur frequently enough to prevent you from working.
Quite often, your medical treatment records for a particular visit will say that you are “feeling better” or that your depression has “improved." The SSA might use these records as a reason to deny you disability benefits. If your medical records include such notes, you can explain at a hearing before an administrative law judge whether you have good days and bad days with your disorder, and how often each occurs.
Social Security will automatically grant disability benefits for depression or bipolar disorder if you can show you have the symptoms and limitations listed in its official disability listing for depression or bipolar disorder. The SSA will consider treatment notes from your doctor or psychologist, mental status evaluations, psychological testing, and any reports of hospitalizations.
Symptoms. To qualify for either disability benefits on the basis of depression, you must show you have at least five of the following symptoms:
To qualify on the basis of bipolar disorder, you must have at least three of the following symptoms:
Limitations. For either disorder, you must show that you also have a loss of abilities, either an extreme limitation in one of the following areas or a "marked” (severe) limitation in two or more of the following areas:
Alternately, if you can't show that you currently have this loss of abilities because you have been living in a highly structured or protected situation or undergoing intense therapy, you may be able to qualify for benefits if you can show that you have minimal capacity to adapt to changes in your environment or demands that are not already part of your daily life.
If the SSA says you don't meet the disability listing, the SSA will consider what you can do. It does this by writing up your mental residual functional capacity (MRFC). An MRFC is a description of what tasks you can do in a work setting; it explains your communication skills, your ability to relate to others, your ability to speak to the public, and whether you can be reliable in showing up to work.
For instance, say you have bipolar disorder and there is evidence in your medical records that you have moderate impairment in your social functioning caused by mood swings and you have a moderate level of difficulty with concentration. Your RFC might look like the following:
This RFC would prevent you from working in many occupations, but you probably wouldn't be found disabled since there are simple unskilled jobs that do not require working with the public. Read more about how the SSA makes this decision in our article on how the SSA evaluates an RFC for disability.
Here are some things to keep in mind before you apply and while you are waiting for a decision.
You'll need a statement from your treating doctor or a psychologist regarding the severity of your depression. For example, your doctor might give an opinion that you would miss several days of work each month due to your depression. Make sure the doctor provides an explanation for this opinion.
Continue to see your doctor or therapist during the waiting process for benefits so that you can amass a long treatment history in your medical records. The SSA can't easily deny the opinion of a therapist who has consistently found you to have a severe mental disorder and who has clinical signs supporting this opinion. If you can't afford to see a doctor or therapist on a regular basis, the SSA might send you to a consultative examination with a psychologist. For more information, see Nolo's article on getting a doctor's report for disability.
The SSA will review your medical records to determine if you have been prescribed any medication for your depression or bipolar disorder and whether this medication effectively controls your symptoms. If you have never been given medication, the SSA might consider your condition to be mild and not disabling.
In addition, if your doctor has recommended therapy or medication for your condition and you chose not to follow the doctor’s advice, the SSA might find you in "noncompliance." You can be denied disability benefits for not complying with your doctor's treatment recommendations. However, a good reason for not following a doctor’s recommendation is if you are financially unable to pay for therapy sessions. For more information, see Nolo's article on being denied benefits for failing to follow treatment.
If you've been diagnosed with drug or alcohol dependency, then you have a major roadblock to obtaining disability benefits for depression or bipolar disorder. An examining psychologist might assume that your symptoms result from drug usage and not from your underlying condition.
The burden will be on you to show the SSA that you would be disabled by your depression or bipolar disorder regardless of your use of drugs or alcohol. In these situations, it's helpful to have a period of sobriety in your medical records during the time you were diagnosed with severe depression or bipolar disorder. Also, you can try to request a statement from your doctor stating that drugs or alcohol are not the cause of your mental condition and that stopping use would not make your condition improve. For more information, read Nolo's article on how drugs and alcohol can keep you from getting disability.
]]>When an anxiety disorder has affected your ability to function at work and at home for at least 12 months, you could be eligible for Social Security disability benefits. But your anxiety has to be more than ordinary worries; it has to be severe enough to significantly limit your ability to do various work activities. For example, if you become nervous and avoid all social situations with friends and family, you might not be able to successfully navigate even short interactions with coworkers. With enough evidence of your anxiety symptoms, Social Security can award you disability benefits. (More on this below.)
Anxiety disorders come in different varieties. Your doctor or psychologist may have diagnosed you with one or more of the following:
Because many of the symptoms of these disorders overlap, some people are diagnosed with several of these disorders. For example, somebody who needs to repeatedly make sure that the stove is off can experience a panic attack when something prevents them from checking the kitchen.
If you have symptoms of several disorders, the SSA will look at the combined symptoms when determining whether you’re disabled. The more symptoms you experience, the more likely it is that the SSA will consider that, in total, your limitations are disabling.
The main symptom of all anxiety disorders is a feeling of excessive fear or worry. The specific symptoms depend on the type of anxiety disorder. Common additional symptoms include:
Anxiety disorders often have physical symptoms as well. Physical symptoms can include:
Additional physical symptoms can include dry mouth, muscle tension, and dizziness. If you’ve been experiencing one or more of these symptoms, it’s important to tell your doctor and get treatment. Social Security needs to see medical documentation that you’ve been experiencing symptoms of anxiety before the agency can find you disabled.
Anxiety disorders affect everybody differently. Some people can manage their symptoms very well with talk therapy, medications, or a combination of both. Social Security is unlikely to find them disabled if their symptoms don’t interfere significantly with their life. Others might find that, despite therapy and medications, they still have a tough time with daily activities like grocery shopping or remembering to pay bills.
For some people, symptoms of their anxiety disorders are so intense that, based on the symptoms and limitations in their medical record, Social Security finds them disabled without needing to determine that they can’t do any job. The SSA identifies these applicants as having a "medical disability." Applicants who are medically disabled due to post-traumatic stress disorder, for example, might have records showing frequent hospitalizations for anxiety symptoms, or an inability to support themselves without lots of outside help.
The SSA more commonly awards benefits for “vocational disability,” meaning that the SSA finds that your limitations prevent you from being able to do any job. Applicants whose anxiety is vocationally disabling might not be able to concentrate long enough to finish even simple work tasks. Or, people with social anxiety disorder or agoraphobia might be unreliable employees because their intense fear of leaving the house causes them to be consistently late.
In order to determine whether your anxiety disorder is disabling—medically or vocationally—the SSA will want to see that you’ve been receiving regular treatment for your anxiety. The agency will ask you to sign a release form, authorizing your doctors to send your medical records to the SSA. Your medical records should contain:
Most importantly, you will need to explain what happens as a result of your anxiety. Social Security wants to know how your anxiety symptoms limit your everyday life. The SSA will conclude that if you struggle to do something at home (such as remembering to do everyday household tasks), you’d have the same struggle at work.
Think of it this way: if you suffer from panic attacks at home and you have a panic attack at work, what would you do? Would you have to leave the job site? Would you lock yourself in the bathroom for an hour? Or, would you suffer in silence but be unable to finish your work tasks because you lost your focus?
The SSA will look at the above factors to determine whether you’re medically disabled or whether, in vocational terms, you’re “unable to sustain competitive employment.” Taking extra breaks, calling in sick too frequently, or being unable to perform your job duties can signal to the SSA that no employers would hire you for full-time work.
If you have a doctor or counselor whom you've seen consistently for a long time—say, over a year—it can be very helpful to your disability claim to ask one or both of them to write a medical source statement about your anxiety disorder. The medical source statement should contain your doctors’ opinions about what triggers your anxiety and the effect of your anxiety disorder on your ability to work.
Because a successful disability application frequently hinges on whether the SSA thinks you can work at any job, you could try to get a statement from your past employer (if possible) regarding any work absences due to anxiety symptoms. If you’ve had a hard time holding on to a job in the past because of your struggles with anxiety, it’s reasonable to conclude that you’d have trouble with employment in the future.
Updated March 15, 2023
]]>The Social Security Administration (SSA) recognizes that panic disorders can pose a significant barrier to employment. If you have frequent, severe panic attacks that interfere with your ability to work full-time for at least twelve months, you might qualify for disability benefits.
A panic attack is a sudden intense fear that triggers severe physical reactions despite the lack of any real danger. During a panic attack, you might feel as though you don’t have any control over your body. Some panic attacks can feel like you’re having a heart attack.
Symptoms of panic attacks include:
Many people experience a panic attack at least once in their lifetime. But if you’re experiencing repeated panic attacks, you might be diagnosed with a condition called a panic disorder.
Some people are able to manage their panic disorder with medication, breathing exercises, or self-soothing behavior. But other people can have more difficulty getting their panic attacks under control. If your panic attacks go untreated, your daily routine can be affected in the following ways:
During a panic attack, you’re likely to have very limited functional abilities. If you’re feeling paralyzed with fear, doing any kind of work can seem impossible. Even when you’re not actively experiencing a panic attack, your mind might be preoccupied worrying about when another panic attack might occur. Such ongoing anxiety can affect your ability to concentrate, complete tasks, or get along with others in the workplace. If your mental impairments are significant enough, they could affect your ability to work at any job.
You can get disability benefits for panic attacks if you can show that your panic disorder is severe enough to meet a listed impairment, or if your panic disorder prevents you from working at any job.
Anxiety and panic disorders are included in Social Security’s Listing of Impairments that the agency considers automatically disabling in certain circumstances. You can be found disabled by “meeting” listing 12.06 if you’ve been diagnosed with panic disorder or agoraphobia and you experience one or both of the following:
You must also be able to show that you have an “extreme” (debilitating) limitation in one, or a "marked" (intense, but not debilitating) limitation in two, of the following areas:
To be found disabled by meeting listing 12.06, you’ll need to provide medical evidence from a psychiatrist or psychologist that shows the extent of your panic attacks. Your medical records should contain at least one full description of a typical panic attack, documentation of how long your panic attacks last for and how often they occur, and possible causes for the panic attacks.
If you have doctors, counselors, or therapists who have witnessed you during one of your panic attacks, they should include their observations along with a medical source opinion stating any difficulties with public interaction, decision making, or concentration you have as a result of your panic disorder. You can also have a friend or family member who’s seen you have panic attacks provide a description of what they saw.
Not everybody with panic disorder experiences panic attacks of the duration and severity required to meet the listing. But you can still qualify for disability benefits if you can show that your panic attacks keep you from performing any job.
Social Security decides whether you can work by looking at your daily activities and your medical records to determine your residual functional capacity (RFC). Your RFC is a set of restrictions on the most you’re capable of doing, mentally or physically, at work.
The amount of restrictions in your RFC depends on how severe your panic disorder is. More limitations in your RFC means that fewer jobs exist that you’re able to perform safely, and certain restrictions can rule out full-time work entirely. For example, somebody who experiences a mild panic attack every month might need an extra 15-minute break to get their fear under control, but that limitation is unlikely to eliminate all jobs. But somebody who is unable to leave their house for days because of ongoing agoraphobia isn’t likely to maintain full-time work.
Few people are awarded disability benefits at the initial determination level, and gathering the medical evidence needed to support an application for panic disorder can be challenging and time-consuming. Consider getting help from an experienced disability attorney or advocate to help guide you through the disability determination process.
Your lawyer or representative will know how to obtain the proper medical evidence to support an argument that your panic disorder meets the listing or that you’d be unable to work full-time. Your attorney can help you document your panic attacks, handle communications with the Social Security Administration, and represent you at a hearing in front of an administrative law judge.
You can find a lawyer near you using our attorney locator tool here.
Updated January 18, 2023
]]>In many DDS offices, mental consultative exams are scheduled for almost all claimants who allege mental health problems, regardless of their treatment history. Sometimes mental examinations are even ordered for applicants who don't actually allege mental health issues, but if there is some indication in the file (for example, on a form completed by a third party) that mental health problems may be present.
There are several different types of mental examinations that SSA can order in a given case. For those with issues like depression, anxiety, or bipolar disorder, SSA will often schedule a mental status exam (MSE), which is meant to provide a snapshot of your current mental condition. In the typical MSE, you will be asked, for example, to name the current president, to count backward by sevens from 100, to recall items from a list after several minutes, to explain a well-known proverb, and to talk about your family and your childhood.
A psychiatric exam will usually be scheduled for individuals with schizophrenia, schizoaffective disorder, or psychosis, and sometimes for those with mood disorders like anxiety and depression.
Psychological evaluations will be ordered for those with a learning disability, cognitive disorder, stroke, head injury, organic brain disorder, or intellectual disability. If a person is believed to have borderline low intellectual abilities, or an IQ that has sharply decreased, a psychological examination will be scheduled. Those with significant memory problems, whether from organic brain disorder, head trauma, or another reason, will often be scheduled for psychological testing as well. Both children and adults may be ordered to undergo psychological testing.
The standard IQ test administered in psychological evaluations is the Weschler Adult Intelligence Scale, designed to measure intellectual functioning in adults. This test, now in its fourth edition, is thus abbreviated as the WAIS-IV. The WAIS-IV yields four separate index scores in the following areas.
In addition to the above scores, a full-scale IQ score will also be given. The median full-scale IQ score is 100, with a standard deviation of 15. The full-scale score is not merely the average of the four index scores, but it is informed by your performance in those areas. Scores of two-and-a-half to three standard deviations below the median are considered borderline low intellectual functioning.
Because the WAIS-IV is valid only for those 16 and over, intelligence evaluation in children is performed using different tests. The Weschler Preschool and Primary Scale of Intelligence (WPPSI) is given to children from ages 2 1/2 to approximately age 7. The Weschler Intelligence Scale for Children (WISC) is valid for children ages 6 to 16.
Adults with memory problems will be given the Weschler Memory Scale (WMS), a test designed to evaluate a person's ability to perform several different tasks using his or her memory. The test results consist of five separate index scores to reflect the various areas tested: Visual Memory, Auditory Memory, Visual Working Memory, Delayed Memory, and Immediate Memory. The WMS is frequently given in conjunction with the WAIS-IV.
In addition to performing intelligence or memory testing, a psychologist performing an evaluation will interview the claimant about his or her life, family, background, thoughts, and feelings. The psychologist must issue a written report to Social Security within ten days of performing the exam.
You should resist the temptation to exaggerate the severity of your condition or to give less than your best effort on any sort of psychological testing. This is called "malingering" (faking), and consultative examiners are trained to spot it. If it is determined that you're overstating the extent of your impairments, you will lose credibility with Social Security and you may lose your disability claim as a result.
Some disability claimants are tempted in the opposite direction; that is, they try to minimize their psychological or mental problems, perhaps out of fear or embarrassment. It is critically important, however, to be completely honest with the examiner about your problems. Failure to do so could result in the denial of a meritorious claim.
]]>To be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits for schizophrenia, you will need to show that you have been diagnosed with this disorder and that you have been (or will be) unable to work for 12 months or more. In addition, you must either meet the requirements of Social Security's listing for schizophrenia or qualify for benefits because of "reduced functional capacity."
The Social Security Administration (SSA) will automatically approve you for disability benefits for schizophrenia if you meet the requirements of Listing 12.03, Schizophrenia spectrum and other psychotic disorders, in its Listing of Impairments. (This listing also covers schizoaffective disorder, schizophreniform disorder, schizotypal (personality) disorder, and substance/medication-induced psychotic disorder.)
To be eligible for benefits under this disability listing, you must have medical evidence showing that you have one or more of the following symptoms on a persistent basis, despite taking medication:
In addition to these signs and symptoms, Social Security will need proof of how your disorder limits you. You don't need to prove specific limitations if your disorder has persisted for at least two years and you have either been receiving intensive medical treatment and mental health therapy or have been living in a highly structured setting that diminishes your symptoms. You will need to prove that you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.
If this doesn't apply to you, you must show that you have an extreme limitation in at least one of the following areas, or a “marked” limitation in at least two of the following areas:
Note that Social Security defines “marked” as less than extreme, but worse than moderate.
Your medical record should include any instances of hospitalization, opinions of your ability to work from your doctor, psychologist, psychiatrist, or psychiatric nurse, medical notes from regular clinic visits, psychological testing, any evidence that you are living in a structured setting where others help you perform most daily tasks, and statements from family and friends regarding your ability to work.
If your medical evidence does not "meet" Listing 12.03, then the SSA will determine your "residual functional capacity" (RFC) to perform basic work tasks, which means how much you are still able to do in spite of your illness. To be found disabled, your RFC must show that you are able to do so little that you cannot perform any jobs you've done in the past or any other work in the U.S.
If you have schizophrenia, it is likely that your ability to perform mental skills will be greatly reduced. Therefore, your mental RFC might also include the following: an inability to concentrate on tasks on a long-term basis, an inability to work well with co-workers, and an inability to perform most basic work tasks quickly and under a deadline. If you have severe problems with basic mental skills such as concentration and understanding directions, then it is more probable that the SSA will find you unable to perform any work. But if the SSA finds you can do some type of simple unskilled job that doesn't require much contact with co-workers, it may find that you aren't disabled.
Schizophrenia is an illness that usually requires lifelong treatment. An important issue in disability cases involving schizophrenia can be the use of medications and whether they are effective in controlling your symptoms. When you submit your claim, the SSA will ask you for a list of your current medications and dosage, the date first prescribed, and how much of the medication you take each day.
The SSA's federal regulations state that you must follow any treatment ordered by your doctor. If you are not taking your medications as prescribed, the SSA may deny you benefits unless you have a good reason for your failure to comply.
If your symptoms are well-controlled with medication, the SSA may use that information as a reason to find you not disabled. But while medication successfully treats hallucinations and delusions for most people with schizophrenia, there are not many people with schizophrenia who aren't left with some negative effects of the disease, such as poor social skills or poor motivation.
Additionally, the SSA must consider whether there are any side effects of the medication you are using and whether those side effects affect your ability to work. Common side effects resulting from the use of antipsychotic drugs include tremors, drowsiness, lightheadedness, fidgetiness, and sluggish movements.
]]>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.
]]>Agoraphobia is the fear of public places. It is caused by panic attacks and the fear of panic attacks, which are sudden and unexplained waves of anxiety, terror, or apprehension. Panic attacks can also manifest themselves in physical symptoms, such as shortness of breath, lightheadedness, racing heartbeat, sweating, and trembling. People with agoraphobia generally seek to avoid situations that trigger panic attacks, so they are often reluctant to be around large groups of people or people they don't know. Everyday tasks like shopping, working, and visiting with friends can become virtually impossible. In severe cases of agoraphobia people will withdraw entirely from society, refusing to leave their own homes. Many others are in fact able to appear in public, but only for short periods of time and accompanied by friends or family for support.
Agoraphobia is diagnosed using a psychological evaluation, a physical exam, and the patient’s own descriptions of her limitations. Agoraphobia can treated with anti-anxiety or antidepressant medications, which are sometimes combined with sessions of cognitive behavioral therapy (CBT) with a mental health professional. CBT is a type of therapy which focuses on understanding one's illness and its symptoms, and it often tries to "desensitize" those with anxiety disorders by gradually and safely exposing them to situations which can cause them anxiety. As with most mental disorders, the earlier agoraphobia is diagnosed and treated, the greater the chances for improvement.
Agoraphobia affects an estimated 3.2 million people in the United States between 18 and 54, and it is about two times more common in women than in men.
The easiest way for a person with agoraphobia to qualify for Social Security Disability benefits is to meet Listing 12.06 for anxiety disorders in SSA's "blue book." To meet this listing, you have been diagnosed with panic disorder or agoraphobia and experience one or both of the following:
You must also be able to show that you are extremely limited in at least one of the following areas or seriously limited in two or more of the following areas:
The opinion of your mental health provider is very important in your Social Security case, as SSA is required to give special consideration to your treating doctor. One of the easiest ways for your doctor to give his or her opinion on your work-related limitations is by filling out a Residual Functional Capacity (RFC) form. In cases of agoraphobia, this form should state your diagnosis and address your ability to:
If agoraphobia is not your only diagnosis, your doctor should take into account the combined effect of all your impairments on your ability to perform the above tasks. Note that it is not necessary for your doctor to state whether or not you are “disabled,” as that as a determination made by Social Security.
In order to bolster the opinions of your mental health provider, or in cases of untreated agoraphobia, reports from friends and family members may be helpful. These reports should focus on first-hand observations of the claimant’s behavior, especially the ability to appear in public and interact with others, rather than on discussing his or her particular medical diagnosis.
Finally, it can frequently be helpful for the Social Security applicant to submit a “statement of claimant” regarding her condition to the SSA. This statement can be short—a page or two is fine—and should describe the person’s struggles with agoraphobia in her own words, focusing on the ability to go out in public and interact in social situations.
]]>The SSA has a disability listing for “intellectual disorder” (previously it used the term "intellectual disability," and before that, "mental retardation"). A person can be automatically approved for disability based on low IQ if he or she meets all of the criteria in the SSA’s listing.
In addition to a low IQ, the applicant must have deficits in one or more areas of functioning, like social interactions, comprehension, concentration, or managing him or herself. Note that those who have a full scale, performance, or verbal IQ score of 71 above won’t qualify for benefits under the intellectual disorder listing (but could still qualify for benefits—see below).
Here's what the listing now requires (it was updated significantly in 2017):
Applicants who are unable to follow directions to the extent that they cannot undergo IQ testing can qualify for benefits under this listing if they can show they are dependent upon others for personal needs (for example, dressing, bathing, or eating).
Intellectual disabilities can also result from traumatic brain injuries or degenerative diseases like Alzheimer’s or multiple sclerosis. Those whose cognitive deficits appeared after age 22 would be evaluated under the listing for neurocognitive disorders.
You or your doctor should submit the results of any psychological testing, detailed doctors' reports that discuss mental limitations and any physical impairments, a description of any jobs held in the past and results from IQ tests.
With regards to IQ tests, the SSA is specific about what type of tests it will consider, how the tests should be administered, who may administer the tests, and what additional information must be provided with test scores. If the SSA questions whether or not an applicant's IQ test results are accurate, it could have the applicant take an IQ test given by one of its doctors.
For people who are unable to take an IQ test, the SSA will need records from caregivers that detail the level of care the individual needs. If the individual is cared for at home, the caregiver should provide evidence of the assistance given to the individual. This can include prescriptions for specialized medical equipment, information about the applicant's participation in specialized therapy, and a description of the caregiver's role in the applicant's daily life.
In addition, the applicant will need to show the SSA that the intellectual disability began during the developmental years, before 22 years old. The SSA will look at whether the applicant was enrolled in an individual educational program (IEP) or special education classes, and will look at any other relevant records from elementary, middle, or high school to make this determination. School records can be requested by filling out a simple form provided to you by the school district.
If the applicant also suffers from physical conditions that, combined with low IQ, prevent the individual from working, the SSA will also need medical records that describe the physical impairment and how it interferes with the individual's ability to work. Examples of the records needed are MRI reports, x-rays, lab results, doctors’ reports, and medication lists.
If your IQ does not meet the listing requirements for automatic approval under intellectual disorder, you could possibly still qualify for disability benefits if your IQ is close to those discussed above. However, the SSA often finds that most people can do simple repetitive tasks even with a lower than average IQ, so you may need to prove to the SSA that you have other significant impairments that combined with your IQ prevent you from working. Note that disability benefits are rarely granted on the basis of IQ to those with IQs above 84.
If your IQ is borderline, the SSA will require you to undergo a mental residual function capacity assessment (MRFC). An MRFC examines your mental and emotional ability to do simple, unskilled jobs. Some work-related functions that the SSA will consider are how well you get along with others, whether you can follow simple instructions, whether you are able to accept direction from authority, whether you are reliable, and how your IQ affects your ability to focus on your job and complete it is a timely fashion.
The SSA will then consider the MRFC prepared by your doctor or the SSA doctor to determine whether you can do unskilled work. If you cannot, you will be granted disability benefits.
]]>While children's Social Security cases are generally harder to win than adult cases, disability benefits are available for children under 18 who suffer from serious physical or mental impairments. A child who has been diagnosed with a learning disability will be eligible for benefits if he or she suffers from certain "marked" (severe) or "extreme" functional limitations that are expected to last at least a year.
Children with learning disabilities typically struggle to keep pace academically with their peers. They may require more time to learn new concepts and acquire new skills. It is not uncommon for children with learning disabilities to score well below average on standardized tests. If a child's learning disabilities are severely limiting the child's ability to learn, complete tasks, and interact with others, Social Security may recognize that child as having a disability. But only the most severely affected children can expect to be granted disability benefits.
A significant fraction of children with learning disabilities have also been diagnosed with a psychiatric disorder such as Attention Deficit Hyperactivity Disorder (ADHD) or a speech disorder. For those children with more than one diagnosis, Social Security will consider the combination of all their impairments in deciding whether to approve or deny their claim for benefits.
Social Security will award disability benefits for a child with a specific learning disorder—or borderline intellectual functioning—if that child meets the requirements of Blue Book Listing 112.11 for neurodevelopmental disorders. This listing used to be only for ADHD, but in 2017, Social Security expanded it to include learning disabilities and tic disorders. Under this listing, a child must have medical documentation showing one of the following:
In addition to meeting one of these three sets of symptoms, the child must experience either an "extreme" limitation in one of the following areas or a "marked" (severe) limitation in two of the following areas:
A "marked" limitation, according to Social Security's regulations, is one that seriously interferes with a child's ability to start or finish activities. It is a "more than moderate, but less than extreme" limitation. "Extreme" limitations are defined as interfering "very seriously" with a child's ability to independently start or finish activities.
The most persuasive evidence to show the severity of a learning disability will be the child's IQ scores, grades, and reports from teachers, counselors, and physicians. For children enrolled in special education classes, obtaining the child's Individualized Education Program (IEP) is also helpful in presenting a fuller picture of the child's level of impairment. (And note that a Social Security regulation (SSR 09-2p) specifically provides that children in special education who achieve good grades or reach the goals set out in their IEP plan may still qualify for disability benefits.)
In cases involving learning disabilities, Social Security is particularly interested in the opinions of medical professionals, primarily psychiatrists and psychologists, about the child's level of functioning. It is often helpful to request that the medical professional fill out a Residual Functional Capacity (RFC) form or write a letter to send to Social Security. The psychiatrist or psychologist should state the child's diagnosis and answer questions including the following:
The more the doctor explains his or her responses, the more likely Social Security is to agree with the conclusions reached.
Letters from teachers, counselors, and even parents can be helpful if they focus on the person's observations and experiences with the child. It is best for these folks to avoid in-depth discussions of the child's medical issues, or any opinion regarding whether the child is "disabled." Social Security generally deems those topics to be beyond the expertise of school employees and parents.
To further aid Social Security in assessing the severity of the child's learning disability, the agency will usually schedule an appointment for the child to undergo a consultative examination (CE) with one of Social Security's doctors. These exams are extremely important and should not be missed. Social Security will often, but not always, give great weight to the opinions of its consulting doctor.
Under Social Security regulations, a child with a learning disability may also qualify for benefits based on a low IQ score. A valid verbal, performance, or full-scale IQ test of 59 or below will qualify a child for benefits. If a child scores from 60 to 70 on such a test, he or she will likely be found disabled if there is an additional physical or mental impairment that significantly limits the child's functioning. For more information, see Nolo's article on disability and low IQ.
Note that children who apply for benefits based on their own disability are eligible only for Supplemental Security Income (SSI), not Social Security Disability Insurance (SSDI). Because SSI, unlike SSDI, is a needs-based program, Social Security will take the child’s household income into account in determining whether the child is eligible for benefits. If the combined income of the child and the parents residing with the child exceeds Social Security's threshold, the child will not receive benefits, regardless of the severity of his or her learning disability.
]]>A traumatic brain injury (TBI) occurs when a sudden blow to the head causes damage to the brain, often in the form of internal bleeding, bruising, or swelling. The most common triggers of TBIs include traffic accidents, falls, assaults, and sports injuries. Many soldiers returning from Iraq and Afghanistan have suffered TBIs, often due to roadside bombs known as IEDs. (Also see Nolo's article on getting VA disability compensation for TBIs.)
In all, about 1.5 million people a year experience a TBI in the United States, with children, teenagers, and military personnel having more than their share of TBIs.
TBIs can be classified from mild to severe. A "mild" TBI, also called a concussion, occurs when a person suffers confusion or loss of consciousness for less than thirty minutes. Despite being classified as "mild," they're frequently accompanied by serious cognitive impairments such as memory loss, headaches, dizziness, and fatigue. Mild TBIs account for 80% of all brain injuries.
"Severe" brain injuries are those that cause loss of consciousness for more than 30 minutes, along with cognitive impairments such as speech and language abnormalities, poor abstract thinking skills, and loss of motor function. Those who have sustained a TBI often experience related symptoms for months or even years afterward, including sleep disturbances, persistent headaches, poor memory, shortened attention span, and depression.
The presence and severity of a TBI may be diagnosed with MRIs and CAT scans, although many mild TBIs will not appear on neuroimaging. For this reason, neuropsychological testing may be performed to assess the extent of any cognitive deficits.
In late 2016, Social Security added a new disability listing for TBI under neurological disorders (listing 11.18). Previously, Social Security evaluated traumatic brain injury under disability listings for other types of medical conditions: stroke, epilepsy, or organic mental disorders (also known as neurocognitive disorders).
If you suffered a TBI but don't have lasting physical problems, your condition will still be evaluated under another listing: listing 12.02 for neurocognitive disorders. Note that a drop in I.Q. of at least 15 points that results in serious limitations is no longer a method of qualifying for benefits for cerebral trauma under that listing. (For more information, see our article on getting disability for a neurocognitive disorder.)
In its listing, Social Security considers TBI to be brain damage caused by a closed head injury, penetration by an object into the brain tissue, or a skull fracture. To qualify for benefits under the listing, your medical records must document that you either:
OR
What does "marked" mean? It can be considered as seriously limiting—worse than moderate, less than extreme. In practice, a mild TBI usually does not qualify a person for benefits based on the listings, but many people who have suffered mild TBIs are approved for disability under a medical-vocational allowance.
If you don't meet the TBI listing, Social Security will measure your residual functional capacity (RFC) to determine whether you can do your current job despite your physical and mental limitations. Your RFC is a description of your maximum work-related capabilities and your limitations.
If your current (or most recent) job is too mentally or physically taxing given your limitations, Social Security will use your age, education, work history, and RFC to determine whether other, less mentally or physically demanding jobs exist that you can perform. If Social Security agrees that your RFC doesn't allow for any gainful employment, you'll receive a "medical-vocational allowance."
It is crucial that you provide documentation of all your medical treatment and functional limitations arising from your TBI so that Social Security can accurately assess your condition. This may include:
If you suffer from impairments other than a TBI, such as depression, PTSD, or anxiety, be sure to submit documentation for those conditions as well. Social Security will consider the total effect of all your impairments on your ability to work. The more evidence you can provide about your limitations, the better your chances of getting approved.
]]>Unlike many impairments that qualify someone for Social Security disability, dyslexia tends to have a less devastating effect on a claimant’s ability to live and be successful in the working world. A dyslexia sufferer’s ability to make use of adaptive methods to minimize the effect of his or her impairment makes a Social Security disability argument nearly impossible to make. This is because dyslexia generally does not prevent individuals from seeking and keeping gainful employment, even when reading and writing are daily requirements. Many successful individuals are dyslexic, and several notable historical figures are popularly believed to have been afflicted with the disorder.
The Social Security Administration (SSA) did not historically consider dyslexia severe enough a disability to fall under its strict “Blue Book” guidelines. (The Blue Book is a listing of impairments that qualify for disability benefits when they are severe.) In 2017, however, Social Security added learning disabilities to the Blue Book.
For adults with dyslexia, the SSA added a brand new listing, listing 12.11, for all “neurodevelopmental disorders.” This includes learning disabilities such as dyslexia and dyscalculia, ADHD/ADD, and tic disorders such as Tourette’s syndrome. For children with dyslexia, the SSA added criteria for learning disabilities and tic disorders onto its listing for ADHD, listing 112.11.
The listing criteria for dyslexia for both children and adults are the same. First, the adult or child applicant must have significant difficulties learning and using academic skills. A moderate or severe form of dyslexia or illiteracy would likely fulfill this requirement.
Next, the applicant must be able to show that the dyslexia causes an "extreme" limitation in one of the following areas or a "marked" limitation in two of the following areas:
If you are an adult and Social Security finds that your dyslexia doesn’t cause serious enough limitations to meet the above listing criteria, the agency will move on to see if your dyslexia is severe enough to prevent you from performing even unskilled work. When it reviews any impairment, the SSA takes into account the severity of the disorder and the degree to which it impacts your ability to work. To be approved for benefits, you would have to show that your dyslexia prevents you from doing even unskilled work that doesn't require reading or writing, such as hand-packing or dish-washing. Since dyslexia doesn't prevent this type of unskilled work, dyslexia alone isn’t likely to qualify you for disability benefits.
The vast majority of claimants who suffer from dyslexia do not see their lives seriously limited by the disorder. Most people with dyslexia do not have difficulty in most social situations or a lower-than-average IQ, and those with dyslexia often excel in other areas not affected by the disorder. While dyslexia sufferers may experience some difficulty with language, they generally do not experience difficulties in other ordinary tasks. In short, it is difficult to prove a high level of impairment for dyslexia because sufferers are usually employable, unless they also have some type of physical impairment.
Even if you have a complete inability to read and write due to dyslexia, the SSA will consider you able to work unless you suffer from a physical impairment as well. In some cases, such as where the claimant is illiterate, older (over 45 or 50), and limited to sedentary or light work, the claimant might be considered disabled and be approved for disability benefits.
The SSA recognizes that while dyslexia is a serious learning disability responsible for hardship and frustration, most dyslexia sufferers can still live ordinary lives and be gainfully employed on a continual basis. As such, disability benefits are not suitable for the overwhelming majority of dyslexia claimants, and the unwritten rule is that dyslexia does not rise to the level of severity required to qualify for SSDI or SSI.
If your symptoms of dementia will prevent you from working for 12 months or more, you may qualify for Social Security Disability (SSD/SSDI) or Supplemental Security Income (SSI) benefits. You can apply for SSDI benefits if you are not currently receiving retirement benefits. Once you reach full retirement age (at either 65, 66, or 67 years of age, depending on the year you were born), your SSDI benefits automatically change to retirement benefits.
The Social Security Administration (SSA) will find you disabled if you meet the requirements of an official disability "listing" in the SSA's listing of impairments, or if your disability has reduced your functioning so much that you can't do your past work or other work. Meeting the requirements of a disability listing is the simplest and quickest way to qualify for disability benefits.
The listing most commonly associated with dementia is disability listing 12.02, neurocognitive disorders. This listing was updated significantly in 2017 (it used to be the listing for organic mental disorders, and the criteria were fairly different). To meet this listing today, you need medical evidence showing that your abilities have significantly declined in one or more of the following areas:
If your records show that you have a significant decline in one of the above areas, the SSA will look to see whether your functioning is severely limited by this decline. Specifically, you must have either an extreme limitation in one of the following areas or a “marked” (more than moderate) limitation in two of the following areas:
You will need medical evidence documenting these factors in order to meet or equal the requirements of this disability listing. The SSA may want to see the results of psychological testing, neuropsychological testing (testing that examines cognitive functioning), intelligence testing, repeated medical visits with clinical testing, and evidence of any hospitalizations.
If your mental condition does not meet or equal a disability listing, the SSA will assess your "residual functional capacity" (RFC) based on all of the evidence you have submitted. Your RFC is the limit of what you can physically and mentally do while working a 40-hour work week.
Physically, you might be limited to sedentary, light, or medium work. Mentally, you might be limited to simple, semi-skilled, or skilled positions. Dementia patients will likely have poor memory and attention skills, so your doctor might limit you to simple, unskilled work. If your cognitive skills have significantly declined, you might be unable to perform any work and be found disabled merely on this basis alone. Similarly, you might suffer from personality changes that affect your ability to work with others. In this scenario, you might be restricted from jobs requiring close contact with the public, co-workers, or supervisors.
In addition, if you are currently taking any medication for treatment of dementia, these drugs could cause side effects including drowsiness or fatigue. The SSA has explained in its Social Security Rulings that fatigue may limit your ability to perform physical demands. If you suffer from fatigue, you might be restricted to only sedentary or light work.
First the SSA will use your RFC assessment to determine whether you can perform your past work. If you cannot, the SSA will use your RFC plus your age, education level, and work skills to see if you can do any jobs in the national economy. The SSA will use its Medical-Vocational Guidelines, which are often illustrated as a grid showing what age, education, and skill groups are deemed disabled at each RFC level. The med-voc grid shows that if you are over age 50, it is more likely that the SSA will find you cannot perform any jobs and will be found disabled. For more information, see our article on getting disability through the medical-vocational guidelines.
When determining your RFC, the SSA will generally place the most weight on your treating doctors' opinions, your medical history, and any psychological or neuropsychological testing. But the SSA will also consider statements given by third persons such as family members and caretakers. These statements are helpful because they give a glimpse into your ability to interact with others, perform daily activities, and concentrate on activities. These statements should contain detailed information on why you cannot perform any work. It is best to have statements from individuals who have known you for a long period of time and who can provide an opinion as to how your daily functioning has declined over at least a one-year period.
In addition, the SSA is also required to consider any work evaluations and any attempts you have made at performing work. The agency must also review any statements you provide about your own treatment and symptoms.
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