You may qualify for Social
Security Disability or Supplemental Security Income (SSI)
benefits if you suffer from a mental illness or psychiatric
disorder such as anxiety, depression, panic attacks,
agoraphobia, schizophrenia, bipolar disorder (manic -
depressive illness), post-traumatic stress disorder (PTSD)
or a personality disorder.
Social Security Disability or
SSI claimants usually qualify for benefits because their
mental impairments are severe enough to meet or equal the
level of severity that Social Security has listed for that
mental disorder.
The Multi-Part Requirements
of Psychiatric Listings
There are
several listings for mental illness. The listings
typically are divided into 2 or 3 parts called Parts
A, B, and C. Depending on the listing, you will
have to meet one or two of the listing's parts for your
psychiatric condition to be severe enough to qualify you for
Social Security Disability or SSI .
The following is
a general description of each of these three parts:
Part A usually requires that
you tend to act in certain ways or exhibit a number of
symptoms.
Part B
usually requires that your mental illness causes at
least two of the following conditions:
(1)
You have marked limitations in your Activities
of Daily Living.
These
activities include cleaning,
shopping, cooking, taking the bus or other
public transportation, paying bills, maintaining
a home, grooming yourself, and maintaining good
hygiene.
Marked
limitations means that you have difficulty
performing these activities (1) without direct
supervision, (2) or in a suitable manner, (3) or
in a consistent, useful, and routine basis, (4)
or without undue interruptions or distractions.
(2)
You have marked limitations in Social Functioning.
Social
functioning includes the ability to get along
with relatives, friends, co-workers,
supervisors, neighbors, grocery clerks,
landlords, bus drivers and other people you
interact with often.
Marked
limitations means
that most of the time you cannot interact
independently, appropriately, and effectively
with these people. Difficulties in
social functioning include a history of
altercations and firings, a fear of strangers,
and a tendency to isolate yourself in your home
or your room.
(3)
You have marked limitations in Concentration,
Persistence, or Pace.
Concentration,
persistence and pace is the
ability to pay attention long enough to do tasks
appropriately and on time, including tasks
commonly found in work settings.
Mental
status examinations are performed by psychiatrists
or psychologists to assess concentration.
These examinations involve such tasks as
counting backwards by 3's or 7's, keeping things
in short-term memory, and completing tasks
within certain time limits.
Marked
limitations means that you cannot complete
simple tasks accurately and consistently (1)
without extra help or supervision, (2) without
too many rest periods, or (3) without too many
interruptions or distractions.
(4)
You have repeated episodes of Decompensation.
Decompensation
means that your anxiety, stress, depression or
other mental condition causes you for a period
of time to lose your ability to perform your
normal activities of daily living, to get along
normally with people, or to maintain normal
concentration, persistence, or pace.
Repeated
means 3 episodes within 1 year, or an average of
1 episode every 4 months, with each episode
lasting 2 weeks or more. Repeated may also
mean more frequent but shorter episodes or less
frequent but longer episodes.
Part C usually requires that your
medical records show that your condition has lasted at
least 2 years and has limited your ability to do basic
work activities, and that while treatment has reduced
your symptoms, one of the following is true:
You
have repeated episodes of decompensation lasting for
an extended time.
Even
a
minimal increase in mental demands would cause you
to decompensate.
You have only been able to function in a highly
supportive living arrangement for at least 1 year
and need to continue living in such an arrangement.
Common Psychiatric Disability
Listings
The following is
a simplified discussion of common Social Security Disability
listings for mental disability.
Listing
12.02
Organic Mental Disorders. This listing
deals with psychiatric problems due to physical problems
with the brain. Such problems may be caused by
head injuries, by the permanent effects of alcohol or
drug abuse, or by inhaling toxic fumes. To qualify
for Social Security Disability or SSI, you must either
(1) meet both Parts A and B, or (2) meet Part C.
Part A requires that your
ability to think and/or your behavior has been
affected and that your medical records show at least
one of the following:
You have difficulty
knowing where you are and the date and time.
You have memory
difficulties.
You hear, see or sense
things that are not really there.
Your personality has
changed.
Your mood is disturbed.
Your emotions are up
and down and you have difficulty controlling
your impulses.
You have lost at least
15 points in IQ or your neuropsychological test
scores are in the severely impaired range.
Listing
12.03
Schizophrenic, Paranoid and Other Psychotic Disorders.
Schizophrenia
refers to difficulties
in perceiving or expressing reality.Schizophrenics
may hear or see things that do not exist and may speak
and think in a very mixed up manner. A paranoid
person has delusions that they are being persecuted.He or she thinks
that someone is or wants to harm him or her.
To win Social Security Disability or SSI under
this listing, you must either (1) meet both Parts A and
B, or (2) meet Part C.
Part A requires that your medical
records must show at least one of these problems:
You see things, hear things, or have
other delusions.
You behave in a bizarre way.
You are isolated and/or emotionally
withdrawn from people.
Listing
12.04
Affective Disorders. This listing
covers three conditions:
Persons who suffer from
intense and debilitating feelings of sadness (what
people call "depression").
Persons who suffer from
mania (extreme and unwarranted feelings of
irritability or happiness), often accompanied by
rapidly changing ideas and decreased sleep.
Manic - depressive
(bipolar) persons, who are people that suffer severe
mood swings.
To get Social Security
Disability or SSI under this listing, you must either
(1) meet both Parts A and B, or (2) meet Part C.
Part A requires that your medical
records show one of the following:
(1) Depression with
at least 4 of the following symptoms:
Anhedonia (you are not interested
in doing things because you get no pleasure
from doing things).
Appetite disturbance with weight
change.
Disturbed sleep.
Constant bodily movement or very
little movement at all.
Lack of energy.
You feel guilty
or worthless.
You have difficulty concentrating
or thinking.
Tou think about or even attempt
suicide.
You have hallucinations, delusions,
or paranoid thinking.
(2) Mania with at
least 3 of the following symptoms:
Hyperactivity.
Pressured speech.
Flight of ideas.
Inflated self-esteem.
Decreased need for sleep.
Easy distractibility.
Involving yourself in activities in
which you are likely to get physically
and/or emotionally hurt without realizing
the danger of being hurt.
Hallucinations, delusions, or
paranoid thinking.
(3) Bipolar syndrome with episodes of depression
and mania.
Listing
12.06
Anxiety-Related Disorders. Anxiety refers to
feelings of fear, apprehension, or worry which are often
accompanied by physical sensations such as heart
palpitations, nausea, sweating, trembling, chest pain,
shortness of breath, stomach aches, or headaches.People with
anxiety usually say they suffer from “nerves.”The listing for
anxiety covers such conditions as panic attacks,
agoraphobia (fear of leaving your home), other phobias,
obsessive – compulsive disorders, and post traumatic
stress disorder (PTSD).
To qualify
for Social
Security Disability or SSI under this listing, you must either (1)
meet both Parts A and B, or (2) meet both Parts A and C.
Part A requires that your medical
records must show at least one of these problems:
(1) Generalized
persistent anxiety with 3 of the following:
Motor
tension (you have rigid body language).
Autonomic
hyperactivity (you cannot keep still).
Apprehensive
expectation (you have a feeling that
something bad is about to happen).
Vigilance
and scanning (you are overly watchful).
(2)A
persistent irrational fear of a specific object,
activity, or situation which results in a
compelling desire to avoid the dreaded object,
activity, or situation.
(3)Recurrent
severe panic attacks manifested by a sudden
unpredictable onset of intense apprehension,
fear, terror and sense of impending doom
occurring on the average of at least once a
week.
(4)Recurrent
obsessions or compulsions which are a source of
marked distress.
(5)Recurrent
and intrusive recollections of a traumatic
experience, which are a source of marked
distress.
Part C requires that your
anxiety makes you
completely unable to function by yourself outside of
your home.
Listing 12.08
Personality Disorders. To obain Social
Security Disability or SSI under this listing, you would
need to have a personality that is so inflexible that
you cannot change your behavior and way of thinking
enough to get along in society. To qualify, you
must meet both Parts A and B.
Part A requires that your medical
records must show that your inability to adapt to
society is deeply ingrained and that at least one of
the following is true.
Seclusiveness or autistic thinking (you
think in an extremely self-centered and
disturbed way).
You
are extremely suspicious of or hostile toward
people without any good reason.
The
way you think, perceive things, speak and behave
is extremely odd.
Your
mood and affect (body language and facial
expressions) are persistently disturbed.
When giving an
opinion about a person's ability to function, psychiatrists
and psychologists often give a Global Assessment of
Functioning (GAF) score. To qualify for Social
Security Disability or SSI by meeting a listing for mental
illness, your GAF scores usually have to remain in the range
of 50 or below despite treatment, including counseling and
taking psychiatric medication. You may qualify for
disability with scores in the 51-60 range if you have
frequent episodes of decompensation or periods of time when
your level of functioning is very poor.
Global Assessment of Functioning Table
91-100
Superior
functioning in a wide range of activities, life's
problems never seem to get out of hand, is sought
out by others because of his or her many positive
qualities. No symptoms
81-90
Absent or minimal
symptoms ( e.g., mild anxiety before an exam ), good
functioning in all areas, interested and involved in
a wide range of activities, socially effective,
generally satisfied with life, no more than everyday
problems or concerns ( e.g., an occasional argument
with family members )
71-80
If symptoms are
present, they are transient and expectable reactions
to psychosocial. stressors ( e.g., difficulty
concentrating after family argument ); no more than
slight impairment in social occupational, or school
functioning ( e.g., temporarily falling behind in
schoolwork ).
61-70
Some mild symptoms
( e.g., depressed mood and mild insomnia ) OR some
difficulty in social occupational, or school
functioning ( e.g., occasional truancy or theft
within the household ), but generally functioning
pretty well, has some meaningful interpersonal
relationships.
51-60
Moderate symptoms (
e.g., flat affect and circumstantial speech,
occasional panic attacks ) OR moderate difficulty in
social, occupational, or school functioning ( e.g.,
few friends, conflicts with peers or co-workers ).
41-50
Severe symptoms (
e.g., suicidal ideation, severe obsessional rituals,
frequent shoplifting ) OR any serious impairment in
social, occupational or school functioning ( e,g.,
no friends, unable to keep a job ).
31-40
Some impairment in
reality testing or communication ( e.g., speech is
at times illogical, obscure, or irrelevant ) OR
major impairment in several areas, such as work or
school, family relations, judgment, thinking, or
mood ( e.g., depressed man avoids friends, neglects
family, and is unable to work; child frequently
beats up younger children, is defiant at home, and
is failing at school ).
21-30
Behavior is
considerably influenced by delusions or
hallucinations OR serious impairment in
communication or judgment ( e.g., sometimes
incoherent, acts grossly inappropriately, suicidal
preoccupation ) OR inability to function in almost
all areas ( e.g., stays in bed all day, no job,
home, or friends ).
11-20
Some danger of
hurting self or others ( e .g., suicidal attempts
without clear expectation of death; frequently
violent; manic excitement ) OR occasionally fails to
maintain minimal personal hygiene ( e.g., smears
feces ) OR gross impairment in communication ( e.g.,
largely incoherent or mute ).
1-10
Persistent danger
of severely hurting self or others ( e.g., recurrent
violence ) OR persistent inability to maintain
minimal personal hygiene OR serious suicidal act
with clear expectation of death.
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