What You Should Know About SSDI Claims for Serious Mental Disorders

Is a serious mental illness preventing you—or someone you love—from working and achieving substantial gainful employment (SGA)? You may be eligible for Social Security Disability Insurance (SSDI) benefits.

SSDI claims for mental disorders are surprisingly common. In fact, roughly a quarter of applicants list mental health conditions, such as anxiety and mood disorders, as their primary impairment.

Unfortunately, SSDI claims involving mental illnesses can be even more complex than those involving physical disabilities. As a result, mental health claims are often denied. Keep reading to find out why—and how working with an accomplished New York Social Security disability attorney when preparing and filing your application can increase your chances of approval.

Mental Disorders Listed in the Social Security Administration Blue Book

Also known as the Listing of Impairments, the SSA Blue Book lists disabling conditions that may qualify individuals for benefits. The Blue Book includes 11 categories of potentially qualifying mental disorders:

• Neurocognitive disorders
• Schizophrenia spectrum and other psychotic disorders
• Depressive, bipolar, and related disorders
• Intellectual disorders (formerly listed as mental retardation)
• Anxiety and obsessive-compulsive disorders
• Somatic symptom and related disorders
• Personality and impulse-control disorders
• Autism spectrum disorder
• Neurodevelopmental disorders
• Eating disorders
• Trauma- and stressor-related disorders

Qualifying for SSDI With a Mental Illness

Generally, in order to be eligible for SSDI benefits, you must have:

• Worked in jobs covered by Social Security long enough to have amassed sufficient work credits
• Been diagnosed with a medical condition that meets the SSA’s stringent definition of disability
• Have a disability that’s expected to last for at least a year or result in death
• Be unable to do the work you did before
• Be unable to adjust to other work due to your disabling condition

However, when applying for SSDI benefits for a mental disorder, you’ll need to provide evidence that your illness causes severe functional limitations that prevent you from working. Each of the mental health conditions listed in the Blue Book has its own evaluation criteria. For example, in order to gain approval for psychiatric and mood disorders, you must be completely unable to function outside of a supportive environment despite two years of treatment or have sufficient evidence showing that your condition prevents you from being reasonably expected to function in a work environment.

Even if you don’t meet a Blue Book mental health listing, you may still qualify for benefits if you can show that your mental disability causes insurmountable limitations. Completing a mental residual functional capacity (MRFC) form with your doctor can help the SSA evaluate your ability to:

• Understand and remember information
• Follow directions
• Control your behavior
• Get along with others
• Tolerate stress
• Concentrate, complete tasks, and get work done in a timely manner
• Adapt to changes
• Maintain good personal hygiene, pay bills, shop for groceries, and complete other activities of daily living

Common Reasons Why SSDI Mental Disability Claims Are Denied

Avoid a denial by carefully reviewing your SSDI application before submitting it. Here are some of the most frequent reasons mental health claims are denied:

• Lack of a specific diagnosis by a specialist. Specific diagnoses made by mental health specialists carry more weight than diagnoses and recommendations made by general practitioners.
• Inadequate treatment history. SSA examiners will evaluate your medical records and treatment history when determining your eligibility for benefits. If you’ve never received treatment or your records show inconsistent treatment, your claim could be denied.
• Insufficient supporting evidence. Mental illnesses can be subjective and, unlike physical illnesses, they can’t be proven with x-rays or other diagnostic tools. As a result, SSDI claims involving mental disorders require careful and thoroughly documented diagnoses and treatment.
• Non-compliance with doctor-recommended treatment. SSDI benefits may be available for applicants with mental disorders so severe that they can’t be successfully managed by treatment. Not only will you have to prove that you’ve received treatment for your mental illness, but you’ll also need to show that you’ve complied with your doctor’s recommendations.

Let Us Handle Your SSDI Claim From Start to Finish

At O’Connor Law PLLC, our Social Security disability attorneys help individuals with severe mental illnesses obtain the benefits they deserve. Contact us today to schedule an appointment for a complimentary consultation.