Social Security Benefits for Mental Illness
If you are considering applying for Social Security Benefits (SSDI) then you might already know that applying for these benefits can be an uphill battle, even with all your information easily verifiable. If you or someone you love is trying to collect these SSDI benefits based on a mental illness, then you need to know that this uphill battle is about to get a lot tougher. While an SSDI case is already a difficult prospect, winning social security disability benefits for a mental illness is much more difficult. Why is it more difficult? For several reasons:
1) Mental Illness is Much Harder to Document– Due to the very nature of mental illness itself, it can be much harder for healthcare providers — whether they are medical doctors, licensed psychiatrists, or anyone else — to be able to provide clear evidence. Many mental disorders are difficult to note, or hard to pin down into a neat, check-the-box diagnosis, which is typically what the SSA uses to make its determinations on claims. Because of this, someone with a mental illness could be suffering, and yet the doctors who are supposed to make the determination might not be able to tell what extent.
2) Mental Illness can be Sporadic– Another aspect of mental illness that can make it harder to win a benefits case is the fact that mental illnesses do not always present themselves when the timing is convenient. If someone has a hurt back, for example, that back is always giving them problems, and it’s easy to predict when it will be a problem and what type of work will be impeded because of it. With mental illness, however, you don’t have that certainty. It is virtually impossible to predict when the illness will present itself, which means that a healthcare provider does not always see the evidence needed to decide.
To compound this problem, someone whose illness has been documented might go for a long time between episodes. To the SSA, this might mean that person’s illness has been cured. However, with mental illness it is possible to go for months, if not years, without a problem, only to have it resurface when circumstances arise.
3) Mental Illness is not Always Understood– Sadly, some people view many types of mental illness as “fake”. Because they do not understand the illness, they refuse to acknowledge that those who suffer from it are really in distress. Instead, they view them as lazy, or as hypochondriacs who are simply making things up. Even in the SSA, there are people with this viewpoint. This lack of understanding can happen for many reasons, but when applying based on mental illness, the result in a social security disability claim is often the same, denial.
How to Proceed
If, however, you or your loved one are suffering and would like to proceed with your case, then the procedure is very similar to cases involving physical injuries or disabilities.
– Document, Document, Document – As you could tell above, documentation is the key to winning a disability case. This means that you need to be able to compile all relevant medical information, including hospital stays, doctor’s visits, notes, lab results, blood work anything that might help to show evidence of the illness in question. Since we are dealing with a mental condition, extensive notes from a psychiatrist or psychologist will also be necessary. Among these notes, make sure to get a prognosis, stating the physician’s informed opinion about your mental state and future prognosis.
– Check the Blue Book– The SSA has a document, known as the Blue Book, which lists many different impairments that qualify for SSDI benefits. Among these listings are many mental issues as well, including anxiety, depression, schizophrenia, autism, bipolar disorder, and substance abuse. If you find the condition listed in this book, it will also include the criteria that need to be met.
– Learn about SGA– If your condition is not listed in the Blue Book, that doesn’t mean you won’t qualify. The SSA has another determining factor as well, which is called Substantial Gainful Activity, or SGA. The SGA is an income limit determined by the SSA. In 2017, the SGA is $1,170 per month. If your condition prohibits you from being able to earn this minimal amount, then you might still be able to qualify for SSDI benefits.
– Consider Legal Help– At least 70% of applicants are initially turned down for social security disability benefits. Since mental illness can be harder to prove, that number is much higher for cases involving those conditions. If you have not yet, you should seriously consider obtaining legal help from an experienced firm. Legal experts know how to build the strongest possible case, and in the long run, you might find that expert help is vital to success. If you’re considering such a case, please consider contacting us. We are ready to help you win your case.
