SSDI is a program designed to provide financial assistance to individuals with medical conditions that prevent them from working. While many people associate SSDI with physical disabilities, mental health conditions such as depression, anxiety, PTSD, and schizophrenia, can impact an individual’s ability to maintain employment and be eligible for SSDI. In this blog, we will cover how mental health conditions affect SSDI eligibility, outlining the criteria that must be met, the evaluation process by the Social Security Administration (SSA), and the importance of medical evidence in successfully securing benefits.
SSDI Eligibility Criteria
In order to qualify for SSDI in general, certain criteria must be met:
- Work Credits: Work Credits are earned through a person’s employment history and the amount of Social Security taxes paid. You earn one work credit for every quarter you work, up to a maximum of four credits per year. Most applicants need a minimum of 40 work credits, with at least 20 of those earned in the last 10 years before the disability began.
- Age: Applicants must be at least 18 years old.
- Unable to Participate in Substantial Gainful Activity (SGA): Applicants must prove that their disability prevents them from participating in any SGA. The SSA defines SGA as earning more than a specified monthly income that fluctuates each year.
Read More: 10 Most Common Qualifying SSDI Conditions
Mental Health Conditions Can Qualify for SSDI
The main criteria for mental health claims for SSDI is that they impact the individual’s ability to work. Here are a few common mental health conditions that can qualify for SSDI and their potential impacts:
- Depression: Severe depression can impact daily life with persistent sadness, loss of interest in activities, difficulty concentrating, and fatigue.
- Anxiety Disorders: Conditions like generalized anxiety disorder and panic disorder may prevent individuals from participating in social situations or managing work stress.
- Bipolar Disorder: Bipolar disorder can come with extreme mood swings, including manic and depressive episodes. This can disrupt a person’s ability to work consistently.
- Post-Traumatic Stress Disorder (PTSD): PTSD symptoms, such as intrusive memories, severe anxiety, and avoidance behavior, can severely limit an individual’s functioning.
- Schizophrenia: Individuals with schizophrenia may experience hallucinations and disorganized thinking, making it challenging to perform job-related tasks.
Learn More: Can You Qualify For SSDI With Depression or Bipolar Disorder?
How the SSA Evaluates Mental Health Claims
The Social Security Administration follows the criteria outlined in its “Blue Book”, which is a guide for determining SSDI eligibility. Here are the key factors the SSA considers for mental health conditions:
- Severity: The condition must significantly impair the individual’s ability to function socially, academically, or occupationally.
- Duration: The impairment must last for at least 12 months. This ensures that temporary issues do not qualify for SSDI benefits.
- Functional Limitations: How the condition affects daily life including cognitive functioning, social interactions, and daily activities.
Challenges in Getting SSDI for Mental Health Conditions
It can be particularly challenging to get SSDI for mental health conditions since they require more detailed evidence than physical disabilities where you can see the severity. One of the common reasons that SSDI claims regarding mental health conditions gets denied is lack of sufficient medical documentation. The SSA requires detailed documentation such as treatments, therapy notes, and test results to determine the severity of the condition. Without sufficient medical evidence, it may be determined the condition isn’t severe enough for SSDI. Another reason why they might get denied is due to not being able to show long-term impact. Applicants must show how their condition will continually affect their ability to work for a long period of time. If the SSA cannot see clear evidence of long-term impairment, the claim may be denied.
Seek Legal Help to Improve Your Chances
Navigating the SSDI claims process can be overwhelming, especially when dealing with mental health conditions. Making sure you have sufficient medical evidence and proof of a long-term condition is key for a successful claim.
If you are looking to file an SSDI claim for a mental health condition, expert legal guidance can make all the difference in ensuring your claim is as strong as possible. If you’re considering applying for SSDI or have been denied, they can work with you, and your doctor, to present the strongest possible case. Schedule a free case review with the trusted experts at Tabak Law.
Nothing posted on this website is intended, nor should be construed, as legal advice. Blog postings and site content are available for general education purposes only.