Mental Health and Disability Claims: Understanding the Process

Mental health and wellness has been prioritized as the topic of discussion the past serval years in organizations across the country. Workers are catching on that they could qualify for disability benefits if their mental health conditions significantly limit their ability to work on a daily basis.

Social Security Disability (SSD) delivers financial assistance to individuals who are unable to work due to their disability. Administered by the Social Security Administration (SSA), the program supports people who have worked in jobs covered by Social Security and who have paid into the system through payroll taxes. SSD benefits are now available for both physical and mental health conditions.

The SSA has strict policies, deeming mental health conditions as disabilities if they prevent you from engaging in “substantial gainful activity” (SGA), or a certain level of work activity and income. Although disabilities are often associated with physical impairments, there is now a list of those mental illnesses that qualify applications to receive Social Security Disability Insurance (SSDI). However, it is much more challenging to evaluate these symptoms since they are not easily identified substantially. Each person exemplifies various conditions that define what’s sufficiently inhibiting, therefore it’s much harder to determine mental illness disorders.

Evaluating Mental Health Disabilities

The SSA follows a rigorous process for claiming a disability due to mental health issues can be extremely complex, often involving the navigation of significant hurdles. The majority of mental health symptoms can’t be measured by tests or other standard medical methodologies, to which SSA doctors are trained to evaluate these standards based on.

Mental health claims are frequently met with skepticism and bias from disability examiners and judges, who don’t take mental illness as seriously as they should. Although mental health cases can be difficult to win, around 34.6% of people who receive benefits receive them for a mental health disorder of some kind.

Mental disorders are arranged in the following 11 categories:

1. Neurocognitive disorders
2. Schizophrenia spectrum and other psychotic disorders
3. Depressive, bipolar and related disorders
4. Intellectual disorder
5. Anxiety and obsessive-compulsive disorders
6. Somatic symptom and related disorders
7. Personality and impulse-control disorders
8. Autism spectrum disorder
9. Neurodevelopmental disorders
10. Eating disorders
11. Trauma- and stressor-related disorders

Proving Your Mental Health Disability

It’s vital to show the government you have a medical condition that makes it impossible to work in order to get approved for disability benefits. You’ll also want to demonstrate that you’re getting medical treatment for your condition by keeping your medical documentation, a record of all your treatments, and evidence of any functional limitations. The SSA will need proof of:

• The Severity of the Condition. First, the SSA determines if your mental health condition is severe enough to cause significant limitations in your ability to perform simple work activities, such as remembering or understanding instructions, responding appropriately to work situations, or maintaining attention and concentration.
• Listing of Impairments. The SSA outlines a “Listing of Impairments” determining specific mental health conditions to qualify an individual for benefits. Next, the SSA assess whether your condition meets the severity required for disability benefits.
• Functional Limitations. Don’t see your condition on the list? There is a possibility you are still eligible if your mental health disorder has major limitations to functioning in everyday life. The SSA carefully reviews how you understand and apply information, interact with others, concentrate or maintain pace, and adapt to your work setting.
• Residual Functional Capacity (RFC). The SSA will evaluate your Residual Functional Capacity (RFC) if your disability doesn’t meet the SSA’s specific criteria of impairments.   RFC measures your ability to do work-related activities despite your disability. The SSA often looks at factors like whether you can perform tasks like following instructions, managing time, or interacting with coworkers to determine your mental health disorder.
• Work History and Skills. Your work history is heavily looked at as well as whether there is any work you can do despite your condition. If your mental health disorder limits your ability to work, but there are still jobs you could perform in the national economy, the SSA explains you may not qualify for benefits.

To increase your chance for successfully qualifying for your mental health disability for benefits, make sure you get as much medical treatment so that your doctors have confirmation of your medical care based on their notes on your health battle. This includes any prescribed medication.

You should also ask your doctor to fill out a “mental residual functional capacity” (MRFC) form. This form outlines what types of tasks you can and cannot do, which only takes your psychologist or psychiatrist about an hour to fill out. It is one of the most helpful things you can do for your case.

The SSA also evaluates if you have been seeing the proper providers, such as counselors, therapists, and psychiatrists to document your illness. Be ready to explain why you saw the provider you did.

Start keeping notes on how you feel, steps you are taking for treatment, doctors you’ve seen, etc. That way when you go to apply for your disability you will already have a log of all the information needed to complete your application. Be as specific as possible with the details of your records.

Using a disability lawyer like Lowery Law Group, most likely increases your chances of winning your disability case. We can help ease the stress in the application process and outline the proper medical records needed for your case