Does My Mental Illness Qualify for Social Security?

how to qualify for mental disability

Mental Disabilities / March 17, 2022

The majority of people who apply for disability for a mental illness or emotional condition are granted benefits.

About a quarter of applicants for Social Security disability list mental illnesses or disorders as their primary impairment. Depression (including bi-polar disorder) and anxiety disorders make up the majority of these claims. In addition, applicants make disability claims based on intellectual disability, dementia, schizophrenia, autism, and learning disabilities. While these claims can be difficult to win, you are more likely to be approved if you learn how the Social Security Administration (SSA) reviews these types of claims and understand the evidence needed to support your claim. While almost half of all mental disability claims are denied at the initial application stage, 75% are eventually approved after appeal.

How Social Security Evaluates Mental Illness Claims

Social Security will review your medical records to see if your mental illness meets the criteria of one of the mental illness listings in its "Listing of Impairments." The listings contain an entire section devoted to what the SSA describes as “Mental Disorders, ” which was updated extensively in January of 2017.

Mental Disorders Listing

Here are the some conditions included under the Mental Disorders listing:

Each category of conditions has a specific set of requirements that must be met. Not only must you have a diagnosis of a certain illness, you must show that the illness causes functional limitations that prevent you from working (discussed more below).

The listing criteria are fairly complicated; you should speak with your treating psychiatrist, psychologist, or therapist to determine whether you may qualify under a mental disorder listing.

If You Don’t Meet a Listing

If your condition doesn’t meet the listing requirements for you condition, the SSA will look at your symptoms to determine your "mental residual functional capacity" (MRFC). Your MRFC is the most you can do despite the mental (or emotional) limitations you have. If the SSA decides you don’t have the MRFC to work on a regular and sustained basis, full time, you will be approved for benefits; otherwise you will be denied.

To determine what type of mental capacity you have, Social Security will look at your medical records and any opinions submitted by your psychiatrist or psychologist. You should have a doctor who specializes in mental conditions prepare an MRFC report for you. It is very hard to win a claim based on a mental condition without the support of a psychiatrist or licensed psychologist, and without a detailed report from the psychiatrist or psychologist about your mental limitations and how they limit you.

Social Security will look to see the extent of any limitations you have in the following areas:

  • your ability to understand and remember information
  • your ability to follow directions and control your behavior
  • your ability to get along with others)
  • your ability to tolerate stress
  • your ability to concentrate, complete tasks, and get work done in an appropriate amount of time
  • your ability to adapt to changes, and
  • your activities of daily living (paying bills, grocery shopping, bathing, and so on)

The more limitations your mental condition causes, or more severe your limitations are, the more likely you are to get approved for benefits. (To learn specifically what types of limitations qualify you for disability, read Nolo's article about getting disability when you can't do a simple, unskilled job.)

If you have hired a disability attorney, he or she will make sure that your doctor has a MRFC form and that it is completed properly and submitted to the SSA on time.

Whether You Are Working

Social Security will look at whether you are working, and if so, how much. Social Security can grant you disability benefits if you are unable to work at or over the "substantial gainful activity" level (called SGA) for at least one year. (For 2017, SGA is defined as earning $1, 170 a month from working.) But if you are earning more than that, Social Security will deny your claim without even looking at your medical records.

Medical Records for a Mental Disability

All disability claims are decided almost solely on the content of the applicant's medical records. Make sure you include all medical records from providers that gave you care based on the condition. For example:

  • records from psychiatrists, psychologist, therapists, counselors, or social workers
  • records from hospitalizations or emergency room visits that were the result of your condition, and
  • pharmacy records (that detail your prescriptions related to your condition).

Do not include irrelevant records from providers who didn’t treat you for your mental condition (such as chiropractors or podiatrists.)

Subjective Evidence

Subjective evidence is a large part of mental illness, which is why these disability claims can be difficult to win. Subjective evidence is based on a person’s individual experience; it cannot be documented by testing procedures or other clinical methods. This is why it can be extremely helpful to provide the SSA with a detailed description of how your life is impacted by your mental illness. Make sure that you speak openly and honestly with your doctors and caregivers as well, so that your records accurately reflect what you are experiencing. You may also consider having a close friend or former co-worker or supervisor write a letter that describes the effects of your mental illness on you. However, letters should be used sparingly. An experienced disability attorney will be able to help you decide if a letter written on your behalf would be helpful to your case.

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