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Midwest Disability Specialists

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Mental Health and Social Security Disability Benefits

Updated: Apr 13


Mental Health and Social Security Benefit Qualifying Conditions

If you or someone you know struggles with mental health issues, the good news is that this may not necessarily be visible, or obvious to others around them. However, mental health challenges can be huge, and these illnesses must be treated on par with physical health challenges.  That being said, it is extremely useful to know that you can qualify for Social Security Disability (SSD) benefits in the United States based on mental health issues. The Social Security Administration (SSA) recognizes various mental disorders as potentially disabling conditions, provided they are severe enough to prevent you from performing substantial gainful activity.


Here is how the process generally works:


Listing of Impairments


The SSA’s “Blue Book” contains a Listing of Impairments, which includes specific criteria for many physical and mental conditions. For mental disorders, the listings are in Section 12. Some examples of covered conditions include:


  • Schizophrenia, paranoid and other psychotic disorders

  • Depressive, bipolar, and related disorders

  • Intellectual disorder

  • Anxiety and obsessive-compulsive disorders

  • Personality and impulse-control disorders

  • Autism spectrum disorder

  • Neurocognitive disorders

  • Eating disorders

  • Trauma- and stressor-related disorders (for example, post-traumatic stress disorder)


Severity and Duration

To qualify, your condition must have lasted or be expected to last for at least 12 months, or it must be expected to result in death. Furthermore, it must be severe enough to prevent you from performing any substantial gainful activity.


Medical Evidence

You will need to provide detailed medical evidence of your mental health condition, including:


  • Medical history

  • Clinical findings (like results from physical or mental status examinations)

  • Laboratory findings

  • Treatment prescribed and your response to it

  • Statements about how your condition limits your activities


Residual Functional Capacity (RFC)

If your condition does not meet the exact criteria in the Blue Book, the SSA will assess your “residual functional capacity” (RFC). This evaluates what activities you can still do despite your limitations. Examples of things that will be considered for mental disorders will typically be your ability to: understand, remember, and apply information;  interact with others; concentrate and complete tasks; and adapt to changes.


Consideration of Work History and Skills 

The SSA will also consider whether you can do any of your past work based on your RFC. If they determine you are unable to do so, they will consider if there are any other jobs in the national economy you can perform.


Consistency

The SSA will assess the consistency of your reported symptoms and limitations with the medical evidence and other evidence in your case record.


The Importance of Treatment

Regular treatment is vital not just for the well-being of the individual, but it also provides a record of the condition over time. If someone is not seeking treatment or is non-compliant with prescribed treatments, the SSA may question the severity of the condition.


Rejection and Appeals

Many SSD claims, including those based on mental health conditions, are initially denied. If rejected, applicants have the right to appeal the decision. Many applicants find success during the appeals process, especially when represented by legal counsel familiar with SSD claims.


Regular Reviews

If someone is approved for SSD based on a mental health condition, their case will likely be reviewed periodically to ensure they still qualify. The frequency of these reviews depends on the expected duration and improvement potential of the condition.


The bottom line is that mental health can be a qualifying medical condition that qualifies for Social Security Benefits.


Contact Midwest Disability Specialists for a free case evaluation today!


Remember, the process for obtaining SSD benefits can be complex, and many claims are initially denied. It would be extremely helpful to consult with a disability specialist if you are considering applying for social security disability benefits for a mental health condition. Midwest Disability Specialists can help guide you through the application process, gather necessary medical evidence, and represent you if your claim goes to a hearing.




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