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Social Security has a set of disability listings for mental disorders, ranging from depression-related illness, anxiety-related disorders, and psychotic disorders to autism, ADHD and learning disabilities, and mental retardation and low IQ. The disability listings contain criteria that the disorders must meet to be considered disabling. But even if your disorder doesn’t “meet” the listing, if you can prove you can’t do even a simple, unskilled job due to emotional, psychiatric, or brain-related problems, you could get disability benefits.
What To Do After You Submit A Fmla For Stress
Once you submit a request, your human resources department will look at the details, ask clarifying questions, and use any additional information you offer to approve or deny your leave. Your employer has five days from your initial request to decide. If you are denied, the employer must provide at least one reason why.
Your employer may want proof for any medical claims. Without this proof, your request may be denied. Your employer can ask for details such as how long you are expected to be away from work due to the health condition or information about symptoms, doctors’ visits, and treatments. These details are for human resources use only. Be careful not to provide more than what is asked for. Avoid sending sensitive details to co-workers, direct supervisors, or your management team.
Filing For Social Security Disability With A Diagnosis Of Depression
While the Social Security Administration does not have a separate listing for Depression in its Impairment Listing Manual, or Blue Book, the condition is considered under Section 12.04 Affective Disorders.
To qualify for Social Security Disability Insurance or Supplemental Security Income benefits on the basis of an affective disorder, your medical records must satisfy at least one of the following two sets of criteria.
The first set of criteria:
If you are unable to meet the first set of criteria, you may qualify for benefits by meeting each of the elements of a second set of criteria:
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How To Claim Your Disability Tax Credit
The National Benefit Authority has assisted thousands of Canadians in successfully claiming their disability credits. Our in-house team of experts can help determine your Disability Tax Credit eligibility, and walk you through your Canadian Disability Tax Credit application .
Well be alongside you every step of the way towards recovering your mental illness disability, helping you or a loved one find the support they need.
You Can Prove Your Case By Meeting A Blue Book Impairment Listing
If your medical evidence and application information confirm you meet the criteria under one of these listings and you meet all other qualifications, you will likely get approved for disability benefits.
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How Someone With A Mental Health Condition Can Qualify For Social Security Disability Benefits
If you have a mental health condition that limits your ability to perform routine daily tasks and keeps you from performing work to earn a living, you may qualify for disability benefits administered by the Social Security Administration . The SSA has two disability programs, Supplemental Security Income and Social Security Disability Insurance . Both programs have strict medical requirements for a claim to be approved.
SSDI vs. SSI
SSDI is a disability program based off your work history. You must have earned enough credits and paid in enough taxes to qualify for benefits. For most people, you must have worked the equivalent of 5 years full-time out of the last 10 years. SSI does not depend on work history, and just so long as you meet the financial criteria, which involve resources and income, you can be approved. You will need to provide supporting documentation for both.
Medically Qualifying for Disability Benefits
The SSA uses a medical guide, which is called the Blue Book, to determine if a claimant qualifies for disability benefits. There is a section in the Blue Book for mental disorders, and it has listings for a variety of conditions, including anxiety-related conditions, psychotic disorders, learning disabilities, depression, and many other mental health issues. Each listing has specific criteria that must be met for the claimant to medically qualify per that specific listing.
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Applying For Disability Benefits
The Listings Are Divided Into 11 Categories:
- Neurocognitive disorders Alzheimers, dementia, inability to concentrate, remember or understand
- Schizophrenia spectrum and other psychotic disorders
- Depressive, bipolar and related disorders loss of interest in life, appetite and sleep disturbances, decreased energy, suicidal thoughts
- Intellectual disorder mental retardation, inability to care for personal needs
- Anxiety and obsessive-compulsive disorders panic attacks, paranoia, agoraphobia
- Somatic symptom and related disorders preoccupation with having or acquiring a serious illness that cannot be explained by a medical disorder
- Personality and impulse-control disorders borderline personality disorder, instability in interpersonal relationships
- Autism spectrum disorder
- Neurodevelopmental disorders hyperactive and impulsive behavior, difficulty sustaining attention and organizing tasks
- Eating disorders anorexia, bulimia
- Trauma and stressor-related disorders PTSD, experience or exposure to actual or threatened death, serious injury, or violence
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Filing A Claim For Stdi/ltdi Benefits
Who is Eligible to Claim Disability Benefits?
If your employer offered STDI or LTDI coverage and you enrolled in this coverage , you are eligible for these disability benefits. Typically, you must have been covered under the policy for a specific amount of time before you are able to file a claim for benefits. Your policys Summary Plan Description and/or Plan Document will explain this specific time period.
You should have automatically received a copy of the Summary Plan Description when you enrolled in coverage. While you do not automatically receive a copy of the Plan Document, you may request a copy from your plan administrator .
How Do I File a Disability Benefits Claim?
To start your disability benefits claim, you should request STDI/LTDI claim forms from your plan administrator, which is probably your HR department. If you are unable to get these forms from the HR department, you can reach out directly to the claims administrator . The claims administrator and their contact information should be listed in your policy documents.
Application Documents Required from You, Your Employer, & Your Doctor
In most cases, the claim forms are comprised of three parts:
a form for you to complete, sometimes referred to as the Claimant Statement or Employee Statement, a form for your employer to complete, sometime referred to as the Employer Statemen,t and a form for your treating provider to complete, sometimes referred to as the Attending Physician Statement.
Basic Eligibility For Benefits
The SSA must see that you meet basic eligibility requirements before further reviewing your application for benefits. This basic eligibility includes having:
- A formal diagnosis of a potentially disabling condition
- A diagnosed condition that will disable you for 12 months of longer
After the SSA confirms that you meet basic eligibility, they will then move on to review your medical condition in detail and verify that you meet all program requirements for SSDI and/or SSI.
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Who Can Use Fmla
FMLA is not available to all employees. There are a few qualifying factors that make someone eligible for the protection. Employees must:
- Work at their place of employment for 12+ months
- Accrue 1,250 hours of work in the past year
- Work for a company that has more than 50 employees
As you can see, FMLA doesn’t cover everyone. There may be a condition under FMLA that disqualifies you from being eligible. New employees, part-time or temporary staff, and small business workers are excluded. In many cases, there are other options available for those who need time away. These other opportunities may not include the protections that come with FMLA and should be used with caution.
A Note On Alcohol And Drug Abuse
Many people who suffer from mental illness also have drug or alcohol problems. You can still get approved for disability if you are currently abusing drugs or alcohol as long as your mental condition would still be disabling if you were sober. If the records indicate your mental condition would go away if you stopped abusing drugs or alcohol, you will be denied. For more information, see Nolo’s article on how alcohol and drugs affect your disability claim.
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We Can Handle Your Appeal
If the SSA already denied you for Social Security Disability Insurance/Disability Insurance Benefits or Supplemental Security Income, we can help you file an appeal and fight for your disability benefits.
Our attorneys can ensure the SSA has all the information it needs about your medical care and care providers.
What To Do If Your Stdi/ltdi Benefits Claim Is Denied
How Do I Know if my Disability Claim is Denied?
If your claim is denied in whole or in part, you will receive written notice of the denial. This denial letter will include:
the specific reason for the denial reference to the policy provisions upon which the denial is based a description of any additional information that may be necessary for you to perfect your claim, including why such information is necessary a description of the policys internal administrative appeal procedures an explanation of the claims administrators basis for agreeing or disagreeing with your treating providers opinions, the medical experts it hired to review your claim, and the Social Security Administrations determination you are disabled .
How do I File a Disability Claim Appeal?
You have 180 days from the date you receive the disability claim denial letter to file an internal administrative appeal. The denial letter will include instructions for submitting the appeal. It is important to strictly follow your plans administrative appeal process, as failing to do so could forever waive your right to pursue your claim for these benefits.
What Should I Include in the Disability Claim Appeal?
In addition to including the information described in the denial letter as being necessary to perfect your claim, you may also consider including the following:
What Happens While the Appeal is Being Reviewed?
Additionally, in some cases, the claims administrators may even have you surveilled.
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Filing For Social Security Disability With The Diagnosis Of An Organic Mental Disorder
The Social Security Administration considers Organic Mental Disorders under Section 12.02 of the Blue Book. A related listing, Cerebral Trauma – Traumatic Brain Injury, is found in Section 11.18. The SSA defines Organic Mental Disorders as psychological or behavioral abnormalities associated with a dysfunction of the brain and requires that when you apply for disability benefits you submit records documenting the patients medical history, including examinations or laboratory tests which demonstrate the presence of a specific organic factor judged to be the cause of the persons abnormal mental state and loss of mental function.
In order to meet the eligibility requirements of this section and qualify for Social Security Disability benefits, you must meet the stipulations of BOTH Paragraph A and Paragraph B below, or ALL of the stipulations of Paragraph C.
You must demonstrate the loss of specific cognitive abilities or affective changes and must provide medical documentation of the persistence of at least one of the following:
The Importance Of Credibility
One critical factor in disability cases, in particular those involving mental conditions, is the issue of credibility. If you appeal your claim to the hearing level, an administrative law judge will hear your case and have the opportunity to question you about your disability. ALJs hear hundreds of cases a year and are well trained at identifying testimony that is exaggerated or untruthful. If an ALJ thinks you are being untruthful about your condition or exaggerating your symptoms, you will probably be denied benefits. Make sure your medical records don’t contradict the testimony you give in court.
Many times there are inconsistencies in medical records that can make it appear as if your condition is not as bad as you claim. For example, disability claimants often go through periods of time without medical treatment due to financial hardship or lack of insurance. If this is true for you, be ready to explain these gaps in treatment to the ALJ.
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Medical Qualifying With A Mental Illness
The SSA conducts a detailed review of your medical records to determine your eligibility for benefits. During this review, they try to match your records to a disability listing in the Blue Book. The Blue Book is the SSAs medical guide that is used to evaluate every disability application.
Disability listings outline the severity level requirements and the specific medical evidence needed to support a claim for benefits. Mental illnesses appear in Section 12.00 and include:
- 12.06, Anxiety-related Disorders you may qualify under this listing if you have a severe phobia, post-traumatic stress, a panic disorder, or another anxiety-related condition.
- 12.08, Personality Disorders this is the listing under which you may qualify if you have severe, clinical depression.
- 12.04, Affective Disorders if you have bipolar disorder, your application will be reviewed under this listing.
Extensive medical records are necessary to qualify, including:
- Information on your diagnosis, ideally from a psychiatrist or psychologist
- Brain scans or other evidence of physical abnormalities that document an organic cause for symptoms, if applicable
- Treatment records, documenting medications, therapy, and other management methods used and their effects
- Thoroughly documented episodes of increased symptoms or periods of decompensation
- Well documented affects of your symptoms on your everyday abilities or activities of daily living
Is Depression A Disability
The Social Security Administration considers depression a disability when it is severe enough to make you unable to work and earn a living.
To qualify for disability benefits, you must have supporting medical evidence that shows you meet the criteria of the Blue Book listing, you are unable to work for at least 12 months, and you have earned enough credits to qualify for Social Security Disability Insurance . In general, you must have worked the equivalent of 5 years full-time out of the last 10 years.
You will need a detailed work history, your drivers license or other photo identification, your Social Security card, and other documentation, such as a birth certificate, to confirm your identity and to prove that you do qualify for benefits from the SSA.
You will need documentation to support your claim, such as a residual functional capacity form completed by your physician. The RFC will fully detail what you can and cannot do, so the disability examiner will be able to determine if you can work, and if you are capable of work, what kind of work you can do.
You should continue receiving medical care and provide a list of healthcare providers to support your claim. Records from doctors, therapists, psychiatrists, and so forth can all be helpful in supporting your disability claim for depression.
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Is Anxiety Considered A Disability
Anxiety disorders, such as OCD, panic disorders, phobias or PTSD are considered a disability and can qualify for Social Security disability benefits. Those with anxiety can qualify for disability if they are able to prove their anxiety makes it impossible to work. You must submit evidence showing your anxiety disorder matches the SSA’s Blue Book requirements.
An anxiety disorder is a condition characterized by persistent feelings of apprehension, tension, or uneasiness. For those who are truly disabled on the basis of such a disorder, these feelings are not simply nervousness, but rather overwhelming feelings of alarm and even terror that can be provoked by ordinary events or situations occurring in everyday life.