Thursday, September 29, 2022

How To Win A Disability Case For Mental Illness

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A Disability Statement From Your Doctor Means Very Little

How to Win a Mental Health Social Security Disability Case in Georgia

Doctors do not determine disability judges do. A finding of disability is a legal decision, not a medical one. Doctors can offer their opinions about your limitations based on the medical conditions they treated you for. People are often quite disappointed and even angry when their doctor tells them they should not be working anymore, and yet they get denied for disability.

How Do You Win Disability With The B Criteria In A Mental Disorder Case

The B Criteria includes 4 areas of limitation. In order to meet the B Criteria of a Mental Listing, you must have seriously limited limitations in at least 2 of 4 areas. Or, you must have extreme limitations or inability to function independently in at least 1 of 4 areas. Basically, when deciding a Mental Disorder case, Social Security seeks to determine whether you are capable of performing a regular full time work schedule on a sustained basis. The areas of limitation include your ability to:

  • Understand, remember, or apply information
  • Interact with others
  • Concentrate, persist, or maintain pace
  • Adapt or manage oneself
  • The same B Criteria listed above are used for various Mental Listings including Depression, Anxiety, Schizophrenia, Major Depressive Disorder, Agoraphobia, Personality Disorder, Psychosis, Delusions, Hallucinations, PTSD, and other mental impairments.

    To reiterate, it is not enough to merely have a diagnosis to win disability with a Mental Disorder. The degree of limitation caused by the Mental Disorder is crucial to winning with a Mental Impairment Listing. Your limitations caused by the disorder must be severe enough to preclude employment.

    Reason : Your Treatment Providers Are Not Creating The Proper Documentation

    From the disability benefits providers perspective, if something isnt written in the medical charts and files, then it doesnt exist.

    Your treatment can be of the highest quality and best practices, but if your treatment providers havent documented it adequately in the medical records , then in the eyes of the insurance company, you have not received that high quality care.

    The reality of what is going on with your treatment doesnt matter. What matters is what is documented in your medical files and records. At the end of the day, the insurance company makes decisions based on the paperwork that is included in their claim file. You can be getting the best care in the world, but if that care has not been recorded and documented properly, then it will not exist in the insurance companys file. Without accurate medical records, there is a strong possibility that your claim will be declined for technical reasons.

    What you can do about it: Point this problem out to your doctors. Have them write a narrative report that explains the treatment provided, your response to treatment, how they have changed the treatment based on your response, and the plan going forward.

    Recommended Reading: Is Supplemental Disability Insurance Worth It

    The Bottom Line: Seek Treatment Outside The Va If You Hope To Win Social Security Disability

    So, to summarize, if you are a veteran who uses VA hospitals and clinics for all of your medical care, your VA records will not be a good fit in a Social Security disability claim. Your VA records are relevant in documenting ongoing treatment and medication management but VA records rarely, if ever, address work capacity issues and VA doctors generally will not complete the functional capacity forms that can make the difference in your SSDI or SSI case.

    Your chances of success in your Social Security disability claim will increase greatly if you file contains non-VA treatment records and functional capacity evaluations.

    How You Should Prepare For Your Hearing

    How Do You Win A Disability Case For Mental Illness ...

    When your case has been denied at the initial and at the reconsideration levels, your next level of appeal is to request a hearing. Statistics show that claimants have a much better chance of success with a lawyer at the hearing. Legal representatives almost always accept Social Security cases under a contingency fee arrangement, meaning that there are no up front fees and your representative gets paid only if he wins your case.

    At a minimum, you can expect your representative to perform the following:

    • Review your file thoroughly make sure that all records of medical treatment are present and up to date.
    • Help you give the Judge specific information. Testimony that I cant concentrate much or I forget things doesnt say much. Testimony that I experience crying spells three times a week for at least 45 minutes to an hour and My sister has to give me my pills because I cannot remember whether I have taken them gives the Judge a specific vocational limitation.

    Read Also: How To Get A 100 Percent Va Disability Rating

    How Can I Appeal My Claim If Im Turned Down

    If you get turned down for social security benefits dont despair. There are a few things you can do to increase your chances of winning an appeal.

    The first thing you must do is:

    • File your appeal right away.
    • If youre denied benefits initially, dont wait. File the appeal as soon as possible. You have within 60 days of the date. Its called a Request for Reconsideration.
    • Request a hearing before an Administrative Law Judge
    • In this phase your claim will be reviewed a second time. If you are denied again, you must file a request for an Administrative Law Judge hearing to appeal.
    • Your request review is heard by the Appeals Council
    • If your claim is denied at the ALJ hearing stage, then you have the right to appeal to Social Securitys Appeals Council. The Appeals Council reviews hearing decisions, and has the power to remand or send cases back to judges when they make mistakes. It can also reverse decisions. If your claim is still denied you can even file an appeal in Federal Court.
    • The best the to do is to not go it alone and get help!

    Getting representation is the best thing you can do. This can save you time, energy and anguish!

    When your mental illness is preventing you from working, getting approved for disability is your top priority. Monthly disability benefits can help you and your family stay afloat.

    Call The Disability Champions today for a free evaluation to help win your case.

    Are Your Medical Records Sufficient

    In many mental health cases, you will see handwritten notes from either a primary care physician, a psychologist or a psychiatrist. The good new about this is that many patients with depression have a consistent history of regular visits to a mental health professional, as well as a solid professional relationship with that professional.

    A common problem with mental health treatment records, however, relates to the fact that claimants often change providers because of insurance changes, financial problems or because of an apparent lack of progress.

    You should be aware that depression is a fairly common mental health condition and the work activity limitations arising from depression or anxiety can range greatly. Social Security decision makers will look for some very specific things in your medical record. There are basically three ways to win a depression or anxiety case:

  • you can meet the listing for depression as set forth at 12.00 . The listing for depression is here, and the listing for anxiety is here. However, you and your mental health professional should look at the entirety of Listing 12 to see if any of the other sections apply.
  • you can prove that your functional capacity for work been so diminished by your mental health condition that you would not be able to reliably perform any kind of job even an unskilled, low pressure type of job?
  • Lets review each way you can win a depression or anxiety case:

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    Using Social Securitys Special Language

    I approach depression and anxiety cases by studying your medical record, then creating a checklist form that tracks most of your symptoms. These forms also include the specific functional limitations set forth in the judges handbook used by your Social Security Judge. Experienced representatives should know which vocational factors carry the most weight with Judges in a particular hearing office.

    For example, a limitation that describes interference with concentration such that you would not be able to understand and carry out complex job instructions is not particularly limiting, since many jobs exist that only require you to understand and carry out simple job instructions.

    On the other hand a limitation that says you would be unable to perform jobs requiring interaction with the public or that you would have difficulty interacting with co-workers or supervisors is extremely significant since there are very few jobs that would permit you to work alone and unsupervised.

    Unique Challenges Of Mental Illness And Applying For Disability Insurance Benefits

    Applying for Disability Benefits with a Mental Illness

    1. The insurance industry sees you as a problem

    Due to volume of disability benefits claims involving mental illness, the insurance industry has made managing mental health claims a top priority. Insurers have developed a number of strategies for how to wrongfully deny your disability claim, while maintaining the appearance of objectivity. There is little you can do about the insurance industry practices. But, understanding how the insurance company acts will help you know what to expect. And, it will allow you to make better plans.

    Focus on things that are in your control. For example, if the insurance company denies your claim, you have to weigh your options. You could appeal directly to the insurance company, or file a lawsuit against the insurance company. In some situations, doing appeals with the insurance company can be a complete waste of time.

    See Related Article: 4 Reasons to Avoid Disability Claim Internal Appeals

    2. Mental illness is invisible

    3. Short-term benefits only

    Insurance companies will often approve disability benefits claims involving mental illness for the short term. It is important that you understand this so you can better prepare yourself and not be caught off-guard by the termination.

    The first definition applies for the first two years and usually says you will qualify for benefits if you cant do your own job.

    4. Surveillance & Social Media

    5. Behind-the-scenes medical advisors

    Also Check: Aflac Short-term Disability Calculator

    Hiring Cannon Disability Law As Your Legal Team

    You can hire the legal team at Cannon Disability Law to help you win SSD and SSI benefits. In the past 30 years, we have won thousands of disability cases. That amounts to over $100 million in disability benefits for our clients.

    Additionally, we can often tell you over the phone if we can take your case. We will be asking you questions about your mental impairments. Also, we will be asking you the names and addresses of your treating mental health providers. For example, we will want to know the name and address of your counselor, psychologist or psychiatrist. Likewise, we may ask you for a list of your medications.

    If you have already applied for benefits and been denied by the SSA, dont worry. We can still help you. Our team are experts at filing appeals for our clients and winning cases at the hearing level. In the last 30 years, we have won over 20,000 disability cases. We represent thousands of Utahns before the SSA. Put our disability experience to work for you. Contact Cannon Disability Law today. We can help you with your Utah mental disability case.

    I just got a MASSIVE deposit into my account and I cannot tell you how thankful I am to you and your firm. I cannot express my appreciation for you guys. THANK YOU!

    I was worried I wouldn’t find a law firm that could help me with my case. But a friend referred me to Cannon Disability and they won my disability benefits for me.

    What Types Of Mental Illnesses Qualify For Ssd Or Ssi

    Unfortunately, there are no specific mental health symptoms that guarantee approval of a claim. Social Security will take a similar approach to mental impairments as they do with physical impairments. They carefully review a person’s functional capacity to work, regardless of their impairments, rather than granting benefits for set illnesses.

    There are, however, common illnesses that tend to qualify, for example:

    • Alzheimer’s

    Also Check: Can You Get Disability If You’ve Never Worked

    If The Ssa Decides My Impairments Together Are Severe Will I Win My Claim

    Just because the SSA determines that your impairment, or combination of impairments, is severe does not necessarily mean you will win your claim. The finding that you have a severe impairment is only the second step in a five-step process. After finding your combination of impairments is severe, the SSA must decide whether it meets or equals a listing or causes limitations too great for you to work your past job or do other work. For more information, see our section on how medical disability is decided.

    The most important thing you can do is let the SSA know about all of your impairments when you first apply for disability. Remember your case is decided almost exclusively on your existing medical records. Make sure to describe your symptoms in detail, the treatment you receive, and how the symptoms affect your day-to-day life. Also, be sure to provide the SSA with your complete medical history, including the names of your treating doctors, any facilities where you have been hospitalized or treated, a complete list of medications, copies of any diagnostic tests, and a description of what treatments you have tried and whether they were effective.

    For more information, see our article on getting benefits for multiple illnesses or disabilities.

    How Do You Win Disability With The C Criteria In A Mental Disorder Case

    How can I win my case due to mental health?

    The C Criteria can be used as an alternative to B Criteria in certain listings, 12.02, 12.03. 12.04, 12.06, and 12.15. To meet the C Criteria, the mental disorder must be serious and persistent. In the eyes of SSA, Serious and Persistent requires the disorder to last at least 2 years. Additonally, there must be evidence of both of the following:

  • Medical treatment, mental health therapy, psychosocial support, or a highly structured setting that is ongoing and that diminishes the symptoms and signs of your mental disorder, and
  • You must satisfy both C1 and C2 above to meet the C Criteria to meet a Mental Disorder Listing. You satisfy the C1 criteria above when the evidence shows you rely on ongoing medical treatment, mental health therapy, psychosocial supports, or highly structured settings to diminish symptoms. You satisfy C2 if despite diminished symptoms, you achieve only marginal adjustment.

    How Does the Social Security Administration View periods of Mental Disorder Exacerbations and Remissions?

    People who suffer from Mental Disorders often go through periods in which their symptoms improve and periods in which their symptoms become worse. They may be able to work during periods of improvement. This does not mean, however, that they are capable of sustaining a regular work schedule.

    Also Check: How To Increase My Va Disability

    Types Of Disability Benefits For Depression

    If you become unable to work because of depression, you have a few options. You might be eligible for disability benefits from the government, your employer, or your insurer.

    This list covers the possible options for depression in Canada:

    • Employment Insurance sickness benefits
    • Short-term disability insurance
    • Provincial disability benefits
    • Disability tax credit

    Lets go over each so you know whether you qualify, how to apply, and how to appeal if they deny your claim.

    Is It Harder To Prove A Social Security Disability Claim Based On A Mental Impairment

    Approximately one-fourth of the total applicants for Social Security Disability list some form of mental disorder as their primary impairment. The majority of the mental impairment claims include anxiety disorders, bipolar disorders, and depression. However, such claims are difficult to win if you do not understand how the SSA reviews such claims or know the documents required to support your claim.

    According to statistics maintained by the Social Security Administration, about two-thirds of all claims get denied during the initial application, about 15% are approved at the reconsideration level, and about 50% or so are approved at the hearing level if the individual is not represented. A greater percentage are approved at the hearing level if represented. Hiring a Social Security Disability attorney can increase your chances of getting approved. At our office, we have prevailed in a significantly higher percentage of claims than the national average because of the thorough preparation of our clients matters.

    Mental Impairments Covered by the SSA

    Listed below are some of the mental disorders listed in the SSAs blue book.

    • Autistic Disorders
    • Bipolar Disorder

    Reasons Why Claims for Mental Impairment Get Rejected

    If you are applying for a Social Security Disability benefits due to mental illness, you need to prove that your disability prevents you from sustaining full-time employment. Below are some of the reasons why the SSA rejects mental impairment claims:

    The Bottom Line

    Also Check: How Much Does Ca Disability Pay

    Get The Help You Need Today

    Contact us using the form below and get a certified attorney on your case, or call us today:

    Arizona Injury and Disability LawyersWe Proudly Serve the State of Arizona

    Phoenix, Tucson, Mesa, Scottsdale, Chandler, Gilbert, Tempe, Peoria, Payson, Surprise, Sedona, Flagstaff and anywhere YOU are in AZ.

    Regular And Frequent Mental Health Professional Appointments

    How can I win my case due to mental health?

    The social security disability administrative law judge that decides your depression-based disability claim will pay careful attention to the frequency of your doctor visits because frequency of visits is a sign of how seriously your psychiatrist views your depression.

    For example, it is standard practice in psychiatry to schedule doctor visits only twice a year for a med check if the patient is stable on their medication. Someone claiming to be disabled due to depression that only sees their psychiatrist for the bi-annual med check may have trouble winning their disability case unless it is clear that the psychiatrist has made many medication changes in the past and the current dosage is simply the best she can do.

    Also Check: Georgia Disability Determination Services

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