At least one in five adults and one in 6 children in the United States suffer from a mental health disability – (Reuters Health). This means that millions of Americans live with mental health conditions that may affect their work performance or school learning ability and ultimately their professional growth. Fortunately, individuals with mental health conditions whose work/schooling is limited or eliminated may qualify for regular monthly payments via Social Security Disability Insurance (SSDI) benefits and Supplemental Security Income (SSI). To navigate the Social Security Disability claim process, we will cover Social Security Administration (SSA) definitions of mental health disorders, eligibility requirements, considerations, application processes, and how to assist a successful claim/appeal.
SSA Definition of Mental Health Disorders:
Although mental health disorders are increasing worldwide, there remains a stigma among some or a lack of awareness, as they are often not as visibly apparent as physical disorders. In serious cases, mental health disorders can make even the simplest tasks impossible to perform, prevent individuals from going to work/school, or performing to standard.
To evaluate individuals with mental disorders, SSA, refers to Listing 12.00 Mental Disorders with 11 categories to include:
Neurocognitive disorders
Schizophrenia spectrum and other psychotic disorders
Depressive, Bipolar, and related disorders
Intellectual disorder
Anxiety and obsessive-compulsive disorders
Somatic symptom and related disorders
Personality and impulse-control disorders
Autism spectrum disorder
Neurodevelopmental disorders
Eating disorders; and
Trauma and stress disorders.
Eligibility for Benefits:
To be eligible to receive Social Security benefits for a mental health disorder, an individual is required to meet the following requirements:
The mental health condition must have persisted for at least one year or is expected to continue for one year.
The mental health condition must be diagnosed as life-threatening.
The condition must render the individual unable to work full time or inhibit their learning at school.
Although, meeting these requirements does not guarantee that your claim will be granted, each claim is evaluated on a case-by-case basis.
Considerations For Disability Benefits:
There is the consideration of Presumptive Disability (PD) to receive SSI. A disability claimant, including a child, applying for SSI may be initially found presumptively disabled, prior to the final determination of disability, and receive up to 6 months of payments. To qualify for a PD claim, the evidence must reflect a high degree of probability that the claimant’s impairment or combination of impairments meets the SSAs definition of disability. Any awarded amount during the Presumptive Disability review will not be owed back if the final decision is a denial.
There are also Compassionate Allowances where the SSA is made aware that the claimant’s disability meets a Blue Book Listing and payments are expedited (average of 19 days to receive payments). Compassionate Allowance applies to disability claims for SSI or SSDI, whereas Presumptive Disability is restricted to SSI.
Applying For Social Security Disability Benefits
The process to apply for mental disability benefits is often confusing and time consuming. Physical disabilities can be seen and easily measured, as opposed to mental health claims that rely on the objectivity and knowledge of the medical examiner. Some examiners don’t always grasp the scope of mental illnesses and approximately 75% of Mental Disability claims filed independently are denied. Fortunately, Help Me Help You, Benefits Access Support advocates have 14 years combined claims experience, maintain an 80% success rate of all claims filed, and do all the work for you to achieve the best outcome.
Jorge, a 47-year-old, Long Beach resident was diagnosed with Schizophrenia. Although he had worked in Customer Service, he was unable to stay gainfully employed due to his psychotic breaks. After Jorge was hospitalized with these symptoms, his Social Worker referred him to Help Me Help You for SSA benefits claims assistance. HMHY, Benefits Access Support advocates gathered the required medical information from his psychiatrist, medical records from his prior Florida residence, and managed SSA communications/ requirements to file the claim which was awarded within 6 months. “Thank you, HMHY for helping me receive monthly SSA payments so I can continue medical treatment and afford to live without the impossible pressure of keeping a full-time job,” said Jorge.
Ways to Assist a Successful Claim or Appeal:
There are a few things you can do which are favorable to SSA benefit claim:
Get medical treatment for your diagnosed mental health condition and documented doctor support.
Follow prescribed medical treatment – a claim can be denied by SSA if the claimant does not follow their prescribed medical treatment.
Attend regular and frequent Mental Health Professional appointments and try not to miss scheduled appointments – consideration of the frequency of your appointments may help in evaluating the severity of your condition.
Ensure your diagnosis meets the SSA Listing - the “listing” represents a set of findings, and criteria for a given condition that medical experts agree are disabling.
Provide evidence of your struggle to work/learn at school.
Provide a credible testimony – do not exaggerate or underreport your condition.
Our Benefits Access Support advocates are ready to help you with your mental disability claim or appeal. There are no fees until your claim is awarded, and as a non-profit, our fees are 70% less than others. Start your free case review now at www.helpmehelpu.org/bas