Navigating Social Security With a Mental Illness

Simon Cunnigham and Creative CommonsAccording to the National Institute of Mental Health’s 2012 National Survey on Drug Use and Health, roughly 18.6% of the US adult population has AMI (any mental illness). Mental illness can be a taboo subject in American society, despite the fact that it affects roughly 43.7 million people. Many people dismiss their mental illness and do not think it qualifies as a disability, much less a disability that would qualify for Social Security benefits. However, the Social Security Administration (SSA) takes mental illness very seriously, and if your mental illness hinders your ability to work and function on a daily basis, you might qualify for benefits.

In order to qualify, you must meet certain criteria outlined on the SSA website, listed below. You must have A (a set of medical findings). If you can demonstrate A, then you must also demonstrate either B or C, depending on the situation.

A. Do you have medical evidence?

A. You are required to present a set of medical findings. There must be medical evidence proving you have a specific mental illness. These medical findings can include documentation of hallucinations, social isolation, and suicidal tendencies. In special circumstances, such as with eating disorders, these mental impairments can be considered physical symptoms.

B. Can you prove debilitating effects of your illness?

B. If you do have a mental illness (you have qualified under A), the mental illness has resulted in:

  • Marked restriction of activities of daily living; or
  • Marked difficulties in maintaining social functioning; or
  • Marked difficulties in maintaining concentration, persistence, or pace; or
  • Repeated episodes of decompensation, each of extended duration.

C. Have you been hospitalized or institutionalized?

C. If you do not meet the criteria listed above, you may still qualify under C, which includes criteria such as whether or not you have ever been hospitalized or institutionalized for the illness, as well as any past records that indicate the severity of your impairment.

Additional considerations

The SSA with also consider the following.

Duration of illness: How long will you have this illness?

The Social Security Administration will also consider whether your limitations previously lasted or will last for a continuous period of at least 12 months.

Diagnosis: Do you fall into one of these groups?

During step A, the SSA uses these nine diagnostic categories to better evaluate each person’s mental disorder:

  1. Organic Mental Disorders: Psychological or behavioral abnormalities associated with the brain.
  2. Schizophrenic, Paranoid, and Other Psychotic Disorders: Onset of psychotic features with deterioration from a previous level of functioning.
  3. Affective Disorders: Disturbance of mood (prolonged emotion that colors the whole psychic life, usually involving depression or elation) and a full or partial manic-depressive syndrome.
  4. Intellectual Disability: Significantly sub-average general intellectual functioning. The impairment must have had its onset before the age of 22.
  5. Anxiety Related Disorders: Anxiety is either the predominant disturbance or it is experienced if the individual tries to master symptoms (trying to resist Obsessive-Compulsive Disorder or confronting a trigger).
  6. Somatoform Disorders: Physical symptoms that have no organic findings or known physiological mechanisms.
  7. Personality Disorders: Personality traits are inflexible and cause significant impairment by limiting functionality or by causing subjective distress.
  8. Substance Abuse Addiction Disorders: Behavioral or physcial changes associated with the regular use of substances. This category requires the applicant to have another mental disorder on the list to demonstrate substance abuse has affected that disorder.
  9. Autistic Disorder and Other Pervasive Developmental Disorders: Qualitative deficits in development of reciprocal social interaction, in the development of verbal and nonverbal communication skills.

Employment: Can you hold a job?

If you fall into one of these categories and sufficiently meet a medical listing, you will also need to prove:

  • you can’t engage in substantial gainful activity,
  • you can’t go back to the lightest job you held in the last 15 years, and
  • there is no job in the national economy you can do.

Documentation: How do you prove you have a debilitating mental illness?

How do you prove that you do indeed have a mental illness that is hindering your ability to work? You get documentation. This documentation can include anything from mental status written by a doctor, information you provide about your illness (this can not be used alone), intelligence tests, personality measures, and/or psychological tests. These are just a few of the ways to demonstrate your limitations.

This may seem overwhelming, but you are not alone. Summit Disability recognizes that Social Security Disability claims can be daunting. Let us help you.

Photo Courtesy of Simon Cunningham via Creative Commons.


Official Social Security Administration Website: Disability Evalution Under Social Security (Mental Disorders – Adult)

National Institute of Mental Health Statistics