Suffering an Unfair Job Loss is Tough, our california employment attorneys can help.

Mental and Psychological Disorders

How Do I Get Social Security Disability Benefits for a Mental Disorder?Mental Disorders and Disability

To qualify for disability, the Social Security Administration requires your mental disorder to have lasted, or expect to last, 12 months. The existence of your mental disorder must be established by medical evidence consisting of clinical signs, symptoms, and/or laboratory or psychological test findings. In addition, there is a requirement that your mental disorder be severe. The severity of your mental disorder is determined by the functional limitations of your mental disorder.

Qualifying for Social Security Disability Benefits due to a mental disorder is a difficult and complicated process. If you have a Mental Disorder, cannot work and have been denied Social Security Disability benefits, call the experienced Corona Del Mar Social Security Disability attorneys at Howard Law and let us help you get the benefits you deserve.

Organic Mental Disorders

Psychological or behavioral abnormalities associated with a dysfunction of the brain. History and physical examination or laboratory tests demonstrate the presence of a specific organic factor judged to be etiologically related to the abnormal mental state and loss of previously acquired functional abilities.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Demonstration of a loss of specific cognitive abilities or affective changes and the medically documented persistence of at least one of the following:
    1. Disorientation to time and place; or
    2. Memory impairment, either short-term (inability to learn new information), intermediate, or long-term (inability to remember information that was known sometime in the past); or
    3. Perceptual or thinking disturbances (e.g., hallucinations, delusions); or
    4. Change in personality; or
    5. Disturbance in mood; or
    6. Emotional lability (e.g., explosive temper outbursts, sudden crying, etc.) and impairment in impulse control; or
    7. Loss of measured intellectual ability of at least 15 I.Q. points from premorbid levels or overall impairment index clearly within the severely impaired range on neuropsychological testing, e.g., Luria-Nebraska, Halstead-Reitan, etc;
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration;
  4. OR

  5. Medically documented history of a chronic organic mental disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
    1. Repeated episodes of decompensation, each of extended duration; or
    2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
    3. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement

Schizophrenic, Paranoid, and Other Psychotic Disorders

Schizophrenic, Paranoid and Other Psychotic Disorders characterized by the onset of psychotic features with deterioration from a previous level of functioning.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Medically documented persistence, either continuous or intermittent, of one or more of the following:
    1. Delusions or hallucinations; or
    2. Catatonic or other grossly disorganized behavior; or
    3. Incoherence, loosening of associations, illogical thinking, or poverty of content of speech if associated with one of the following:
      1. Blunt affect; or
      2. Flat affect; or
      3. Inappropriate affect;
    4. OR

    5. Emotional withdrawal and/or isolation;
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration;
  4. OR

  5. Medically documented history of a chronic schizophrenic, paranoid, or other psychotic disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
    1. Repeated episodes of decompensation, each of extended duration; or
    2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
    3. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Affective Disorders

Affective disorders characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves either depression or elation.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Medically documented persistence, either continuous or intermittent, of one of the following:
    1. Depressive syndrome characterized by at least four of the following:
      1. Anhedonia or pervasive loss of interest in almost all activities; or
      2. Appetite disturbance with change in weight; or
      3. Sleep disturbance; or
      4. Psychomotor agitation or retardation; or
      5. Decreased energy; or
      6. Feelings of guilt or worthlessness; or
      7. Difficulty concentrating or thinking; or
      8. Thoughts of suicide; or
      9. Hallucinations, delusions, or paranoid thinking; or
    2. Manic syndrome characterized by at least three of the following:
      1. Hyperactivity; or
      2. Pressure of speech; or
      3. Flight of ideas; or
      4. Inflated self-esteem; or
      5. Decreased need for sleep; or
      6. Easy distractibility; or
      7. Involvement in activities that have a high probability of painful consequences which are not recognized; or
      8. h. Hallucinations, delusions or paranoid thinking; or
    3. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes);
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration;
  4. OR

  5. Medically documented history of a chronic affective disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
    1. Repeated episodes of decompensation, each of extended duration; or
    2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
    3. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

Mental Retardation

Mental retardation refers to significantly subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of the impairment before age 22.

The required level of severity for this disorder is met when the requirements in A, B, C, or D are satisfied.

  1. Mental incapacity evidenced by dependence upon others for personal needs (e.g., toileting, eating, dressing, or bathing) and inability to follow directions, such that the use of standardized measures of intellectual functioning is precluded;
  2. OR

  3. A valid verbal, performance, or full scale IQ of 59 or less;
  4. OR

  5. A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing an additional and significant work-related limitation of function;
  6. OR

  7. A valid verbal, performance, or full scale IQ of 60 through 70, resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration.

Anxiety- Related Disorders

In these disorders anxiety is either the predominant disturbance or it is experienced if the individual attempts to master symptoms; for example, confronting the dreaded object or situation in a phobic disorder or resisting the obsessions or compulsions in obsessive compulsive disorders.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in both A and C are satisfied.

  1. Medically documented findings of at least one of the following:
    1. Generalized persistent anxiety accompanied by three out of four of the following signs or symptoms:
      1. Motor tension; or
      2. Autonomic hyperactivity; or
      3. Apprehensive expectation; or
      4. Vigilance and scanning; or
    2. A persistent irrational fear of a specific object, activity, or situation which results in a compelling desire to avoid the dreaded object, activity, or situation; or
    3. Recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week; or
    4. Recurrent obsessions or compulsions which are a source of marked distress; or
    5. Recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress;
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration.
  4. OR

  5. Resulting in complete inability to function independently outside the area of one’s home.

Somatoform Disorders

Somatoform Disorders are mental disorders in which physical symptoms are of psychological origin.

To qualify for Social Security Disability benefits, you must have physical symptoms for which there are no demonstrable organic findings or known physiological mechanisms. The required level of severity for these disorders is met when the requirements in both A and B are satisfied.

  1. Medically documented by evidence of one of the following:
    1. A history of multiple physical symptoms of several years duration, beginning before age 30, that have caused the individual to take medicine frequently, see a physician often and alter life patterns significantly; or
    2. Persistent nonorganic disturbance of one of the following:
      1. Vision, or
      2. Speech; or
      3. Hearing; or
      4. Use of a limb; or
      5. Movement and its control (e.g., coordination disturbance, psychogenic seizures, akinesia, dyskinesia); or
      6. Sensation (e.g., diminished or heightened).
    3. Unrealistic interpretation of physical signs or sensations associated with the preoccupation or belief that one has a serious disease or injury;
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration.

Personality Disorders

A personality disorder exists when personality traits are inflexible and maladaptive and cause either significant impairment in social or occupational functioning or subjective distress. Characteristic features are typical of the individual’s long-term functioning and are not limited to discrete episodes of illness.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied.

  1. Deeply ingrained, maladaptive patterns of behavior associated with one of the following:
    1. Seclusiveness or autistic thinking; or
    2. Pathologically inappropriate suspiciousness or hostility; or
    3. Oddities of thought, perception, speech and behavior; or
    4. Persistent disturbances of mood or affect; or
    5. Pathological dependence, passivity, or aggressivity; or
    6. Intense and unstable interpersonal relationships and impulsive and damaging behavior;
  2. AND

  3. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration.

Substance Addiction Disorders

Federal law prohibits payment of Social Security Disability benefits to people who are disabled because of drug addiction or alcoholism to the extent their problems would be reversible by ceasing the addictive activity.

To qualify for Social Security Disability benefits you must have behavioral changes or physical changes associated with the regular use of substances that affect the central nervous system.

The required level of severity for these disorders is met when the requirements in any of the following (A through I) are satisfied.

  1. Organic mental disorders.
  2. Depressive syndrome.
  3. Anxiety disorders.
  4. Personality disorders.
  5. Peripheral neuropathies.
  6. Liver damage.
  7. Gastritis.
  8. Pancreatitis.
  9. Seizures.

Autistic and Other Pervasive Development Disorders

Autism is a form of pervasive developmental disorder, for which there are a number of specific diagnostic criteria. It is characterized by qualitative deficits in the development of reciprocal social interaction, in the development of verbal and nonverbal communication skills, and in imaginative activity. Often, there is a markedly restricted repertoire of activities and interests, which frequently are stereotyped and repetitive.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied.

  1. Medically documented findings of the following:
    1. For autistic disorder, all of the following:
      1. Qualitative deficits in reciprocal social interaction; and
      2. Qualitative deficits in verbal and nonverbal communication and in imaginative activity; and
      3. Markedly restricted repertoire of activities and interests;
    2. OR

    3. For other pervasive developmental disorders, both of the following:
      1. Qualitative deficits in reciprocal social interaction; and
      2. Qualitative deficits in verbal and nonverbal communication and in imaginative activity;

    AND

  2. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration.

For more information on Mental Disorders and the Social Security Administration guidelines, visit the Social Security Administration website.

[Back to Top]

Listing vs. Residual Functional Capacity (RFC): How Does the Social Security Administration Determine Whether I Qualify for Disability Benefits for a Mental Disorder?

Social Security disability benefits may be available for people who suffer from a Mental Disorder. The Social Security Administration must first determine whether your Mental Disorder is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. The Social Security Administration will conclude that you are disabled and eligible for disability benefits if it determines that you meet or equal a listing because of your Mental Disorder.

If the Social Security Administration decides that your Mental Disorder is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

[Back to Top]

How Can I Meet a Listing and Win Social Security Disability Benefits for a Mental Disorder?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your Mental Disorder is severe enough to equal a listing.

The term “listing” refers to a compiled list of common impairments. The Social Security Administration created a set of guidelines called the Listing of Impairments that contains the most common impairments. For each listing of a particular impairment, there is an explanation regarding the degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work.

The Social Security Administration will consider you disabled if your Mental Disorder is severe enough to meet or equal a listing.

[Back to Top]

What is Your Residual Functional Capacity Assessment for your Mental Disorder?

If the Social Security Administration decides that your Mental Disorder is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

The Social Security Administration expressesan RFC for physical impairments in terms of whether the Social Security Administration believes you are able to do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

[Back to Top]

Can Your Doctor’s Medical Opinion Help You Qualify for Social Security Disability Benefits for a Mental Disorder?

The role of the Social Security Administration is to conclusivelyestablish whether you are disabled based on your education, work experience, medical evidence, and your age.

The role of your doctor is to provide the Social Security Administration with informationconcerning the degree of your medical impairment by providing the Social Security Administration medical source statement that describes your capacity for work which is part of your residual functional capacity assessment. Your residual functional capacity is what you can still do despite your limitations.

The Social Security Administration must consider your treating physician’s opinion because the Social Security Administration considers it to be controlling when making its decision.

[Back to Top]

What is the 5 Step Sequential Evaluation Process?

The Social Security Administration has created a five (5) step sequential process to determine whether an adult claimant is entitled to receive disability benefits. Children have a different test to determine eligibility.

Step 1: Substantial Gainful Activity

The Social Security Administration presumes that if you are working and that you make a certain amount of money that you are engaging in what it determines to be a substantial gainful activity (SGA). The Social Security Administration considers a person to be engaged in a SGA if that person is earning more than a certain amount of money each month (i.e. net of impairment - related work related expenses).

In 2013, the Social Security Administration has determined that a statutorily blind individual is engaged in a SGA if they earn more than $1740.00 per month while a non-blind individual must earn more than $1040.00 per month. Changes in the national average wage index usually affect the aforementioned SGA amounts.

Step 2: Severe Impairment

The Social Security Administration has determined that each claimant must either have a severe impairment or a combination of impairments. The impairment or combination of impairments must drastically limit the claimant's physical or mental ability to do basic work activities without regard to age, work history, or education. For many claimants, the level of proof at this level is minimal; therefore, they usually satisfy the Step 2 requirements and proceed to Step 3.

Step 3: Listing of Impairments

The Listing of Impairments details specific impairments that the Social Security Administration considers severe enough to prevent an adult claimant from engaging in a substantial gainful activity and in the case of a minor, the impairment has to be severe enough to cause functional limitations. There is also a durational requirement. The Social Security Administration has determined that the impairment must last for 12 months or long or result in the death of the claimant. If the claimant fails Step 3 because they do not meet or equal a listing then the case will proceed to Step 4.

Step 4: Past Relevant Work

At Step 4, if your condition is severe enough to meet the requirements of Step 2 (Severe Impairment); however, your severe impairment does not meet or equal a listed impairment that is the subject of Step 3 (Listing of Impairments), then the Social Security Administration must decide whether your severe impairment interferes with your ability to do any of the work you previously performed. The Social Security Administration likes to look at the work you performed over the past 15 years prior to the onset of your disability. If the Social Security Administration determines that your impairment does not interfere with work you previously did then you must proceed to Step 5.

Step 5: Ability to Perform Other Work

A majority of disability claims are decided at this level. If you cannot perform work you did in your past, then a determination must be made as to whether you can adjust to different types of work. The determination at this level takes into consideration your education, age, and prior work and is better known as your residual functional capacity.

[Back to Top]