| SOCIAL SECURITY:
HOW TO PROVE YOU ARE DISABLED
WHEN YOU HAVE A MENTAL ILLNESS
By Martha A.
Churchill
Some individuals with mental illness are not
aware of their own behaviors and symptoms. The person realizes
he or she cannot work, but does not understand exactly why.
This makes it difficult for someone with a mental illness to
obtain benefits.
It's hard for you to prove you are disabled
when you don't even realize what your behaviors are, and how you
affect others.
That’s why it is so important for friends,
family, and former employers to write letters and reports about
you. They notice the things you do or say that don’t fit in at
the employment scene. Statements from the people who know
you best are important to your Social Security claim.
Observations from your family can carry a lot of weight and make
a big difference for the success of your claim.
Your doctor is a key person when you are
trying to prove your disability to the Social Security
Administration. A doctor’s report carries more weight if your
doctor knows you well, and has been treating you for a long
time.
A psychiatrist or psychologist is the best
type of doctor to write a report about your disability. A family
practitioner is okay, but a specialist is better. Your
psychologist, social worker, or psychiatrist should be helping
you with your Social Security claim by writing a suitable letter
explaining your symptoms and behaviors, in detail.
Anyone who is around you frequently, and
knows you well, can write a report or come to your hearing and
explain what problems you have interacting with other people.
For example, maybe you isolate yourself for hours at a time when
you feel stressed, but you don’t realize you do this. Your
friends or family might notice this. Information of this type is
extremely helpful when you are trying to prove that you are
disabled due to mental illness.
Some people think that if they have a
diagnosis such as "depression" or
"schizophrenia," the Social Security Administration
will automatically grant benefits. That is not true. You can’t
get benefits just because you have a label like
"schizophrenia." First, you have to prove that your
illness is severe enough to stop you from working.
There is a "Catch 22" here. Because
of your illness, you have trouble realizing what the problems
are that you have in the workplace, and you don’t know how to
explain it. But if you are too good at writing reports
and expressing yourself, the Social Security judge will think
that you are capable of getting a job. So, you need other people
to talk or write about your difficulties. It isn’t pleasant to
hear these things about yourself, but it has to be done if you
want to receive Social Security benefits or SSI.
As a general
rule, for people with psychiatric disabilities, having an attorney
or other representative is a must.
There are four main areas of functioning that
are considered by the Social Security judge in deciding whether
your illness is severe enough to prevent you from working: (a)
daily living, (b) social functioning, (c) concentration, and (d)
decompensation. (see chart.)
If you have bipolar disorder, major
depression, phobias, agoraphobia, Tourette Syndrome, obsessions,
compulsions, or panic attacks, you must prove that you have
problems in at least two of the four areas of
functioning.
If you have somatoform disorder or a
personality disorder, Social Security requires you to have
serious problems in three of the four areas.
THE FOUR AREAS OF FUNCTIONING
|
(a)
Daily living skills |
Activities of daily living include
cooking, cleaning, and laundry. It includes getting
dressed, brushing your teeth, going to the grocery store,
and paying your rent on time. If you need reminders to do
those kinds of tasks, or just don’t do them, you have
"marked restriction of activities of daily
living." That is important in proving that your
mental illness prevents you from working.
|
|
(b)
Social functioning |
Social functioning means knowing how to
say the right thing, and when. Evictions, firings, fear of
strangers, and social isolation are important signs that
you can’t work. Are you unable to start up a
conversation? Do you make rude remarks-- or "clam
up" and don’t speak to others? Can you get along
okay with family, neighbors, and the landlord? Can you get
things done with a group of people? How do you act with
people in authority? Those social skills are necessary to
work, no matter what the job. |
|
(c) Concentration, persistence, or pace |
If you can’t complete tasks in a
timely manner, that shows you have a deficiency in your
"pace." Lots of people start a project and don’t
finish it, especially with a hobby. But if you start
important projects and never finish them, because your
mind wanders, then you have a significant deficiency in
concentration and you can’t work. |
|
(d) Episodes of deterioration or decompensation |
Decompensation means that you withdraw
from the situation when you feel stress, or perhaps you
"blow up" all of a sudden when things aren’t
going right. Do you go into a tailspin sometimes, and lose
your cool? Does this happen even when you are trying to be
on your best behavior? Any exacerbation of your signs and
symptoms is an "episode" that keeps you from
working. Having episodes like that, repeatedly, is a sure
sign that you can’t function at work. |
For schizophrenia, the criteria is a little
bit more complicated. Delusions, hallucinations, or illogical
thinking could help prove you can’t work. Emotional withdrawal
could be a factor. If you have problems in two of the four
areas, that could show disability. Or, you could show that you
can’t function outside a highly supportive living situation,
and that it’s been that way for at least two years.
Conclusion:
To prove that you are
disabled, the Social Security office needs to know all about
your behavior as it relates to the four areas of functioning.
Your doctor has to write a letter or report that explains
whatever problems you are having in these areas. The doctor has
to give specific examples, and go into detail. Show your doctor
this chart about the Four Areas of Functioning. Make sure he or
she has written a report that discusses your problems in a way
that will be understood at the Social Security office.
For a look at
the complete Social Security rules for mental illness, check the
"Listing." This listing has a wide variety of
mental conditions covered, including personality disorders,
mental retardation, and
panic attacks. For your convenience, I have added a few
comments in brackets [like this] to help you navigate. The
first half of this listing is an essay on mental illness
generally, and the second half is a list of mental illnesses with a
description, by the number. Click on "Listing."
I have prepared
summaries of some actual law cases which deal with "Activities
of daily living."
|
|
