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."
|
