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) |
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 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."
Martha A. Churchill has prepared summaries of some actual law
cases which deal with "Activities
of daily living."