Social Security Disability Insurance (SSDI) benefits are intended for eligible workers who are unable to perform a job due to long-term disabling (from work) medical condition(s). It covers not only those with physical disabilities, but also those with mental health concerns. Social Security lawyer Russell J. Goldsmith understands the nuances of proving a mental disability for the purposes of obtaining SSDI benefits, having assisted people with the application process for over 30 years. At the Law Offices of Russell J. Goldsmith, our legal team provides competent and diligent representation for people seeking benefits, as well as guidance throughout the entire process.Eligibility Requirements for Mental Disorders
The Social Security Act defines “disabled” as the inability to engage in any substantial gainful activity due to a medically determinable physical or mental impairment that has lasted, or can be expected to last, for a continuous period of 12 months or longer, or that can be expected to result in death. In evaluating SSDI claims based on mental disorders, the claims examiner will assess whether the medical evidence establishes a medically determinable impairment, determine the limitations imposed on the applicant and how it affects his or her ability to work (i.e., the severity of the condition), and whether the limitations have lasted or are expected to last continuously for a period of at least one year.Medically Determinable Mental Impairments
A medically determinable impairment is one that can be proven by medically acceptable clinical and laboratory diagnostic techniques and findings—not by a statement of symptoms alone. The claims examiner will evaluate the applicant’s medical records from psychologists and other treating doctors (including those from psychiatric nurse practitioners, physician’s assistants, counselors and other clinicians), as well as any medications that have been prescribed and any evaluation or testing that has been undertaken to evaluate and verify your diagnosis and treat your condition(s). If there is a lack of medical evidence, the claims examiner may request that you undergo a consultative examination with one of Social Security’s doctors. If the mental impairment is supported by objective medical evidence, the claims examiner will then determine whether the applicant’s impairment is severe enough to be considered a disabling condition under Social Security’s rules and regulations.Listing of Impairments
The Social Security Administration (SSA) publishes a “Listing of Impairments,” also known as the “Blue Book,” which includes mental impairments. The Listing of Impairments is used to evaluate the severity of an applicant’s mental disorder. If the applicant has a condition on the list, and it satisfies the criteria needed to meet or equal the severity requirements, the applicant will automatically be considered disabled. Mental impairments in Section 12.00 of the Blue Book include the following categories:
- Organic mental disorders
- Schizophrenic, paranoid, and other psychotic disorders
- Affective disorders
- Intellectual disability
- Anxiety-related disorders
- Somatoform disorders
- Personality disorders
- Substance addiction disorders
- Autistic disorder and other pervasive developmental disorders
There are many conditions that are not included in the Blue Book, and if an applicant’s mental impairment is not listed, the claims examiner will evaluate the severity of the disability and its effect on your mental residual functional capacity (that is to say, your ability to function both at home and potentially at a work site undertaking mental health functions necessary for unskilled employment).Mental Residual Functional Capacity
The claims examiners evaluating the claim will be looking to see the extent to which the mental health condition, once medically determined to be severe, affects your ability to function, both in every day life and in a work setting: that is to say, they will be evaluating what is called your mental residual functional capacity. This includes one’s ability to understand, remember, concentrate, use judgment, interact socially, adapt to changes, among a panoply of other considerations. The claims examiner will look to documentation from clinical examinations, information from mental healthcare providers, and other medical evidence provided both by your doctors and yourself (or your attorney).
The claims examiner will then evaluate the applicant’s mental residual functional capacity as it affects the applicant’s ability to work in his or her previous job and in any other job, considering his or her mental impairment, education, work experience, and other factors. Based on the medical evidence, the applicant may be approved if his or her condition is severe enough to meet or equal a mental listing in the Blue Book (in which case, one is automatically deemed incapable of performing any form of gainful employment), or if not, if the condition is severe enough to prevent him or her from engaging in substantial gainful activity (both in terms of any past work one has performed in the prior 15 year, deemed your “past relevant work” and in any jobs for which you may be suited by age, education and experienced with a view as well to your residual functional capacity). It is important to note that, although an SSDI applicant may be working, he or she cannot be engaging in substantial gainful activity to qualify for SSDI benefits (or be deemed capable of such work). The SSA determines and publishes each year the applicable earnings limit for what is deemed “gainful wages”: for 2015, the limit is $1,090 for most claimants, and $1,820 for statutorily blind individuals.
Finally, the SSA will evaluate the medical evidence to confirm that the applicant’s mental condition will prevent him or her from working for a continuous period for one year or longer. There are very complicated rules having to do with unsuccessful work attempts during what may be that year period of time: these rules would need to be explained to you by a knowledgeable Social Security disability lawyer (and, in turn an evaluation can provided as to whether any work you’ve undertaken during the year may not be counted against the year duration requirement).Discuss Your SSDI Application with an Experienced Lawyer
At the Law Offices of Russell J. Goldsmith, our legal team provides individualized legal services and thorough attention to the details of your case. We understand the claims process and can help present your case in the most persuasive way possible. To schedule a free consultation with SSDI attorney Russell J. Goldsmith, contact our office by phone at (800) 773-8622 or online.