How to Get Disability for Mental Illness: A Guide

If you suffer from mental illness, you know that it can be debilitating. Mental health issues can prevent you from doing your day-to-day activities, such as spending time with your family, enjoying hobbies, and even going to work.

When you can’t work due to a disability, the federal government provides SSDI, or social security disability benefits, an SSI, or social security income. There are certain requirements you must meet in order to qualify, however.  To learn more about these programs and how to get disability for mental illness, read on.

What Are SSDI and SSI?

The federal government provides two different programs that pay benefits to people when they are unable to work or are disabled to the point where they can no longer be employed. These programs provide health insurance and a monthly income for those who are unable to work and support themselves.

Social Security Disability Income (SSDI)

SSDI is meant for people who cannot work for at least 12 months due to some impairment. In addition, you have to have worked and paid into the Social Security program through payroll taxes (FICA) for at least 5 of the past 10 years.

The amount you receive is based on the amount of payroll taxes you paid while you were working. In 2020, the average amount of SSDI a disabled person received was $1,259, but this amount could be higher or lower depending on your lifetime earnings. If you keep your Social Security statements, which are mailed every 5 years after you turn 25, you can estimate what your benefit might be by looking at the Estimated Benefits section.

Your children who are in high school or younger as well as your spouse can also receive benefits from your SSDI income, and after 24 months on SSDI, you can apply for Medicare benefits.

Supplemental Security Income (SSI)

To qualify for SSI benefits, an adult must have an impairment that prevents them from working on a regular basis. Additionally, you must show that you have a financial need and have few assets.

Specific requirements are for less than $2,000 in assets. If you are married, you and your spouse cannot have more than $3,000 in assets.

The amount you can get from SSI changes each year. In 2020, an individual on SSI received $783 a month and a couple on SSI received $1,175 a month.

Assets do not include your primary residence, one car, wedding and engagement rings, and some other type of financial support.

How to Get Disability for Mental Illness

In order to get disability for a mental illness, your diagnosis must be included in the Blue Book, which is used by the Social Security Administration to determine which disorders are covered by SSDI or SSI.

There are nine different mental disorders covered by SSDI and SSI, including:

  • Affective disorders
  • Anxiety
  • Autism
  • Mental retardation
  • Somatoform disorders
  • Schizophrenia, paranoia, bipolar disorder, and psychotic disorders
  • Organic mental disorders
  • Personalty disorders
  • Substance abuse disorder

There are separate criteria for each disorder, and to get benefits, you must demonstrate that you meet the criteria for that disorder. In addition, you need to show that you are receiving treatment for that disorder and following the treatment plan laid out by your doctor. Not doing this could jeopardize your claim and could result in your claim being denied or the loss of your benefits.

In addition, some other conditions that may qualify under a mental disorder designation include:

  • ADHD
  • Asperger’s syndrome
  • Chronic insomnia
  • Depression
  • Dysthymia
  • Eating disorders
  • Hallucinations
  • Memory loss
  • Mood disorder
  • Obsessive compulsive disorder
  • Panic attacks
  • Postpartum depression
  • Post Traumatic stress disorder
  • Schizoaffective disorder

In order to qualify, you must meet the requirements listed in the Blue Book, seek treatment, and follow the treatment plan.

Applying for Benefits

Before you can apply, you must meet the basic eligibility requirements, including a formal diagnosis of a disabling condition that will disable you for one year or longer. If you meet these requirements, the Social Security Administration (SSA) will review your medical condition to verify that you meet the medical requirements for benefits.

After the SSA confirms that you meet basic eligibility, they will then move on to review your medical condition in detail and verify that you meet all program requirements for SSDI and/or SSI.

To determine if you qualify for benefits, the SSA will thoroughly review your medical records and try to match your diagnosis to one of the disorders listed in the Blue Book. The Blue Book lists the requirements and how severe the disorder must be in order to qualify.

Providing the documentation and diagnosis is up to you and your doctor. To make a strong case, you will need to provide the following:

  • Description of your diagnoses, typically from a psychologist or psychiatrist
  • Brain scans or evidence of brain abnormalities to indicate an organic cause for symptoms (if this is relevant)
  • Treatment records, medication records, treatment plans, etc.
  • Documented episodes of the continued and increasing negative impact of your symptoms
  • Documentation of your symptoms impacting your ability to completed “activities of daily living” (ALDS)

You will also need to document that you have been taking medications for two or more years and haven’t had any improvement in your condition.

Getting approved for SSDI or SSI with a mental disorder can be difficult and many initial claims are denied. The process generally takes a few months as well. If your claim is denied, you can appeal the decision. Working closely with your doctor and an experienced disability attorney can greatly improve your case.

How to Apply

If you want to apply for SSDI only, you can do it online or in person. If you want to apply for SSI, you will have to complete an interview, which is typically done in person.

If you are approved, you will have periodic reviews of your case. For mental illnesses, they will typically occur each year. If your condition does not improve, your benefits will typically be continued, but if it does improve, your benefits may be denied.

Increase Your Chances of Success with a Disability Attorney

Now that you have a clearer understanding of how to get disability for mental illness, you can start building your case if you feel that it applies to you. To improve your chances of success the first time around, or to improve the likelihood that your appeal is successful, consider hiring an experienced disability attorney.

Here at Sweet Law, our attorneys can help you apply and handle any appeals. We will take care of the paperwork and negotiate with the SSA on your behalf. Contact us today for a free case evaluation.

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