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How Social Security Disability Attorneys Identify Winning Mental Health Claims

Are you pursuing Social Security disability benefits based on a mental health condition such as:

  • depression
  • anxiety
  • PTSD
  • bi-polar disorder
  • schizophrenia
  • personality disorder

A significant number of disability applicants list mental health problems as either a primary or secondary impairment that prevents that applicant from working. From my perspective as a disability attorney who speaks with hundreds of honest, sincere claimants every year, I think that mental health disorders are both extremely common and widely untreated in the general population.  In short, there are a lot of folks out there who are really suffering and far too few get treatment that could really improve their lives.  Perhaps you fall into this situation.

Every day I speak with men and women struggling with depression, post-traumatic stress disorder, bi-polar symptoms, schizophrenia, anger control issues, and other personality disorders that make consistent, full-time work all but impossible.

I also know that many of these mental health disorders are very difficult and very expensive to treat and many of the folks I speak with simply cannot afford the various therapies that might make life more bearable and steady work more likely.

Mental Health Claims Increasingly Difficult to Win in Social Security Disability Claims

In the Social Security disability world, claims based on mental health conditions are increasingly difficult to win. With limited exception MRIs, CT scans and other brain imaging technology cannot conclusively document the existence of a mental health problem. Social Security decision makers, be they adjudicators or administrative law judges, are left to rely on treatment notes from psychologists, psychiatrists and other therapists to identify a diagnosis and to evaluate the severity of the underlying mental health condition in terms of how that condition impacts work.

These decision makers also must rely on written statements from third parties and testimony from the disability applicant to understand medication side effects and the “real world” implications of living with a significant mental health condition.

Adjudicators and judges are also facing increased pressure from SSA to deny claims that cannot be documented with objective diagnostic testing. Since mental health conditions generally cannot be “viewed” claimants pursuing disability based on a mental condition face an uphill battle.

Finally, I advise folks calling or emailing me regarding mental heath disability claims that they should not expect an early or fast decision. Most of these cases will be denied at the initial application and reconsideration appeal stages, and end up before a judge at a hearing. And given the long delays currently in the system, this means that an applicant will most likely end up waiting 2 to 3 years for a decision.

Characteristics of Winning Mental Health Disability Claims

Here is what I look for when evaluating a disability claim based on a mental health condition:

  • How old are you? My experience has been that you have a better chance for approval if you are age 50 or over. There are several reasons for this. First, judges are generally more sympathetic to older claimants – they recognize that many chronic health issues, whether mental or physical, tend to get worse as we age. Second, if you are approved at age 50 or 55, the disability trust fund will only be on the hook for 5 or 10 years. Third, if you are younger and have children or teenagers at home, judge will question why you say you cannot work, but you can raise your children.
  • Do you have a long and consistent work history? Judges tend to give more benefit of the doubt to disability claimants with long and consistent work histories. I encourage my clients to reinforce this tendency by testifying to the judge that they would not leave a steady and financially rewarding job or career to sit and home for 3 years hoping that Social Security will award benefits.
  • Do you have a consistent treatment history? Many mental health claimants have been struggling for years and judges expect to see years of treatment with psychologists or psychiatrists.
  • Does the medical record document a specific diagnosis? While it is true that some mental health conditions result in multiple diagnoses, there are diagnostic testing procedures that will allow a psychologist or psychiatrist to make a firm diagnosis.
  • Have you been prescribed psychotropic medications by a psychiatrist? It is becoming increasingly difficult to win a disability claim based on mental health conditions if you have not been prescribed medications. Further, since psychotropic medications tend to lose effectiveness over time, I look for cases where my client’s medical record shows a history of increased dosages, then one or more prescription changes. If I can argue that my client has been prescribed multiple medications over time, and that these medications needed to be changed because they became ineffective or because of significant side effects, I can contend that my client’s condition cannot be readily treated.
  • Does your medical record contain evidence of multiple mental health hospitalizations and/or suicide attempts? I need to be able to argue that my client’s condition is significantly more than a mild impairment. I need to show that my client’s level of functioning regularly deteriorates to the point where formal intervention is needed.
  • Can I get evidence from third parties of significant problems with activities of daily living? Ideally, I look for a former co-worker or supervisor who will complete an affidavit stating that my client was unable to withstand the pressures of working and experienced breakdowns and job performance problems.
  • Is my client’s medical record free of evidence of street drugs or substance abuse. Unfortunately many folks struggling with mental health issues will turn to drugs or alcohol to “self medicate.” This type of behavior raises questions in the mind of disability judges as to whether the symptoms being alleged are related to the underlying problem or the street drugs.
  • Does your condition interfere with your activities of daily living? It is difficult to argue for disability if you are able to function adequately at home – doing housework, cooking, cleaning, driving carpool, helping the kids with homework, etc. Judge expect to see a person who struggles even in a controlled environment.
  • Does your condition result in odd behavior that would likely create problems at work. For example, if you experience crying spells, or inappropriate outbursts of anger, any job would be difficult to perform reliably.
  • Can you explain your struggles? I often ask my clients to explain to the judge what it is like to have severe depression, or to struggle with the symptoms of PTSD. If your condition was the result of a specific trauma (such as violence, sexual abuse), can you describe that trauma?
  • Do you have strong support from one or more treating psychiatrists or psychologists? I tend to rely on functional capacity evaluation checklist forms. Some of my colleagues prefer narrative reports. Either way, it will help you case greatly if we have statements from your doctors that your condition has left you unable to perform tasks that would be required at any job, such as maintaining attention and concentration, performing tasks in a timely manner, behaving in an emotionally stable manner, and interacting appropriately with co-workers, supervisors or the general public.

As you can see there are many factors that a lawyer will consider when evaluating a case for possible intake. I don’t necessary need to see every factor listed above but I hope this article gives you an idea about the degree of severity I look for when deciding whether to accept a case for representation.

You can still win Social Security disability benefits if your ability to work is limited by symptoms of your mental health condition or by medication side effects.  However, you need to give SSA decision makers what they need to approve your claim.

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