Mental Disorders & Legal Eligibility for Social Security Disability
The Social Security Administration recognizes that mental impairments may cause just as much disruption as physical impairments to a person’s ability to work. Thus, a claimant with a qualifying mental disorder may be eligible for Social Security disability benefits. The SSA Listing of Impairments contains a section devoted to mental disorders. It includes the following 11 types of impairments:
- Neurocognitive disorders
- Schizophrenia spectrum and other psychotic disorders
- Depressive, bipolar, and related disorders
- Intellectual disorder
- Anxiety and obsessive-compulsive disorders
- Somatic symptom and related disorders
- Personality and impulse-control disorders
- Autism spectrum disorder
- Neurodevelopmental disorders
- Eating disorders
- Trauma- and stressor-related disorders
Distinctive rules apply to the process of determining whether a claimant’s condition satisfies the criteria of an entry in the Listing. If they do not satisfy the criteria of any entry, however, they still may be eligible for benefits if they meet certain other requirements.
Benefits Based on a Mental Disorder Under the Listing of Impairments
Depending on the type of mental disorder from which a claimant suffers, one of three paths to eligibility may apply. One path applies to people with somatic symptom and related disorders, personality and impulse-control disorders, autism spectrum disorders, neurodevelopmental disorders, or eating disorders. Each of these entries contains two paragraphs of requirements, both of which the claimant must satisfy. Paragraph A consists of medical criteria, while Paragraph B consists of functional criteria. The SSA applies a rating scale to determine how a claimant’s mental disorder affects their functioning in four areas. A claimant will meet the Paragraph B criteria if their mental disorder causes an extreme limitation of one of these four areas, or a marked limitation of two of these four areas.
A second path applies to people with neurocognitive disorders, schizophrenia spectrum and other psychotic disorders, anxiety and obsessive-compulsive disorders, trauma- and stressor-related disorders, or depressive, bipolar, and related disorders. These entries each contain three paragraphs. A claimant must satisfy the criteria of Paragraphs A and B, or Paragraphs A and C. Again, Paragraph A provides medical criteria, while Paragraph B consists of the same functional criteria provided by Paragraph B under the previous path. Paragraph C contains criteria for serious and persistent mental disorders. A condition is serious and persistent if it has been medically documented for at least two years, and two other requirements are met. There must be evidence of ongoing medical treatment, mental health therapy, psychosocial support, or a highly structured setting that alleviates the disorder, and the claimant must have minimal capacity to adapt to changes in their environment or demands that are not part of their daily life.
Finally, the entry for intellectual disorder is unique. It contains two paragraphs, each of which lists three criteria. A claimant must meet either all the criteria of Paragraph A or all the criteria of Paragraph B. In general, a claimant must have significantly sub-average general intellectual functioning, significant deficits in current adaptive functioning, and evidence showing that their disorder began before they turned 22.
Further Paths to Benefits Based on a Mental Disorder
The criteria for each entry are extremely precise, and some claimants may be unable to perform any work due to a mental condition even though they do not meet all the criteria for any given entry. However, the SSA allows a claimant with a severe mental impairment to receive benefits if their impairment is medically equal to an entry in the Listing. Also, a claimant with a mental disorder may have developed a secondary physical impairment as a result of their mental disorder. If their secondary physical impairment meets the criteria of an entry elsewhere in the Listing, they could receive benefits on this basis even though their primary mental impairment does not qualify.
Otherwise, a claimant still may receive benefits based on a residual functional capacity assessment. This essentially requires that they cannot perform past relevant work and cannot make an adjustment to other work. The SSA notes that evaluating a claimant’s residual functional capacity will involve considering any physical limitations resulting from their mental condition, as well as their mental limitations. Some people who suffer from mental disorders must take medications to manage their symptoms. These medications may cause physical side effects that undermine a claimant’s ability to work.
