The Blue Book is used by the Social Security Administration to establish guidelines for which conditions qualify a claimant for Social Security disability benefits. Section 12 of the Blue Book deals with mental disorders, detailing which types of mental disorders can qualify you for benefits, and under what circumstances. There are nine categories of mental disorders covered in the Blue Book. These include:
- Organic Mental Disorders
- Schizophrenia, paranoia, and psychotic disorders
- Affective disorders
- Mental retardation
- Anxiety Disorders
- Somatoform disorders
- Personality disorders
- Substance addiction
- Autism and related disorders
Each type of disorder is evaluated according to its own set of criteria. To qualify for benefits with that condition, you must be able to show that you meet the criteria or that the sum total of all of your disabling conditions is equivalent to the listed criteria or otherwise completely hinders you from engaging in any gainful activity.
Regardless of which type of mental disorder you are dealing with, you will need to be able to show that you are receiving and complying with treatment. It is important that you continue to undergo treatment while you are in the process of claiming Social Security disability benefits.
Organic Mental Disorders
To qualify for disability benefits with organic mental disorders, the medical evidence needs to show that your disorder has continued for two years or more despite treatment and that it hinders you from performing even basic work functions. Essentially, you need to show that you cannot function outside of a highly supportive environment. Alternately, you may qualify if you have at least one condition from each of the columns in the chart below:
|Time and place disorientation||Significant limitation of daily living activities|
|Impaired memory (short or long term)||Significant limitations in social situations|
|Hallucinations or delusions||Difficulty concentrating or keeping pace|
|Personality changes||Extended and repeated periods of decompensation|
|Mood disturbances||Loss of 15 or more points of IQ|
|Lability of emotions|
Psychotic Disorders (including Paranoia and Schizophrenia)
To qualify for disability with psychotic disorders, you must have medical documentation showing two years or more showing that your condition severely limits your ability to function in a work environment. The documentation must show that any change in your work situation would lead to more problems or that you are incapable of living outside of a supportive environment. Alternately, you may qualify if you have one of the following conditions and you can show that it severely affects your ability to function in a work or social environment:
- Disorganized behavior
- Illogical thinking
- Speech significantly affected by blunt effect, inappropriate affect, or flat affect
- Isolation and emotional withdrawal
The specific requirements to qualify for disability benefits vary with the type of affective disorder, but in general, you must have medical documentation showing that the disorder affects your ability to function despite undergoing treatment for the disorder. You must show either that you:
- Have been in treatment for two years and cannot function outside of a supportive environment or
- Have medical documentation giving sufficient evidence that your condition hinders you from reasonably being expected to function in any work environment.
You (or one whom you represent) will qualify for disability benefits based on mental retardation if you have medical documentation showing any of the following conditions:
- Dependence for personal needs such as bathing, eating, getting dressed, and using the toilet.
- IQ of less than 60
- IQ of less than 70 combined with other conditions (mental or physical) which limit your ability to function in a work environment, your social situations, or your daily living activities
To qualify for Social Security disability benefits with an anxiety disorder, the medical evidence must show that you have at least one of the following:
- Persistent anxiety with appropriate symptoms (i.e., motor tension, apprehensive expectation, etc.)
- Constant irrational fear
- Recurring, unpredictable panic attacks at least weekly
- Recurring compulsions and obsessions leading to significant distress
In addition, the evidence must show that these conditions significantly impact your ability to function in normal work and social conditions.
To qualify for disability with a somatoform disorder, you need medical documentation showing that, by age 30, you had a history of having unexplained physical symptoms which last for several years and that these symptoms require you to make significant changes to your lifestyle. You will generally qualify for disability if the symptoms involve loss of sight, hearing, speech, loss of movement, loss or heightening of sensation, or loss of use of one or more limbs.
To qualify for Social Security benefits with a personality disorder, you need evidence showing that your condition causes you to be unable to adapt to social or work situations and that the condition has caused long term problems. The disorder needs to cause at least one of these symptoms:
- Autistic thinking
- Inappropriate hostility
- Inappropriate suspiciousness
- Odd thought, speech, behavior, or perception patterns
- Constant mood disturbances
- Impulsive, damaging behavior, especially regarding relationships
To qualify for disability due to substance abuse issues, you will need medically documented evidence that your substance abuse issue causes you to meet the requirements for one of the other mental disorders, neurological disorders (evaluated in Section 11 of the Blue Book), or digestive disorders (Evaluated in Section 5 of the Blue Book).
Autism and Related Disorders
To qualify for disability benefits with autism or similar pervasive development disorders, you will need to show that the condition limits the ability to communicate, engage in activities outside of a few interests, and interact socially. Further, you must be able to show that these limitations cause significant difficulty in your ability to function in work and social situations.