Table of Contents
- Mental Disorders and Disability Qualification Under the ADA and SSA
- How to Apply For Mental Health Disability Benefits
- Get Connected with a Disability Attorney
- Mental Illness Disability Benefits FAQ's
Mental Disorders and Disability Qualification Under the ADA and SSA
Mental illness is considered a disability by the Americans with Disabilities Act (ADA) as an impairment that substantially limits one or more major life activities and by the SSA as an impairment that can last at least 12 months and makes it impossible to engage in substantial gainful activity (SGA).
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. Many mental health conditions qualify for disability. There are 11 categories of mental disorders covered in the Blue Book. These include:
- Affective Disorders
- Anxiety Disorders
- Autism and Related Disorders
- Intellectual Disabilities
- Organic Mental Disorders
- Personality Disorders
- Schizophrenia, Paranoia, and Psychotic Disorders
- Somatoform Disorders
- Substance Addiction
How to Apply For Mental Health Disability Benefits
1. Demonstrate Inability to Work
To get approved for disability benefits, you must demonstrate to the SSA that your medical condition makes it impossible for you to work. Additionally, you need to provide evidence of ongoing medical treatment for your mental health condition.
2. Meet Technical Eligibility
Confirm that you meet the work history or income limits for disability programs. This involves collecting and submitting extensive paperwork to the SSA, attending any medical examinations mandated by the SSA, and sending in follow-up documentation if requested by the SSA.
3. Meet Medical Requirements
To get disability benefits for a mental illness from the SSA, you must meet the medical requirements for your condition, as listed in the SSA’s Blue Book. Ensuring your condition matches one of the listings in the Blue Book is important because the SSA will review your medical records to determine eligibility. The Blue Book outlines the specific medical evidence needed and severity level requirements for each disability claim.
Mental illnesses, categorized under Section 12.00 of the Blue Book, encompass various conditions such as anxiety-related disorders, personality disorders, and affective disorders. Specific listings include:
- 12.06: Anxiety-related Disorders (e.g. severe phobia, PTSD, panic disorder)
- 12.08: Personality Disorders (e.g. severe clinical depression)
- 12.04: Affective Disorders (e.g. bipolar disorder)
To qualify, comprehensive medical documentation is crucial. These medical documentation (i.e., medical records) include:
- Diagnosis information, preferably from a psychiatrist or psychologist.
- Evidence of physical abnormalities through brain scans or other means that highlight an organic cause for your symptoms, if applicable.
- Treatment records detailing therapy, medications, and other management methods you’ve used, along with their effects.
- Well-documented instances of heightened symptoms or periods of decompensation.
- Extensively recorded impacts of your symptoms on your day-to-day abilities or "activities of daily living" (ADLs).
Detailed impacts of your symptoms on daily living activities (ADLs), such as interacting with others or dressing yourself.
4. Proof of Condition Severity
Show that your mental health condition prevents you from functioning outside your home. Provide evidence of adherence to medication without improvement over at least two years to strengthen your case.
5. Gather Comprehensive Documentation
Compile all relevant medical records, professional opinions, a comprehensive list of medications and their impacts, and pharmacy records. Ensure you include contact information for all your healthcare providers. Avoid including irrelevant medical records from non-mental health providers. Make copies of all documents as backups.
6. Understand Work Requirements
For SSDI, ensure you have the necessary work credits based on your age. Generally, you need 40 work credits, with 20 earned in the last 10 years, but the exact number depends on your age. In 2023, one work credit is earned for every $1,640, up to four credits per year. SSI, on the other hand, does not have work credit requirements but is based on financial need.
7. Meet Financial Requirements
Your earnings must fall below the substantial gainful activity (SGA) limit, which is $2,590 per month if you are blind (up from $2,460 in 2023) and $1,550 per month if you are not blind (up from $1,470 in 2023). SSI has additional financial criteria: your unearned income must be below $934 per month ($1,391 for couples), earned income can be up to $1,913 per month ($2,827 for couples), and your assets should not exceed $3,000 for couples or $2,000 for individuals.
Get Connected with a Disability Attorney
Applying for disability benefits is unfortunately quite difficult and the process can take many months. Working with a disability attorney can significantly increase your chances of getting approved for disability. According to data released by the SSA, disability claimants who worked with a disability lawyer had higher success rates (i.e., got approved for disability benefits) compared to those who did not work with a lawyer.
A disability lawyer can analyze your case to determine if it shows signs that you will be approved for disability. The application process can be complex, but a lawyer can assist you by gathering and presenting necessary medical evidence and representing you during appeals if your initial claim is denied. Their expertise and support can be invaluable in ensuring your case is as strong as possible, improving your chances of receiving the benefits you need.
Mental Illness Disability Benefits FAQ's
What Happens After You Get Approved for Mental Illness Disability?
You will receive monthly benefits for treatment, medication, and basic needs, along with possible backpay for the period between application and approval.
How Much Does Mental Health Disability Pay?
For 2024, SSDI payments can be up to $3,822 per month, with an average of $1,483. SSI payments are up to $943 per month for individuals and $1,415 for couples.
How Long Does It Take To Process A Mental Illness Disability Application?
The process can take three to five months, but it may vary depending on the complexity of your case and the completeness of your application.
Do I Need A Lawyer To Apply For Disability Benefits?
While not required, having a disability lawyer or advocate can significantly help navigate the application process, especially if your initial application is denied.
