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Episodes of Decompensation

If you suffer from a psychiatric or psychological disorder, you will probably be familiar with periods of time when the treatment you receive is effective and you are able to function on one level or another. Then there are other times when treatment, even previously effective treatment, fails, and you are unable to carry on. Your mental state deteriorates and your ability to function is negatively affected. These periods of deterioration, regardless of cause, are called “episodes of decompensation” and are referred to in the Social Security Disability impairment listings found in the Blue Book.

Episodes of decompensation are important in establishing the severity of your mental condition when you are applying for Social Security Disability benefits because of a psychological or psychiatric disorder. Since the SSA places a heavy emphasis on determining what you can do despite your disability, establishing the fact that you have periods where your ability to function is severely impaired can help you build a case for your inability to work and your inability to engage in normal activities. This, in turn, can result in your being found eligible for Social Security Disability benefits.

It is not enough for you to relate episodes of decompensation in your Social Security Disability interview. Each such episode and its duration must be medically documented, that is, it must appear in the medical records you submit as part of your disability application. Therefore, whenever you experience an episode of decompensation, you should tell your doctor and make sure that the episode is properly documented.

In the course of his or her review of your application for disability benefits, the examiner will study your medical records from acceptable medical sources to see how often and for what period of time you experience periods of decompensation and to see how severely these episodes affect your ability to function. To qualify for Social Security Disability benefits under the various mental health impairment listings, you must experience repeated episodes of decompensation which must be of extended duration and must be of sufficient severity to limit your ability to perform normal daily activities. If these episodes are not noted in your medical records, they cannot be proven. It is just as important for you to document periods of decompensation as it is for someone suffering from cancer to document each radiation treatment.

When applying for Social Security Disability benefits for a psychological or psychiatric condition, periods of decompensation are not the only measure taken into consideration, but they are quite important and you should be certain to relate each episode to your treating physician.