Social Security Disability Insurance (SSDI) benefits are available to U.S. citizens who cannot work due to uncontrollable symptoms of a diagnosed mental disorder. Qualifying for SSDI payments is not easy, however.
Covered Conditions
The Social Security Administration recognizes the following categories of mental disorders as potentially permanently disabling:
- Neurocognitive disorders, which include disorders that impair learning, memory, language, social cognition (e.g., responding to cues like smiling), and executive functions (e.g., decision-making, planning);
- Schizophrenia spectrum and other psychotic disorders;
- Depressive, bipolar, and related disorders;
- Intellectual disorder, which includes problems that prevent people from progressing past the mental development of a young child and problems that leave people requiring assistance with the activities of daily living such as using the bathroom and dressing;
- Anxiety and obsessive-compulsive disorders;
- Somatic symptom and related disorders, such as extreme and irresolvable hypochondria or seemingly voluntary but disturbing behaviors that cannot be explained by a more-specific diagnosis;
- Personality and impulse-control disorders;
- Autism spectrum disorder;
- Eating disorders; and
- Trauma- and stressor-related disorders, which for SDI purposes require a trigger of witnessing a death or nearly dying.
The agency will also allow an applicant for SSDI benefits to present medical evidence for disabling symptoms of a condition that des not fall into one of the listed categories.
An Example of What Social Security Considers a Disabling Mental Disorder
The SSDI program applies different criteria for deeming each of the listed mental disorders permanently disabling. Consulting with an experienced Social Security disability lawyer will clarify which criteria apply in your case. Be aware, too, that a parent, legal guardian, or legal executor can apply for SSDI benefits on behalf of a disabled child or adult. An attorney can then assist with completing the application and working through any appeals that may be necessary.
Each case will be different, but looking at a general example will help illustrate what an applicant will need to demonstrate in order to receive disability benefits from Social Security. Let’s go with autism, as spectrum disorder diagnoses are becoming more common in Columbus, Ohio, where we practice, and across the United States.
The SSDI program requires someone with an autism spectrum disorder to present “medical documentation”—that is, health records, therapists’ notes, evaluations from occupational specialists and such—of significant deficits in verbal communication, an inability to meaningfully engage in social interactions, and either repetitive behaviors or obsessive interests. Additionally, the person with autism must display an “extreme limitation of one, or marked limitation of two, of the following areas of mental functioning”:
- Understanding, remembering, or applying information;
- Interacting with others;
- Concentrating on tasks, persisting with tasks until completion, and working through tasks at a reasonable pace; and/or
- Adapting to new situations or managing oneself as situations change.
These criteria clearly exclude the majority of people with autism spectrum disorders that show milder symptoms from eligibility for SSDI benefits. Similarly, the criteria for other common types of mental disorders such as eating disorders and depression are very strict. The general rule is that a person must be nearly or completely unable to function in order to qualify for disability payments from the federal government. Additionally, symptoms must have persisted for years and resisted multiple forms of treatment. Last, even after accepting an applicant’s medical documentation, the SSDI program will make the person undergo an assessment from a specialist chosen by the program. Only after clearing all those hurdles can a person with a mental disorder qualify for Social Security disability.