According to the American Psychiatric Association, PTSD affects about 3.5 million adults in the United States. It is a mental health disorder that may cause extreme and disturbing thoughts and emotions in people who have witnessed or experienced a traumatic event, such as war, a serious car accident, or sexual violence.
People with post-traumatic stress disorder may experience nightmares and flashbacks forcing them to relive or be reminded of the traumatic event. The APA estimates that one in 11 people will, at some point in their lives, be informed by a health care professional of a PTSD diagnosis.
If you have been diagnosed with PTSD that causes you to be unable to work, you may qualify to get Social Security disability PTSD benefits provided the condition meets guidelines to qualify for them. You should begin with a free consultation and claim evaluation with an SSD advocate at London Eligibility to learn more about how the facts of your specific condition may affect your ability to qualify for benefits.
What is a disability under Social Security guidelines?
There are two disability programs administered by Social Security: Social Security Disability Insurance and Supplemental Security Income. Each of them pays monthly benefits to individuals who are disabled. Applicants for SSDI must have a work history of sufficient duration to qualify for benefits. SSI does not require a work history, but it is a needs-based program with limits on the income and financial resources a person may have available to them.
A person is disabled for purposes of Social Security disability when unable to engage in substantial gainful activity as a result of a medically determinable physical or mental impairment. The impairment must be expected to last for at least 12 consecutive months or cause the person to die. “Medically determinable” means the impairment can be proven through medically acceptable laboratory and clinical diagnostic techniques, such as physical examinations or mental health evaluations.
Work activity involving significant physical or mental activities for which someone receives profit or pay is substantial gainful activity. Examples of work activities include climbing steps, walking, lifting, remembering things, and following instructions.
PTSD and the Listing of Impairments
Social Security has a Listing of Impairments, which is commonly referred to as the “Blue Book.” It contains physical and mental conditions that Social Security has determined to be severe enough that a person with the condition qualifies as being disabled provided medical evidence proves each of the criteria for a particular listing.
A claim for benefits because of a disability caused by PTSD would have to satisfy all of the criteria for the Blue Book listing under trauma- and stressor-related disorders. Your medical records must be capable of proving the following:
A). Exposure to a threat or actual death, serious injury, or violence.
B). Involuntary reliving the event through flashbacks, nightmares, intrusive memories, or similar episodes.
C). Avoidance of reminders of the traumatic event.
D). Mood and behavior disturbances.
E). Increased reactivity, including sleep disturbance.
Medical documentation proving that you experienced a traumatic event and exhibit the listed behaviors is only part of the process of qualifying for SSI or SSDI benefits based on PTSD. The medical documentation also must show that you experience extreme limitation of one of the following mental functions:
1). Ability to understand, apply or remember information.
2). Ability to interact with other people.
3). Ability to concentrate or maintain pace.
4). Ability to adapt or manage yourself.
If your mental function limitation is marked and not extreme, you must show it exists in at least two of the areas listed above. Your SSI advocate can help determine whether the medical evidence proves the required level of limitation of mental function.
An alternative method to meet the listing criteria in cases where the medical evidence does not establish the level of mental function limitation called for is by proving that the PTSD is serious and persistent. An SSDI advocate may accomplish this by presenting a medically documented history establishing existence of the disorder for at least two years and showing an ongoing course of treatment that diminishes the symptoms of the disorder, but you still cannot make more than a marginal adjustment to changes in your environment.
What happens if you cannot satisfy the listing criteria?
Meeting the criteria of the Listing of Impairments to prove PTSD can be difficult but failing to do so does not mean you cannot get Social Security approved for PTSD. The evaluation process used by Social Security lets it review your application for benefits to determine if your PTSD is severe enough to prevent you from performing work that you did before the onset of the disability. It also looks at your age, education, work history, and other factors to determine if your impairment permits you to engage in other types of work.
Speak with a disability advocate
Obtaining Social Security disability for PTSD can be challenging, but the disability advocates at London Eligibility have the knowledge and experience to improve your chance of success. Schedule a free consultation today.