Proving a mental health disability claim is hard. Most of the time, the symptoms are hidden, and measuring their impact on people’s lives isn’t easy.
For example, if you suffer a broken leg, an X-ray will confirm it, and claim assessors can easily understand why you can’t work. Now, imagine if you had bipolar disorder or severe depression. Just proving you were suffering from this condition would be a tall order, let alone how it affects you.
The difficulty of proving mental health disability claims is unfortunate, considering thousands of people suffer from these conditions. For example, two percent of disability claims revolve around psychotic disorders like schizophrenia and delusional disorder.
If you or a loved one is considering filing a mental health disability claim, you need to understand how the process works. This guide will help you do just that. You’ll also learn the common reasons for denial, the legal help available, and more.
The Process of Filing a Mental Health Disability Claim
Many people fail to win claims because they don’t understand how the filing process works. Here’s the breakdown of each step:
Determine Eligibility
There are two main types of benefits you can enjoy as a person living with a mental disability.
Social security disability insurance (SSDI) caters to people who can’t work due to mental health issues but have been paying social security through taxes. The monthly payments under SSDI depend on your past earnings.
The other benefit is the supplemental security income (SSI), which caters to people in need, specifically those above 65 years with mental health issues.
Gather Medical Evidence
Having strong medical proof, like getting a diagnosis from a reputable health facility and records of treatments, is important if you want to win a claim. It’s also helpful if doctors can demonstrate how your condition affects daily life and work.
Prove Consistent Medical Treatment
If you have a mental disability, it’s expected that you visit the doctor, receive therapy, and take medication regularly. These actions prove to the Social Security Administration (SSA) that you have a long-term mental health condition and deserve a claim.
Seek Legal Assistance
This isn’t a must but can greatly help you win a claim. A disability attorney will help you correctly file all your paperwork and even represent you if your claim is denied. Since most initial requests are rejected, having an attorney will make the appeal process smoother.
Submit the Application
Once you’re confident that everything’s in order, it’s time to submit your application to the SSA. You can do so by phone, online, or in person. Once you apply, you’ll have to wait several months as the SSA reviews your medical records, work history, and other supporting documents.
Common Mental Health Conditions in Disability Claims
Most mental health conditions that qualify for claims include those that severely affect daily life and the ability to work. Some of the most common include:
Mood Disorders
Common conditions that fall under mood disorders include major depression and bipolar disorder, which cause intense mood swings. Patients often experience extreme sadness, hopelessness, or hyperactivity, which makes it hard for them to focus and interact socially or maintain their jobs.
Anxiety Disorders
Post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) are the most common conditions under anxiety disorders. These conditions often cause reduced concentration and poor decision-making due to constant worry and compulsive behaviors, among other things affecting daily work activities.
Psychotic Disorders
Delusions and hallucinations are some of the main symptoms of psychotic disorders, which affect the perception, thinking, and behavior of patients. Here, you’ll find conditions like schizophrenia and schizoaffective disorder, which make it almost impossible for sufferers to work and earn a living.
Why Mental Health Disability Claims Get Denied
Filing a mental health disability claim doesn’t guarantee approval. Many claims are denied due to the following reasons:
Insufficient Medical Evidence
Detailed medical records are the backbone of your claim and determine whether you’ll succeed. For a claim to go through, you’ll need to prove how the mental conditions limit your daily life and ability to work. Your claim will likely be rejected without professional diagnoses and detailed treatment history.
Failure to Meet SSA’s Definition of Disability
According to the SSA, mental health conditions can qualify if they severely affect your ability to perform basic work activities. However, if treatment enables you to function normally and work, the SSA may determine that the condition is not disabling.
Incomplete Treatment Records
Your medical records need to make sense if you are to win a claim. Things like missed appointments or gaps in treatment send negative signals to the SSA, which may doubt your story. Consider things like demonstrating continuous care from psychiatrists, therapists, and primary doctors, which will strengthen your case.
Application Mistakes
Since thousands of people apply for benefits yearly, the SSA is strict on the rules when assessing claims. Any errors or omissions, like failing to submit all required paperwork or missing deadlines, can lead to automatic disqualification. Additionally, errors in the application process, such as incomplete forms, can cause delays.
Legal Rights and Support for Mental Health Disability Applicants
The claim filing process is long and confusing. And that’s why you should take advantage of the following resources.
Americans With Disabilities Act (ADA)
The ADA protects you from workplace discrimination. It does this by requiring your employer to offer reasonable accommodations to help you work better. This includes flexible schedules, remote work, or job duty modifications.
SSDI and SSI Programs
These are state programs that offer help to people with mental disabilities. Each program caters to a unique set of patients depending on their circumstances and program rules.
Legal Representation
Getting a lawyer to represent you is a smart move. Since disability attorneys have experience in these matters, they can help you gather evidence, file paperwork accurately, and appeal denials better.
The Appeals Process
Most claims fail to go through every year. That explains why there is an appeal process. If you feel you’ve been unfairly denied a claim, you can seek justice through reconsideration, a hearing, or a federal court review.
Ensuring a Strong Mental Health Disability Claim
The chances of you getting a mental health disability claim depend on how well you’re prepared. For the best outcome, always read the rules carefully, follow all application requirements, and keep detailed medical records. Additionally, you should maintain a consistent treatment plan and seek legal assistance when stuck in the process.
