How the SSA Evaluates PTSD for SSDI

The SSA evaluates disability claims based on whether the condition meets the criteria of the Listing of Impairments or whether the condition limits the applicant’s ability to perform basic work activities. For mental health conditions like PTSD, the SSA uses a specific set of guidelines to assess the severity of your symptoms and their impact on your ability to work.

The SSA’s Mental Disorder Listing (12.15)

PTSD is considered under Listing 12.15 for mental disorders. To qualify for SSDI benefits based on PTSD, you must provide medical evidence that meets the SSA’s criteria for mental impairments, which include:

• Marked limitation in at least two of the following areas:
• Understanding or applying information.
• Interacting with others.
• Concentrating or maintaining pace.
• Adapting or managing oneself.
• Extreme limitation in one of these areas.

The SSA will assess whether your PTSD symptoms are severe enough to limit your functioning in these areas. For example, if you have difficulty concentrating due to intrusive thoughts, nightmares, or hypervigilance, it may significantly impair your ability to complete work tasks or maintain employment.

Medical Evidence of PTSD

To qualify for SSDI, it is crucial that you have sufficient medical documentation to support your claim. This includes:

• Diagnosis from a licensed healthcare provider: A mental health professional (e.g., psychologist, psychiatrist) must formally diagnose you with PTSD.
• Treatment history: Evidence that you have been receiving ongoing treatment for PTSD, including therapy or medications.
• Documented symptoms: A record of how PTSD symptoms affect your daily life and your ability to function, particularly at work.
• Statements from your healthcare provider: A detailed letter or report from your doctor explaining the limitations caused by your PTSD and how it prevents you from working.

Steps to Apply for SSDI with PTSD

If you believe your PTSD symptoms are severe enough to qualify for SSDI, here are the steps to apply:

Step 1: Gather Your Medical Evidence

The first step in applying for SSDI is to gather all relevant medical records that document your PTSD diagnosis and treatment. This includes:

• Therapy or counseling records.
• Psychiatric evaluations.
• Medication history.
• Any other documentation that shows how your PTSD affects your ability to work and manage daily activities.

Step 2: Complete the SSDI Application

Once you have your medical evidence ready, you can apply for SSDI benefits through one of the following methods:

• Online: Visit the SSA’s website at www.ssa.gov to complete your application online.
• By Phone: You can apply by calling the SSA at 1-800-772-1213. They can guide you through the process and help with any questions you may have.
• In-Person: Visit your local SSA office to apply. You can find your nearest office using the SSA’s office locator.

Step 3: Be Detailed and Honest

It’s essential to be detailed and honest when completing your application. Be clear about your symptoms, how they affect your ability to work, and the impact on your daily life. The more detailed you are, the better the SSA will understand the severity of your condition.

Step 4: Wait for a Decision

The SSA typically takes 3 to 5 months to review your initial application. If your application is denied, which is common, you have the right to appeal. The appeal process can take several months or even years, depending on the stage you’re at in the process.

Step 5: Appeal if Denied

If your application is denied, you can appeal the decision. The appeal process involves several steps:

• Request for Reconsideration: Ask the SSA to review your case again.
• Request a Hearing: If reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ), where you can present new evidence and testimony.
• Appeals Council: If the ALJ denies your claim, you can appeal to the Appeals Council.
• Federal Court: If the Appeals Council also denies your claim, you can take your case to federal court.