Steps to Qualify for SSDI with a Mental Illness

Understand SSA’s Listing of Mental Disorders

The SSA has a Listing of Mental Disorders that outlines specific criteria for mental health conditions to qualify for SSDI benefits. If your condition is listed in the SSA’s listings and meets the severity requirements, you may qualify for SSDI without needing to go through the entire five-step evaluation process. Some common mental illnesses listed by the SSA include:

• Mood Disorders (e.g., major depressive disorder, bipolar disorder)
• Anxiety and Obsessive-Compulsive Disorders
• Psychotic Disorders (e.g., schizophrenia)
• Autism Spectrum Disorders
• Intellectual Disorders
• Trauma- and Stressor-Related Disorders (e.g., PTSD)

For your mental illness to meet the SSA’s criteria, it must severely limit your ability to function and perform basic work activities.

Prove Severe Limitations in Functioning

To qualify for SSDI with a mental illness, you must demonstrate that your condition significantly impairs your ability to work and perform daily activities. The SSA evaluates mental illness claims based on the following factors:

• Understand or Apply Information: You must show that your mental illness prevents you from understanding and applying information effectively in a work environment.
• Interact with Others: Difficulty interacting with co-workers, supervisors, or clients can be a major barrier in many jobs.
• Concentrate or Maintain Pace: If your mental illness causes problems with focus, concentration, or maintaining a steady pace at work, it can support your claim.
• Adapt or Manage Change: If your condition prevents you from adapting to changes in the workplace or managing the demands of a job, it may help strengthen your case.

Provide Detailed Medical Evidence

The most crucial part of your SSDI application is medical evidence that proves your mental illness prevents you from working. To increase your chances of approval, ensure that you provide:

• Complete Medical Records: Your medical records should include notes from all mental health professionals you’ve seen, including psychiatrists, therapists, and psychologists.
• Doctor’s Opinion: A letter or report from your treating physician outlining your diagnosis, symptoms, and how your condition limits your ability to function in a work setting is vital.
• Treatment History: Documenting your treatments, medications, hospitalizations, and therapy sessions is important. This shows that you are actively seeking treatment for your condition.

Understand the SSA’s Five-Step Evaluation Process

If your mental illness isn’t on the SSA’s listing or doesn’t meet the specific criteria, the SSA will evaluate your case using a five-step process to determine if you are eligible for SSDI benefits:

• Step 1: Substantial Gainful Activity (SGA): If you are working and earning more than a certain income threshold, the SSA may find that you are not disabled.
• Step 2: Severe Condition: Your mental illness must be severe enough to prevent you from performing basic work tasks.
• Step 3: Meet a Listed Impairment: If your mental illness is listed in the SSA’s impairment list, you may qualify automatically.
• Step 4: Past Work: The SSA will assess whether your mental illness prevents you from doing your past work.
• Step 5: Other Work: The SSA will determine if you can do any other type of work given your age, education, and skills. If your mental illness severely limits your ability to perform any type of work, you may qualify for benefits.

Appeal if Denied

It is common for SSDI claims based on mental illness to be denied, especially if the evidence is insufficient. If your initial claim is denied, don’t be discouraged. You have the right to appeal the decision. The first step in the appeals process is to request a reconsideration. If that doesn’t result in approval, you can request a hearing before an Administrative Law Judge (ALJ). Having a lawyer or advocate help with the appeals process can improve your chances of success.