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690 Flatbush Avenue West Hartford, CT  06110-1308

860 236-9350             800 856-6400  toll free     860 523-9101  fax

27 Holmes Avenue Downtown Waterbury 203 756-6100

 

 

Anxiety, Depression and Other Psychiatric Disability Cases

Anxiety

Depression

    You may qualify for Social Security Disability or Supplemental Security Income (SSI) benefits if you suffer from a mental illness or psychiatric disorder such as anxiety, depression, panic attacks, agoraphobia, schizophrenia, bipolar disorder (manic - depressive illness), post-traumatic stress disorder (PTSD) or a personality disorder.

    Social Security Disability or SSI claimants usually qualify for benefits because their mental impairments are severe enough to meet or equal the level of severity that Social Security has listed for that mental disorder.

 

The Multi-Part Requirements of Psychiatric Listings

    There are several listings for mental illness.  The listings typically are divided into 2 or 3 parts called Parts A,  B, and C.  Depending on the listing, you will have to meet one or two of the listing's parts for your psychiatric condition to be severe enough to qualify you for Social Security Disability or SSI .

    The following is a general description of each of these three parts:

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Part A usually requires that you tend to act in certain ways or exhibit a number of symptoms.

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Part B usually requires that your mental illness causes at least two of the following conditions:
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(1)  You have marked limitations in your Activities of Daily Living.
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These activities include cleaning, shopping, cooking, taking the bus or other public transportation, paying bills, maintaining a home, grooming yourself, and maintaining good hygiene.

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Marked limitations means that you have difficulty performing these activities (1) without direct supervision, (2) or in a suitable manner, (3) or in a consistent, useful, and routine basis, (4) or without undue interruptions or distractions.

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(2)  You have marked limitations in Social Functioning.
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Social functioning includes the ability to get along with relatives, friends, co-workers, supervisors, neighbors, grocery clerks, landlords, bus drivers and other people you interact with often.

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Marked limitations means that most of the time you cannot interact independently, appropriately, and effectively with these people.   Difficulties in social functioning include a history of altercations and firings, a fear of strangers, and a tendency to isolate yourself in your home or your room.

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(3)  You have marked limitations in Concentration, Persistence, or Pace.
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Concentration, persistence and pace is the ability to pay attention long enough to do tasks appropriately and on time, including tasks commonly found in work settings.

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Mental status examinations are performed by psychiatrists or psychologists to assess concentration.  These examinations involve such tasks as counting backwards by 3's or 7's, keeping things in short-term memory, and completing tasks within certain time limits.

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Marked limitations means that you cannot complete simple tasks accurately and consistently (1) without extra help or supervision, (2) without too many rest periods, or (3) without too many interruptions or distractions.

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(4)  You have repeated episodes of Decompensation.
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Decompensation means that your anxiety, stress, depression or other mental condition causes you for a period of time to lose your ability to perform your normal activities of daily living, to get along normally with people, or to maintain normal concentration, persistence, or pace.

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Repeated means 3 episodes within 1 year, or an average of 1 episode every 4 months, with each episode lasting 2 weeks or more.  Repeated may also mean more frequent but shorter episodes or less frequent but longer episodes.

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Part C usually requires that your medical records show that your condition has lasted at least 2 years and has limited your ability to do basic work activities, and that while treatment has reduced your symptoms, one of the following is true:
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You have repeated episodes of decompensation lasting for an extended time.

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Even a minimal increase in mental demands would cause you to decompensate.

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You have only been able to function in a highly supportive living arrangement for at least 1 year and need to continue living in such an arrangement.

 

Common Psychiatric Disability Listings

    The following is a simplified discussion of common Social Security Disability listings for mental disability.

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Listing 12.02 Organic Mental Disorders.  This listing deals with psychiatric problems due to physical problems with the brain.  Such problems may be caused by head injuries, by the permanent effects of alcohol or drug abuse, or by inhaling toxic fumes.  To qualify for Social Security Disability or SSI, you must either (1) meet both Parts A and B, or (2) meet Part C.
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Part A requires that your ability to think and/or your behavior has been affected and that your medical records show at least one of the following:
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You have difficulty knowing where you are and the date and time.

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You have memory difficulties.

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You hear, see or sense things that are not really there.

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Your personality has changed.

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Your mood is disturbed.

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Your emotions are up and down and you have difficulty controlling your impulses.

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You have lost at least 15 points in IQ or your neuropsychological test scores are in the severely impaired range.

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Part B (explained above).

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Part C (explained above).

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Listing 12.03 Schizophrenic, Paranoid and Other Psychotic DisordersSchizophrenia refers to difficulties in perceiving or expressing reality.  Schizophrenics may hear or see things that do not exist and may speak and think in a very mixed up manner.  A paranoid person has delusions that they are being persecuted.  He or she thinks that someone is or wants to harm him or her.

    To win Social Security Disability or SSI under this listing, you must either (1) meet both Parts A and B, or (2) meet Part C.
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Part A requires that your medical records must show at least one of these problems:
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You see things, hear things, or have other delusions.

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You behave in a bizarre way.

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You are isolated and/or emotionally withdrawn from people.

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Part B (explained above).

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Part C (explained above).

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Listing 12.04 Affective Disorders.  This listing covers three conditions:
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Persons who suffer from intense and debilitating feelings of sadness (what people call "depression").

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Persons who suffer from mania (extreme and unwarranted feelings of irritability or happiness), often accompanied by rapidly changing ideas and decreased sleep.

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Manic - depressive (bipolar) persons, who are people that suffer severe mood swings.

To get Social Security Disability or SSI under this listing, you must either (1) meet both Parts A and B, or (2) meet Part C.
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Part A requires that your medical records show one of the following:
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(1)   Depression with at least 4 of the following symptoms:
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Anhedonia (you are not interested in doing things because you get no pleasure from doing things).

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Appetite disturbance with weight change.

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Disturbed sleep.

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Constant bodily movement or very little movement at all.

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Lack of energy.

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You feel guilty or worthless.

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You have difficulty concentrating or thinking.

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Tou think about or even attempt suicide.

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You have hallucinations, delusions, or paranoid thinking.

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(2)   Mania with at least 3 of the following symptoms:
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Hyperactivity.

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Pressured speech.

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Flight of ideas.

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Inflated self-esteem.

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Decreased need for sleep.

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Easy distractibility.

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Involving yourself in activities in which you are likely to get physically and/or emotionally hurt without realizing the danger of being hurt.

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Hallucinations, delusions, or paranoid thinking.

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(3)  Bipolar syndrome with episodes of depression and mania.

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Part B (explained above).

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Part C (explained above).

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Listing 12.06  Anxiety-Related Disorders.  Anxiety refers to feelings of fear, apprehension, or worry which are often accompanied by physical sensations such as heart palpitations, nausea, sweating, trembling, chest pain, shortness of breath, stomach aches, or headaches.  People with anxiety usually say they suffer from “nerves.”  The listing for anxiety covers such conditions as panic attacks, agoraphobia (fear of leaving your home), other phobias, obsessive – compulsive disorders, and post traumatic stress disorder (PTSD).

    To qualify for Social Security Disability or SSI under this listing, you must either (1) meet both Parts A and B, or (2) meet both Parts A and C.
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Part A requires that your medical records must show at least one of these problems:
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(1)  Generalized persistent anxiety with 3 of the following:
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Motor tension (you have rigid body language).

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Autonomic hyperactivity (you cannot keep still).

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Apprehensive expectation (you have a feeling that something bad is about to happen).

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Vigilance and scanning (you are overly watchful).

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(2)  A persistent irrational fear of a specific object, activity, or situation which results in a compelling desire to avoid the dreaded object, activity, or situation.

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(3)  Recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week.

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(4)  Recurrent obsessions or compulsions which are a source of marked distress.

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(5)  Recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress.

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Part B (explained above).

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Part C requires that your anxiety makes you completely unable to function by yourself outside of your home.

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Listing 12.08  Personality Disorders.  To obain Social Security Disability or SSI under this listing, you would need to have a personality that is so inflexible that you cannot change your behavior and way of thinking enough to get along in society.  To qualify, you must meet both Parts A and B.
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Part A requires that your medical records must show that your inability to adapt to society is deeply ingrained and that at least one of the following is true.
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Seclusiveness or autistic thinking (you think in an extremely self-centered and disturbed way).

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You are extremely suspicious of or hostile toward people without any good reason.

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The way you think, perceive things, speak and behave is extremely odd.

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Your mood and affect (body language and facial expressions) are persistently disturbed.

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Part B (explained above).

 

Global Assessment of Functioning

    When giving an opinion about a person's ability to function, psychiatrists and psychologists often give a Global Assessment of Functioning (GAF) score.  To qualify for Social Security Disability or SSI by meeting a listing for mental illness, your GAF scores usually have to remain in the range of 50 or below despite treatment, including counseling and taking psychiatric medication.  You may qualify for disability with scores in the 51-60 range if you have frequent episodes of decompensation or periods of time when your level of functioning is very poor.

 

Global Assessment of Functioning Table
91-100 Superior functioning in a wide range of activities, life's problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms
81-90 Absent or minimal symptoms ( e.g., mild anxiety before an exam ), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns ( e.g., an occasional argument with family members )
71-80 If symptoms are present, they are transient and expectable reactions to psychosocial. stressors ( e.g., difficulty concentrating after family argument ); no more than slight impairment in social occupational, or school functioning ( e.g., temporarily falling behind in schoolwork ).
61-70 Some mild symptoms ( e.g., depressed mood and mild insomnia ) OR some difficulty in social occupational, or school functioning ( e.g., occasional truancy or theft within the household ), but generally functioning pretty well, has some meaningful interpersonal relationships.
51-60 Moderate symptoms ( e.g., flat affect and circumstantial speech, occasional panic attacks ) OR moderate difficulty in social, occupational, or school functioning ( e.g., few friends, conflicts with peers or co-workers ).
41-50 Severe symptoms ( e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting ) OR any serious impairment in social, occupational or school functioning ( e,g., no friends, unable to keep a job ).
31-40 Some impairment in reality testing or communication ( e.g., speech is at times illogical, obscure, or irrelevant ) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood ( e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school ).
21-30 Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment ( e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation ) OR inability to function in almost all areas ( e.g., stays in bed all day, no job, home, or friends ).
11-20 Some danger of hurting self or others ( e .g., suicidal attempts without clear expectation of death; frequently violent; manic excitement ) OR occasionally fails to maintain minimal personal hygiene ( e.g., smears feces ) OR gross impairment in communication ( e.g., largely incoherent or mute ).
1-10 Persistent danger of severely hurting self or others ( e.g., recurrent violence ) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

 

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Attorney John Serrano - Personal Injury, Social Security Disability, Divorce, Bankruptcy, Immigration, Workers Compensation.  Hartford, Waterbury

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