Assessment of Mental Health Claims

The Social Security Administration assesses all claims for disability based on a five step process.

Step 1: Are you working?

If you are currently working and your earnings average more than $1,010 a month, SSA will generally not consider you disabled. If you are not working, then you move on to Step 2.

Step 2: Is your condition “severe”?

Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, then SSA will find you are not disabled. If it does interfere with basic work-related activities, then move on to Step 3.

Step 3: Is your condition found on the list of disabled conditions?

For mental health conditions, such as depression, anxiety, and posttraumatic stress disorder it is very difficult to have a condition rise to severity required to be on the list of disabled conditions.

Depression: For depression the severity requirement of the list of disabled conditions is met when two elements are met.

  • Depressive syndrome characterized by at least four of the following: Pervasive loss of interest in almost all activities, appetite disturbance with a change in weight, sleep disturbance, psychomotor agitation or retardation, decreased energy, feelings of guilt and worthlessness, difficulty concentrating or thinking, thoughts of suicide or hallucinations, delusions or paranoid thinking.
  • AND the depression results in at least two of the following: marked restrictions of activities of daily living, marked difficulties in maintaining social functioning, marked difficulties in maintaining concentration, persistence, or pace, or repeated episodes of de-compensation, each of extended duration.
  • OR, if the second requirement is not met, disability benefits can still be awarded if the first requirement is present, and there is a medically documented history of a chronic affective disorder of at least two years duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following: repeated episodes of de-compensation, each of extended duration, a disorder of such nature that even a minimal increase in mental demands or change in environment would be likely to cause the claimant to de-compensate, or current history of one or more years inability to function outside of a highly supportive living arrangement.

Anxiety Disorder and Posttraumatic Stress Disorder: For an anxiety disorder the severity requirement of the list of disabled conditions is met when two elements are present.

  • There must medically documented evidence of generalized persistent anxiety accompanied by motor tension, autonomic hyperactivity, apprehensive expectation or vigilance and scanning, OR there is persistent irrational fear of a specific object, activity, and situation which results in a compelling desire to avoid the object, activity, and situation, OR there are recurrent severe panic attacks at least once a week, OR recurrent obsessions or compulsions, OR recurrent and intrusive recollections of a traumatic experience.
  • AND there must be marked restriction of activities of daily living, marked difficulties in maintaining social functioning, marked difficulties in maintaining concentration, persistence or pace, or repeated episodes of de-compensation, each of extended duration.
  • OR, if the second requirement is not present, disability benefits can still be awarded if the first requirement is present and the disability makes it so the claimant is unable to function independently outside of the home.

Step 4: Can you do the work you did previously?

If your condition is severe, but not at the same or equal level of severity as a medical condition on the list, then SSA must determine if it interferes with your ability to do the work you did previously. If it does then your claim will be denied. However, if it does not then you move on to Step 5.

Step 5: Can you do any other type of work?

If you cannot do the work you did previously, SSA then considers whether you can do other work based on your age, education, and work experience. These factors are assessed with your capacity to work to determine if you can be expected to adjust to other work that exists in the national economy. Contact our social security lawyers today for a free consultation.