Clients with mental impairments present challenges when it comes to disability for mental illness. There are ways to win these cases, whether mental disability is the complete claim, or part of a physical disease such as cancer or heart disease. It is not unusual for a mental disability, like depression, to accompany a physical disability that causes great pain. Once a psychiatric or psychological diagnosis has been established, the key to wining a disability for mental illness claim is proving functional impairment.
Medical providers and therapists sometimes get frustrated, throw their hands up and ask “What do I need to do to prove my patient's illness?” The process is not as difficult as it may at first seem. Establishing functional impairment is the difference between winning and losing your Social Security disability case.
The first step is a diagnosis. Social Security law tracks the 2013 Diagnostic and Statistical Manual (DSM V)¹. The DSM V standards are familiar to those who work with mentally impaired clients. For example, when proving depression, you must demonstrate a minimum of four clinical signs. Examples would be sleep disturbance, decreased energy, suicidal ideation or appetite change. Similar findings are needed for other mental illnesses.
The second step is to establish functional impairment. Most cases will require documented functional impairment. For the depression example above, two functional impairments must be established. Some disorders are considered severe enough to prevent gainful activity without any additional assessment of functional limitations. For others, the degree of functional limitation must be documented precisely. If necessary, information may also be obtained from third parties like non-medical sources, husbands, wives, children, other family members and close neighbors, to supplement the record of impairment severity and longevity.
When it comes to Social Security Disability based on mental conditions or mental illness, functional impairment looks at, the following:
Two or more impairments at the “marked” level must be present. “Marked” is one of the four measures for degree of limitation, and is defined here by Social Security as “more than moderate but less than extreme.”
The third step in establishing disability for mental illness is to establish "marked" mental limitations. Social Security says a “marked” limitation may arise when several activities or functions are impaired, or even when only one is impaired, as long as the degree of limitation is such as to interfere seriously with ability to function “independently, appropriately, effectively and on a sustained basis.”
The mental impairment regulations were extensively revised several years ago. Although the detail required to prove a case appears daunting, we can show you exactly how to develop and present evidence that will maximize your client’s chances of winning.
Keep in mind that mental illness such as depression is commonly an element of other illnesses and should be documented to strengthen a case.
If you would like to discuss long term disability for mental Illness and how to win a disability case for mental illness, please call us today.