Social Security Disability and SSI for Depression

Learn about your options for getting Social Security disability benefits based on depression

American doctor with depressed woman patient
American doctor with depressed  patient

To qualify for disability benefits, an individual with depression must either meet certain specific disability criteria (found in Social Security’s impairment listing manual), or be granted a medical-vocational allowance based on the severity of their depression and a combination of other factors (such as other impairments, work history, age, and a level of education).

Social Security publishes a list of common, serious illnesses (“Listings”) that qualify for disability if they meet the specified criteria. The purpose of the list is to grant disability quickly for severe impairments. Depression is covered in impairment listing 12.04 Depressive, Bipolar and related disorders. To qualify for either Social Security disability or SSI disability benefits solely on the basis of depression, you must show you have severe depression by having at least five of the following symptoms:

  • depressed mood
  • diminished interest in almost all activities
  • appetite disturbance with change in weight
  • sleep disturbance
  • observable psychomotor agitation or retardation
  • decreased energy
  • feelings of worthlessness or guilt
  • difficulty concentrating or thinking, or
  • thoughts of suicide or of death.

Bipolar disorder must be characterized by three or more of these symptoms:

  • pressured speech
  • flight of ideas
  • inflated self esteem
  • decreased need for sleep
  • distractibility
  • involvement in activities that have a high probability of personal consequences that are not recognized or
  • increase in goal-directed activities or psychomotor agitation

You will have to prove by treatment records from your therapist that these symptoms exist and that they cause serious functional limitations despite treatment for some period of time. If you regularly see a psychiatrist or psychologist, he or she should be recording your symptoms. If not, you may want to track your condition using a self-rated depression scale:

(http://healthnet.umassmed.edu/mhealt/ZungSelfRatedDepressionScale.pdf)

Social Security requires that your symptoms of depression cause you serious difficulties (one extreme or two marked) with:

  • understand, remember or apply information
  • interact with others
  • concentrate, persist, maintain pace, and
  • adapt or manage oneself

Affleck & Gordon are experienced attorneys who represent individuals in Social Security disability appeals. We offer a free consultation and will be happy to answer any questions you may have.

Will Your Lawyer Pay Your Doctor Bills on Your Personal Injury Case?

Will Your Lawyer Pay Your Doctor Bills on Your Personal Injury Case?
Will Your Lawyer Pay Your Doctor Bills on Your Personal Injury Case?

Your lawyer may pay a doctor to review your medical chart and render an expert opinion, but your lawyer won’t pay your regular medical bills. But what if your lawyer sends you to a doctor to be examined? Your lawyer may pay for you to be examined by a doctor on a one-time basis to render an opinion that your condition was caused by the accident, but not for ongoing regular treatments. For example, you were involved in a car wreck on June 15, 2017 and had a lumbar strain and saw the doctor every week and the physical therapist three times a week for three months. You’ll need a statement from your doctor that it’s her opinion that your lumbar strain and resulting medical care was caused by the June 15, 2017 car wreck. However, your doctor may be unwilling to get involved or sign a statement. Your attorney will either have your records reviewed or send you to a doctor to obtain a causation and disability statement. This is an expense that your attorney will probably pay for. However, no lawyer can pay your ongoing medical bills.

Treatment that is provided by your doctor is a regular medical bill. You will need to treat these bills as you would any other medical expense. If you have health insurance, your health insurance carrier should be billed. Be sure to tell your attorney about all types of insurance coverage including Medicare, a Medicare supplemental provider, any other health insurance carriers, TRICARE, or the VA.

Why is it vital to maximize your health insurance policies coverage? The answer is simple. Any unpaid medical bills will have to be subtracted from your settlement. When you hear the settlement offer you may feel it’s favorable until after all your doctor and hospital bills are paid and you are left with the net amount and feel disappointed. Wait. You’re still worried. You recall signing something that if you obtained a recovery that the insurance company is entitled to be reimbursed. Lo and behold, there is a statute that considers this. If your case settles and does not go to trial, you can argue that the insurance carriers are not entitled to reimbursement on the grounds that you were not fully compensated by the recovery or “made whole” for all your economic and non-economic losses. You will need to consult an attorney to ensure that your settlement documents provide such a statement.

For those involved in a motor vehicle accident, our firm will look to see if you will benefit from MEDPAY or Medical Payments coverage. Medical Payments coverage is a form of no-fault medical coverage which follows your vehicle. If you or passengers in your vehicle are injured, whether you are at fault, Medical Payments may be available to contribute towards your medical bills.

For those who do not have health insurance, there are some doctors who treat on a lien basis. You will need to sign an agreement that you will pay the doctor out of your settlement or verdict. Of course, not all doctors are willing to treat on a lien basis and you may have to do some searching until you find a doctor willing to treat you based on a lien. Your attorney will be able to assist you with this.

In summary, a good personal injury attorney will assist you with identifying all possible sources of insurance coverage for payment of medical bills. The coordination of medical benefits is likely to ensure that you receive the best possible medical care and increase the value of your personal injury settlement.

Lawyer Referral Information Service – August Newsletter 2017

A General Scope for Social Security Eligibility.
by Allison Affleck

A person may become unable to work for many different reasons. He or she may, for example, develop a form of cancer, or lose a limb to diabetes, or develop a blockage resulting in a heart attack. The physical manifestations are often obvious. There may also, however, be mental or psychological impairments that one cannot physically see that plague a person the most. These symptoms may be brought on by emotional trauma as well as physical, and may result in post-traumatic stress disorder, for example. Sometimes, psychological conditions such as severe depression and anxiety may develop as the result of the continued effects of physical injuries such as pain. Unfortunately, these conditions may not be as easily recognized, diagnosed, or treated as quickly and effectively as physical problems may be.

To determine whether or not a person is disabled because of a mental impairment, Social Security considers how a person’s functional limitations may preclude work. To be eligible for Social Security disability based on a mental or psychological impairment, a person must demonstrate one of the following: first, that his or her psychological condition(s) meets or equals one of the “listed” impairments outlined by the Social Security Administration (SSA listing 12.00 Mental Disorders – Adult) or second, that his functional limitations result in a “residual functional capacity” that would preclude work. To satisfy these requirements, SSA looks to medical evidence, including opinions from treating medical providers, and testimony from the claimant, among other information.

The requirements for meeting or equaling a listed impairment are very specific. Some of these general conditions include: neurocognitive disorders; schizophrenia; depression; bipolar; intellectual disorders; anxiety; obsessive-compulsive disorders; and trauma- and stressor- related disorders. If a person’s condition(s) meets or equals the requirements of one of these listings, and the durational component is met, he should be awarded disability.

If a person can’t prove that his mental impairment meets or equals the requirements of a listing, he may also establish the degree of his disability through his “residual functional capacity” or “RFC.” Here, he demonstrates how his functionally impaired abilities would preclude his ability to perform certain work activities. Some abilities SSA may consider in determining an RFC include: the ability to relate and respond appropriately to people in a work setting; the ability to attend meetings; the ability to work around the home; the ability to socialize with friends and neighbors; the ability to care for personal needs; the ability to understand, carry out and remember instructions; the ability to maintain attention/concentration; the ability to respond appropriately to supervision; the ability to function independently to complete tasks; the ability to respond to customary work pressures; the ability to demonstrate reliability; and the ability to maintain persistence and

pace. SSA considers, alone or together, whether the total of such limitations would preclude work. For example, perhaps a person’s symptoms cause him to be “off-task” for 15% or more of the work day. Or, maybe a person’s symptoms would cause him to be consistently late to work, need to leave early from work, or to miss more than one day of work per month. Such limitations would most likely preclude work.

Counsel should keep in mind the importance of psychological or mental impairments, as well as physical components of a disability, to determine the true cause and limiting effects of a person’s conditions. He or she should fully bring into focus the participation of each and the weight that each must be afforded.