If a mental disorder prevents you from working, you may be eligible to receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. To qualify for either of these programs, you should be able to prove that your condition meets the Social Security Administration’s definition of disability. Often, this involves submitting medical records, getting an evaluation, and meeting other criteria. Additionally, you may need to show that you have enough work credits to qualify for SSDI. If you’re applying for SSI, you must meet the income, age, or disability requirements.
For over 85 years, Krasno, Krasno & Onwudinjo has stood by those who cannot support themselves because of a disability. Our Pennsylvania Social Security Disability lawyers seek to restore the dignity of those out of work because of a condition outside their control. We understand the unique challenges of people whose mental illnesses keep them from earning income. Our law firm works hard to equip clients with knowledge, tools, and legal representation as they apply for much-needed benefits.
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Can I Get Social Security Benefits for a Mental Illness?
The Social Security Administration (SSA) empowers a person with a mental illness to seek benefits if their condition prevents them from working. Depending on the person’s work history and situation, they may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Both of these programs exist to help support those who cannot work because of a disability.
SSDI is for people with a disabling condition and sufficient and qualifying work history. In contrast, SSI is for people who are below a certain income threshold and have a disability, are blind, or are over 65. Those wishing to receive benefits because of a mental disorder should see what their options are under the SSDI and SSI programs.
What Mental Disorders Can Qualify Someone for Social Security Disability Insurance?
The SSA’s Bluebook describes the range of psychological conditions that may fall under its definition of disability. They divide these up into categories, which include:
- Neurocognitive (e.g., dementia caused by HIV, Alzheimer’s, and traumatic brain injury),
- Intellectual,
- Anxiety or panic-related disorders,
- Depressive or bipolar (e.g., bipolar depression, major depressive disorder, and dysthymia), and
- Personality and impulse control (e.g., borderline personality, intermittent explosive, paranoid, and schizoid disorders).
Additionally, the SSA includes other conditions, such as autism spectrum disorder, in their definition of disability if the person meets other requirements, too. Likewise, someone may qualify for benefits for a mental illness even if the SSA doesn’t list it in the Bluebook. In this situation, the person must show that the condition prevents them from working and meets the other eligibility criteria.
What Are the Eligibility Requirements for Receiving SSDI for a Mental Health Issue?
The SSA examines several factors to determine if someone qualifies for benefits under the SSDI program. The first is whether their condition is a disability based on SSA’s standards. Part of this involves looking at medical evidence of the person’s mental illness. Additionally, the person may need to show that the condition impairs their ability to function.
In some cases, the individual must also show the SSA that their disorder is both serious and persistent. Likewise, the applicant must prove they cannot participate in substantial gainful activity (e.g., earn money through work). Finally, the person should have enough work credits to qualify for SSDI benefits (if applicable).
There Is Medical Evidence of Your Condition
The person has to submit medical proof that they have a mental disorder. The applicant may have to send records from their current and past healthcare team. Additionally, the SSA may ask them to participate in an evaluation with a neutral provider.
What the medical information should show to meet the criteria depends on the specific condition. For example, as the SSA explains, someone applying because of a personality or impulse disorder may have to have records showing they are deeply suspicious of or have detached relationships with others. In contrast, SSA indicates that someone seeking benefits for autism spectrum disorder would need to show they have marked difficulty communicating with others (verbally and nonverbally) and restricted and repetitive behavior, interests, or activities.
Your Mental Illness Impairs Your Ability to Function
For most conditions, the SSA also wants to know that it impacts the person’s ability to function. The SSA looks at four areas in particular, which include:
- Someone’s ability to comprehend, recall, and use information,
- If the person can interact with others (and the quality of those encounters),
- The individual’s capacity to focus and continue working on a task, and
- The person’s ability to adapt to different situations and manage their behavior, emotions, and environment.
In evaluating the above areas, the SSA rates the individual’s level of function. To accomplish this, they assign one of five ratings, ranging from none to extreme. Someone with a none or mild rating may be (but isn’t always) ineligible for benefits. However, someone with a marked, severe, or extreme limitation in an area may qualify for coverage. A disability lawyer can help people gather and submit the necessary information to apply for benefits.
Your Disorder Is Serious and Persistent
Sometimes, the SSA requires an individual to prove their condition is serious and persistent. For the condition to qualify as serious and persistent, it needs to last at least two years and involve the following:
- Ongoing medical treatment or management that addresses the person’s symptoms, and
- Even with treatment, the person has an impaired ability to adapt to changes or requests that are not part of the person’s daily life.
Not everyone needs to meet these criteria. For example, someone applying because of a neurocognitive disorder may have to meet the functional requirements (discussed above) or show that their disorder is both serious and persistent. That said, a person who has a significant intellectual disorder would not have to do this. Instead, they would have to meet the special requirements in that Bluebook listing.
You Cannot Participate in Substantial Gainful Activity
The individual should also establish that their condition prevents them from earning money through substantial gainful activity (SGA). The SSA updates these requirements yearly to adjust for inflation and other factors. In 2024, the SSA indicates that SGA is $1,550 per month, meaning someone should make less than that to qualify. If the person is blind, this maximum may be $2,590.
You Have Sufficient Work History
If the person is applying for SSDI, they must also have enough credits built up through their work history. Those applying for benefits in 2024 may have to have worked for 5 of the past ten years. During those years of working, they should have earned a specific amount each quarter, which gives them credits. The SSA has different requirements for people based on the person’s age, unique situation, and earning capacity.
How Much Can You Get in Disability Benefits for a Mental Illness?
If someone successfully applies for SSDI, they may be eligible to receive a monthly check and insurance coverage through Medicare. How much they get in benefits each month depends on a host of factors, including their age, condition, monthly earnings from work (if applicable), and built-up credits. People may be able to get SSI and SSDI benefits each month if they meet the criteria for both programs.
Krasno, Krasno & Onwudinjo: Dedicated Disability Attorneys Serving Pennsylvania Since 1936
Having a mental illness can take a toll on your ability to earn a living and function in daily life. It’s not your fault that you’re in this position, and some programs may help equip you with the support you need to get by. SSDI and SSI can be lifelines to those who qualify, but the application process can be confusing and feel overwhelming to go through without assistance.
At Krasno, Krasno & Onwudinjo, we dedicate our time and resources to fighting for those who cannot work because of a disability. Our over 85 years in practice give us critical insights into the workers’ compensation and social security disability systems. Martin Chitjian has been fighting for the injured since 1992. During his 32 years of service, he has taught seminars on key workers’ compensation law topics and argued (and won) cases before many courts and tribunals.
If you have a mental disorder and want to know if you can get Social Security benefits, contact us today by calling 844-243-4841 to schedule a free consultation.