On January 17, 2017, new listings for mental disorders went into effect. Anyone applying for Social Security disability because of a mental disorder should be familiar with the new requirements and how to get the Social Security disability benefits they deserve.
Mental Disorders: Section 12.00 of the Social Security Administration Listing of Impairments
There are 11 categories of mental disorders included in Section 12.00 of the Blue Book Listing of Impairments. These categories and the basic requirements for each category are as follows.
Neurocognitive Disorders
Section 12.02 establishes Social Security disability eligibility for neurocognitive disorders. Neurocognitive disorders include a “clinically significant decline in cognitive functioning” such as dementia, progressive brain tumors, multiple sclerosis, Parkinson’s syndrome, Huntington disease, traumatic brain injuries, and other conditions.
In order to be eligible for benefits pursuant to this listing, you must be able to prove that you suffer a significant cognitive decline in one or more of the following areas: complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition Alternatively, you may qualify if you have medical evidence of a “serious and persistent” mental disorder that has lasted for at least two years and for which you receive treatment.
Schizophrenia Spectrum and Other Psychotic Disorders
Eligibility for Social Security disability for one of these disorders is established in Section 12.03 of the Listing of Impairments. You may be eligible for Social Security disability benefits if you have one of the following: delusions, hallucinations, disorganized thinking, grossly disorganized behavior, or catatonia. Alternatively, you may qualify if you have medical evidence of a “serious and persistent” mental disorder that has lasted for at least two years and for which you receive treatment.
Depression, Bipolar, and Related Disorders
These types of conditions are included in Section 12.04 of the Blue Book. The disorders included are things such as bipolar disorders (I or II), cyclothymic disorder, major depressive disorder, and persistent depressive disorder.
You may establish eligibility for depressive disorders by proving that you have five or more of the following:
- 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 guilt or worthlessness
- Difficulty concentrating or thinking
- Thoughts of death or suicide
You may establish eligibility for bipolar disorder by proving that you have three or more of the following:
- Pressured speech
- Flight of ideas
- Inflated self-esteem
- Decreased need for sleep
- Distractibility
- Involvement in activities that have a high probability of painful consequences that are not recognized
- Increase in goal-directed activity or psychomotor agitation
Alternatively, you may qualify if you have medical evidence of a “serious and persistent” mental disorder that has lasted for at least two years and for which you receive treatment.
Intellectual Disorders
People with intellectual disorders may qualify for Social Security disability pursuant to Section 12.05 of the Listing of Impairments. You may prove that you have significantly sub-average general intellectual functioning and significant deficits in adaptive functioning that began before your 22nd birthday.
Anxiety and Obsessive-Compulsive Disorders
Anxiety and obsessive-compulsive disorders can make it impossible to work and are included in Section 12.06 of the Blue Book. Conditions such as social anxiety disorder, panic disorder, generalized anxiety disorder, agoraphobia, and obsessive-compulsive disorder may be included in this listing.
If you have an anxiety disorder, you must prove that you experience three or more of the following conditions:
- Restlessness
- Fatigue
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbance
If you have a panic disorder, you must prove that you have one or both of the following:
- Panic attacks followed by persistent worry about additional panic attacks or their consequences
- Disproportionate fear or anxiety about at least two different situations
If you have obsessive-compulsive disorder, you must prove that you have one or both of the following:
- Involuntary, time-consuming preoccupation with intrusive, unwanted thoughts
- Repetitive behaviors aimed at reducing anxiety
Alternatively, you may qualify if you have medical evidence of a “serious and persistent” mental disorder that has lasted for at least two years and for which you receive treatment.
Somatic Symptom and Related Disorders
Somatic symptom disorder, illness anxiety disorder, and conversion disorder may all be evaluated pursuant to Section 12.07 of the Blue Book. In order to establish your eligibility, you must prove one of the following: changed voluntary motor or sensory functioning that is not explained by other disorders, at least one somatic symptom that is distressing, or preoccupation with having or acquiring a serious illness without significant symptoms being present.
Personality and Impulse Control Disorders
Section 12.08 establishes eligibility for people with personality and impulse control disorders such as paranoid, schizoid, schizotypal, borderline, avoidant, dependent, obsessive-compulsive personality disorders, and intermittent explosive disorder. You may qualify pursuant to this standard if you can prove that you have a pervasive pattern of at least one of the following:
- Distrust and suspiciousness of others
- Detachment from social relationships
- Disregard for and violation of the rights of others
- Instability of interpersonal relationships
- Excessive emotionality and attention seeking
- Feelings of inadequacy
- Excessive need to be taken care of
- Preoccupation with perfectionism and orderliness
- Recurrent, impulsive, aggressive behavioral outbursts
Autism Spectrum Disorders
People with an autism spectrum disorder may qualify for benefits pursuant to Section 12.10. You will need to prove that you have qualitative deficits in verbal and nonverbal communication and social action and that you have significantly restricted and repetitive patterns of behavior, interests, or activities.
Neurodevelopmental Disorders
Neurodevelopmental disorders, including specific learning disorder, borderline intellectual functioning, and tic disorders, are evaluated pursuant to Section 12.11 of the Blue Book. You can prove that you are eligible if you have one or more of the following: frequent distractibility, difficulty paying attention, difficulty organizing tasks, hyperactive and impulsive behavior, significant learning issues or recurrent motor movement or vocalization.
Eating Disorders
Section 12.13 of the Blue Book explains when someone may be eligible for Social Security disability due to an eating disorder such as anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food disorder. You will need to prove that you have an eating disorder and that it impacts your physical or psychological health.
Trauma- and Stressor-Related Disorders
Section 12.15 allows you to recover for trauma- and stressor-related disorders if you can prove all of the following: that you’ve been exposed to actual or threatened violence, serious injury, or death; that you involuntarily re-experience the event; that you avoid things that remind you of the event; that you have mood or behavior disturbances; and that you have increases in reactivity and arousal (such as your startle response).
Alternatively, you may qualify if you have a serious and persistent condition that has been medically treated for at least two years.
An Additional Requirement You Need to Know About
Most listings also require that you establish that you have extreme limitations of one of the following (or marked limitations of two of the following): understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; or adapting or managing yourself.
This information about specific mental disorders is intended as an overview. There are additional details and rules you should know before you apply for benefits. The majority of first time Social Security disability applications are denied. The Social Security Administration requires specific evidence to be submitted to prove your eligibility. If anything is missing on your application, your application will be denied.
Get the Help You Deserve Before You Apply for Benefits
A board certified Social Security disability lawyer can help you meet the exact requirements and get the benefits you deserve. For more information, please read our FREE book, Social Security Disability: What You Need to Know, or contact us directly to schedule a confidential initial consultation.
by Paul B. Burkhalter Managing Partner of Morgan Weisbrod , Board Certified in Social Security Disability Law.
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