Mental Disorders and Social Security Disability

Mental health conditions can qualify for Social Security Disability benefits, but these claims are often misunderstood and frequently denied. In this post, we explain how the Social Security Administration evaluates mental disorders, what medical evidence is required, and the most common problems we see in mental-health-based disability claims.

Can Mental Illness Serve as the Basis for a Social Security Disability Claim?

You can be eligible for Social Security Disability benefits for physical or mental medical conditions (or a combination). However,  it is usually more challenging to collect disability for a mental disability than for a physical impairment.

Why? Because you cannot prove a mental illness with an objective medical test like an X-ray or MRI. Although a mental health expert like a psychologist or psychiatrist can diagnose mental illnesses, it may take several visits to the doctor to evaluate the symptoms of a mental condition and assess a diagnosis.

Moreover, even if a diagnosis is established, it may take even more time to determine the severity of the condition as severity is difficult to measure objectively.

How the SSA Views Mental Disability Claims

Social Security Disability claim examiners are not licensed psychologists or psychiatrists, and they do not always understand the full scope of limitations caused by certain mental illnesses.

For example, some disability examiners do not recognize the cycling nature of mental illnesses such as bipolar disorder (sometimes called by its older name of “manic depression”) and may assume a claimant is cured because they do not currently display specific symptoms.

However, in reality, those symptoms may have just dissipated for the moment and are almost sure to return in the relatively near future. In addition, some disability examiners are biased against disability claims for mental illness.

Why Professional Help Matters When Applying for Disability Benefits for Mental Disorders

Given the extra challenges of proving a mental health impairment to the Social Security Administration, having a seasoned ally on your side can make a significant difference. The SSA requires precise documentation that matches their often-stringent Blue Book criteria—not just general evidence of your diagnosis, but detailed information about how your symptoms affect your ability to function day-to-day.

Here’s where it gets tricky:

• The SSA will look for specific evidence of significant limitations in key areas such as remembering and using information, interacting with others, focusing on tasks, or handling changes and self-care.
• Missing even a small piece of required information can lead to a denial, as initial applications are frequently rejected—especially for mental illness claims.

A legal professional specializing in Social Security Disability claims understands exactly what documentation and detailed narratives the SSA needs. They can gather medical records, request comprehensive notes from your providers, and help you communicate the true extent of your limitations. In many cases, their experience is essential for translating complicated symptoms into the language the SSA recognizes and accepts.

Having expert support from the outset not only increases your chances of approval but can also help you avoid unnecessary delays and frustration.

Mental Impairment Listings

In evaluating a mental health condition, the disability examiner will first refer to Social Security’s official Listing of Impairments (often referred to as the Blue Book). The Listings in the Blue Book specifically identify medical conditions that the Social Security Administration recognizes as inherently disabling.

In other words, Social Security accepts that anyone who satisfies all the requirements of a listed condition would be unable to work (or engage in substantial gainful activity). The disability examiner will review the medical evidence to determine whether a disability applicant’s symptoms meet the criteria of any mental condition listed in the Blue Book.

The listings for mental disorders are arranged in nine diagnostic categories:

• Organic mental disorders (Listing 12.02);
• Schizophrenic, paranoid, and other psychotic disorders (12.03);
• Affective disorders (12.04);
• Mental retardation (12.05);
• Anxiety-related disorders (12.06);
• Somatoform disorders (12.07);
• Personality disorders (12.08);
• Substance addiction disorders (12.09); and
• Autistic disorder and other pervasive developmental disorders (12.10).

Each listing (except 12.05 and 12.09) consists of (1) a statement describing the disorder and (2) two sets of criteria that must be satisfied for the listing: paragraph A criteria (a set of medical findings) and paragraph B criteria (a set of impairment-related functional limitations). There are additional functional criteria (paragraph C criteria) in listings 12.02, 12.03, 12.04, and 12.06.

Social Security will assess the paragraph B criteria before it applies the paragraph C criteria. Social Security will assess the paragraph C criteria only if it finds that the paragraph B criteria are not satisfied. Social Security will find that you have a listed impairment if the diagnostic description in the introductory paragraph and the criteria of both paragraphs A and B (or A and C, when appropriate) of the listed impairment are satisfied.

However, even if your disorder does not “meet” the listing, if you can prove you cannot do even a simple, unskilled job due to emotional, psychiatric, or brain-related problems, you could qualify for disability benefits due to a mental impairment.

Here is what the Social Security Administration will look for when reviewing claims for specific mental health issues:

Depression and Mood Disorders

Depression

Social Security will consider how your depression and resulting limitations affect your ability to do work activities. Even simple, unskilled work requires you to:

• Understand, remember, and carry out simple instructions,
• Make simple work-related decisions
• Respond appropriately to supervision and co-workers, and
• Handle changes in routine.

If depression is the only impairment you identified in your application for disability benefits, being approved for disability will be a long shot unless you have severe, disabling depression that is well-documented in your medical records. If you also have another mental impairment or physical impairment in addition to your depression, you have a better chance of being approved for benefits.

When evaluating your claim, Social Security will look for evidence of a depressive disorder—such as major depressive disorder or persistent depressive disorder—by assessing whether you experience at least five or more of these 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 guilt or worthlessness
• Difficulty concentrating or thinking
• Thoughts of death or suicide

These symptoms must be persistent and significantly interfere with your ability to function daily, especially in a workplace setting.

Bipolar Disorder

Individuals with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” One state of mind is a manic episode, which usually involves being overly joyful or overexcited. The other state of mind is a depressive episode, which makes the individual extremely sad or hopeless.

Sometimes, a mood episode called “mixed state” may involve symptoms of both mania and depression. Some individuals with bipolar disorder may also be explosive and irritable during a mood episode.

Extreme energy, activity, sleep, and behavior changes often accompany these mood changes. Someone with bipolar disorder can experience long-lasting periods of unstable moods rather than shorter episodes of depression or mania.

It would not be unusual for an individual experiencing an episode of bipolar disorder to experience several manic or depressive symptoms for most of the day, nearly every day, for a week or longer. Sometimes, symptoms are so severe that the individual cannot function normally at work, school, or home.

To establish eligibility for disability benefits due to bipolar disorder, Social Security requires evidence that you have experienced at least three or more of the following symptoms during manic episodes:

• 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

Additionally, Social Security may also consider whether you have a “serious and persistent” mood disorder that has lasted at least two years, despite ongoing treatment. Documentation of long-term limitations and the need for structured support are important factors in your claim.

Anxiety Disorders

Anxiety Disorder

Anxiety disorders can affect people in many different ways. Common symptoms include nausea, headaches, stomachaches, heart palpitations, and shortness of breath. Cases can cause as little as occasional nervousness or can be as extreme as some of the instances listed above. In any form, anxiety disorders can cause life-affecting psychological and physical damage.

To be considered for disability due to an anxiety disorder, you generally need to show that you experience at least three of the following symptoms on a regular basis:

• Restlessness
• Fatigue
• Difficulty concentrating
• Irritability
• Muscle tension
• Sleep disturbance

If your anxiety disorder takes the form of panic disorder, you must demonstrate either persistent concern or worry about additional panic attacks or their consequences, or an intense fear or anxiety about at least two different situations.

For those with obsessive-compulsive tendencies, the requirements may include involuntary, time-consuming preoccupation with intrusive, unwanted thoughts, or repetitive behaviors specifically aimed at reducing anxiety. In any case, medical documentation of your symptoms and their impact on your daily functioning is essential.

Alternatively, individuals may qualify for benefits if they have a “serious and persistent” anxiety-related disorder that has lasted for at least two years and has required ongoing medical treatment or structured support.

Agoraphobia

Agoraphobia is a type of anxiety disorder defined by its panic attacks or periods of intense fear and horror. A panic attack is a short period of intensely heightened anxiety characterized by chest pain, choking, dizziness, nausea, a racing heart, sweating, and trembling. They appear at moments of incredible stress.

Agoraphobia specifically causes anxiety in environments that are not familiar or that are thought to have no easy escape. Places like shopping malls, airports, or bridges are common areas for an agoraphobic attack, which is most likely to occur in wide-open spaces or social situations in which the person has no control.

Post Traumatic Stress Disorder (PTSD)

PTSD, which is characterized by extreme emotional disturbance, may qualify for disability. You must have at least one detailed record of a mental episode caused by post-traumatic stress disorder in your medical records. What brings on symptoms, how long they last, and how frequently they occur should be well-documented.

Your doctor should note whether or not he agrees that how you describe your mental state matches his opinion of it and the guidelines for being diagnosed with the disorder. Most importantly, your medical records must clearly explain how the disorder has affected your daily life and your ability to function in a work environment.

To further meet the criteria for disability under trauma- and stressor-related disorders, you generally need to demonstrate all of the following:

• You’ve been exposed to actual or threatened violence, serious injury, or death.
• You involuntarily re-experience the event, such as through flashbacks or nightmares.
• You avoid things that remind you of the trauma.
• You experience mood or behavioral disturbances.
• You have heightened reactivity or arousal, like an exaggerated startle response.

Alternatively, if you have a serious and persistent PTSD condition that has been medically treated for at least two years, you may also qualify for disability. Comprehensive documentation from your healthcare providers remains essential in showing how your symptoms meet these requirements and how they significantly interfere with your daily functioning.

Psychotic Disorders

Schizoaffective Disorder

Disability applicants suffering from a schizoaffective disorder can qualify for Social Security Disability Insurance and SSI benefits.

Schizophrenia

The effects of schizophrenia usually begin with trouble sleeping or concentrating and a tense, irritable state of mind. As the disease develops, it is expected to experience a lack of emotions, appearances of hallucinations and delusions, and a tendency to isolate oneself. Many patients claim to hear voices, which adds to the false assumption that it causes multiple personalities.

Schizophrenia patients may qualify for Social Security disability, especially where the medical records evidence that they are limited in functioning socially, focusing on tasks, or in other ways.

Eligibility Requirements for Disability

Eligibility for Social Security disability for these types of disorders is established in Section 12.03 of the Listing of Impairments. You may be eligible for benefits if you experience symptoms such as:

• Delusions
• Hallucinations
• Disorganized thinking
• Grossly disorganized behavior
• Catatonia

Alternatively, you may also qualify if there is medical evidence of a “serious and persistent” mental disorder that has lasted for at least two years and for which you are receiving ongoing treatment. Detailed documentation in your medical records is crucial, showing not only a clear diagnosis but also how these symptoms impact your daily life, social functioning, and ability to work.

Brain Disorders That Affect Mental Function

Traumatic Brain Injury (TBI)

One can also qualify for disability by meeting the requirements of organic mental disorders. These are extreme changes in personality, mood, or cognitive function brought on by brain damage. Disorientation, an inability to concentrate, disruption of daily activities, and problems with social function are common symptoms.

Memory Loss

If you have quantifiable memory loss and the memory problems interfere with your personal, social, or work functions, you may qualify for disability benefits.

Developmental Disabilities and Autism

Attention Deficit Hyperactivity Disorder (ADD and ADHD)

Attention Deficit Hyperactivity Disorder, commonly known as ADHD, is a chronic neuropsychiatric disorder that affects a person’s inability to focus, stay on task, and remember directions. While this diagnosis is more common in children, and many children learn to adapt, some adults who struggle with ADHD into adulthood find it very hard to work.

The symptoms of ADHD might seem trivial when a person is young. As employees, the consequences of these symptoms could be dangerous and even fatal if not appropriately managed. Symptoms include:

• Trouble concentration
• Paying attention
• Staying organized
• remembering details
• Managing impulsivity
• Following directions

Autism

Autistic adults have symptoms that can be either very mild or severe to the point of being debilitating. Those with autism are usually highly attached to specific objects, get unnaturally distressed at any change in everyday routine, have difficulty starting or maintaining conversations, have heightened or abnormally low senses, prefer to spend time alone, use repetitive body movements, and throw aggressive tantrums when agitated.

Though many autistic adults lead typical lives, others are incapable of upholding their desired routines without the assistance of family or others. The individual symptoms of autism may include the widely known effects listed above but can also include unique quirks of the person with the disorder. However, diagnosis is generally based on signs of repetitive behavior, restricted interests, and communication impairment.

People with an autism spectrum disorder may qualify for disability benefits pursuant to Section 12.10. To be considered, you must provide evidence of qualitative deficits in both verbal and nonverbal communication as well as in the ability to engage in reciprocal social interaction.

Additionally, there must be significantly restricted, repetitive patterns of behavior, interests, or activities. These requirements highlight the pervasive impact autism can have on daily functioning, ranging from social challenges to difficulties managing changes in routine or environment.

Pervasive Developmental Disorder

Pervasive developmental disorder is characterized by qualitative deficits in developing reciprocal social interaction, verbal and nonverbal communication skills, and imaginative activity. Often, there is a markedly restricted repertoire of activities and interests, which frequently are stereotyped and repetitive.

Intellectual Disorders

When it comes to qualifying for Social Security disability due to an intellectual disorder, the Social Security Administration looks closely at your history and daily functioning. To be considered eligible, you must demonstrate that you have significantly below-average intellectual abilities, along with notable challenges in adaptive behaviors—that is, everyday skills like communication, self-care, or social participation. Importantly, these difficulties need to have started before age 22.

The assessment isn’t just about a single test score; medical records, school reports, and evaluations by specialists are all important in showing the extent and early onset of these challenges. If your intellectual limitations make it difficult for you to live independently or maintain employment, you may meet the requirements for disability benefits.

Personality Disorders

Borderline Personality Disorder

Though there is no specific listing for borderline personality disorder, there is a general listing for personality disorders characterized by an inability to function in a social or economic capacity. To be eligible for this listing, you must have the following symptoms: a tendency towards isolation, unprompted hostility towards others, uncommon thoughts, speech or behavior, and frequent alterations in mood.

You must also have at least two of the following signs: difficulty with concentration, inability to perform daily activities, inability to maintain a steady social relationship, and recurring instances of worsening symptoms.

Other Personality and Impulse Control Disorders

Section 12.08 covers eligibility for a range of personality and impulse control disorders, including but not limited to paranoid, schizoid, schizotypal, borderline, avoidant, dependent, obsessive-compulsive personality disorders, and intermittent explosive disorder. To qualify, you must demonstrate a pervasive pattern of at least one of the following characteristics:

• 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

These patterns must significantly interfere with your ability to function socially or economically. If your symptoms align with any of these descriptions and have persisted despite efforts to manage them, you may meet the requirements under the general listing for personality disorders.

Eating Disorders

Social Security recognizes several eating disorders as potentially disabling, including anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food intake disorder. To qualify based on an eating disorder, you must show more than just a diagnosis—you need clear medical evidence that your eating disorder significantly impacts your physical or psychological health and prevents you from working.

Proof often includes:

• Thorough medical documentation from your healthcare providers
• Records of treatments, hospitalizations, or complications (such as extreme weight loss, cardiovascular issues, or psychological symptoms)
• Reports detailing how the disorder affects your ability to concentrate, perform daily tasks, or interact with others

Social Security will use these records to determine if your symptoms meet the level of impairment required for disability benefits.

Mental RFCs

If your condition is not specifically listed in the Blue Book or is not as severe as the Blue Book listing requires, you may still be eligible for disability. You must have been diagnosed with a mental condition that is preventing you from working, and you must demonstrate that your disability has lasted (or is likely to last) for at least twelve months.

Suppose your mental residual functional capacity (RFC) shows you have intellectual, social, or functional limitations. Depending on your mental limitations, age, education level, and job skills, you may be eligible for a medical-vocational allowance. You can download a free Mental RFC to use in your disability claim.

Frequently Asked Questions

Get Help with Your Social Security Disability Claim

If you have a disabling mental health condition and are looking to see whether you qualify for disability benefits, disability attorney Nick Ortiz can help. He represents Social Security Disability claimants nationwide. Call Ortiz Law Firm at  (888) 321-8131 to schedule a free case evaluation today