Do You Qualify for Disability Benefits for PTSD?

Post-Traumatic Stress Disorder or PTSD affects as many as 12 million Americans each year. If you or a loved one suffer from PTSD, it can make it impossible to work. If you find PTSD is keeping you from working full-time, you can qualify for Social Security Disability Insurance (SSDI). Here we explain how PTSD can affect your ability to work and the process to apply for SSDI benefits.

PTSD is Listed as a Disability by Social Security

Social Security Administration (SSA) has a “blue book” listing the impairments they consider disabling for workers. PTSD is listed under mental disorders as a “trauma- and stressor-related disorder.” The SSA defines trauma as an event caused by “experiencing or witnessing a traumatic or stressful event or learning of a traumatic event occurring to a close family member or close friend, and the psychological aftermath of clinically significant effects on functioning.” If you or a loved one experiences PTSD whether it is a result of childhood abuse, active military combat, a serious accident, sexual or physical assault, surviving a natural disaster, or other traumatic experiences you could be eligible for SSDI.

Recognizing the Signs and Symptoms of PTSD

It is possible for someone to experience trauma but not suffer from a stressor-related disorder like PTSD. PTSD can occur immediately or over time and last for a short period of time or become chronic. For most, the symptoms resolve themselves in a few weeks or months. The signs and symptoms listed by the SSA include:

• Anxiety
• Avoiding certain situations, you otherwise might enjoy or not think twice about
• A lack of positive emotions
• Difficulty concentrating
• A lack of interest or participation in significant activities
• Distressing memories
• Nightmares
• Flashbacks of the event
• Starling easy or an exaggerated startle response
• Irritability
• Aggression
• Persistent negative emotions such as anger or fear
• Difficulty sleeping

As many as six out of 10 men and five out of 10 women will experience some form of PTSD in their lives. You might not realize you have PTSD, which generally makes you feel the world is no longer safe. If you recognize these symptoms in yourself or a loved one, and you have experienced a traumatic event, speaking to your doctor about the possibility of PTSD is advised. This is especially important if you are experiencing depression, or find your relationships or work are negatively impacted.

Getting Approved for SSDI for PTSD

Approval for SSDI benefits begins with the application process. It can be more challenging to apply for a stressor-related disorder and therefore you’ll need adequate evidence to prove you suffer from disabling PTSD. It begins with a diagnosis but must be supported by documentation related to your condition, treatment, medications, etc.

What Evidence is Required for the SSDI Application?

You must provide relevant medical evidence from your physician, psychologist, and other medical sources including:

• Physician assistants
• Psychiatric
• Nurse practitioners
• Licensed clinical social workers
• Clinical mental health counselors

However, the SSA does not just consider medically documented evidence. They also review evidence provided by people you know and who have witnessed your symptoms whether it is family and friends, co-workers, clergy, management, neighbors, etc.

The type of medical records and evidence required can include any of the following:

• Reported symptoms and diagnosis
• Medical, psychiatric, and psychological history
• The results and clinical findings of physical or mental status examinations or psychological testing
• Medications and therapy received and the effectiveness of such treatments
• Side effects that might limit your ability to function from treatments received
• Your clinical course with changes based on your progress and the effectiveness of changing treatments
• Observations and descriptions of how you function at exams or during therapy
• Sensory, motor, or speech abnormalities
• The expected duration of your symptoms and their effects on your functioning

Submitting this information is crucial to your approval.

Meeting the Extreme Limitation Criteria for PTDS

The SSA also requires proof you suffer from the extreme limitation of one, or marked limitation of two, of the following:

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

If evidence shows your PTSD is considered serious and persistent over a period of at least two years, your case could be approved with the following evidence:

• Proof you have undergone medical treatment, mental health therapy, psychosocial support, or living in a highly structured setting designed to manage and diminish the symptoms of your disorder
• Evidence you are capable of only marginal adjustment with minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life

If you suffer from a stress-related disorder but don’t meet the blue book requirements, you might still qualify for what is called a medical-vocational allowance. It is important to explore your rights and ensure you receive the maximum payout available.

What is a Medical-Vocational Allowance?

A medical-vocational allowance is provided when you don’t meet SSA blue book requirements, but meet requirements based on a residual functional capacity (RFC) exam. The exam is performed by an SSA medical consultant. An RFC tells the SSA what types of work if any you can perform.

If the SSA finds you are unable to perform tasks to hold your current job or be trained to hold a different type of job, they might approve you for SSDI based on a medical-vocational allowance. The test is usually scheduled if you decide to appeal your case following a denial of disability benefits. A disability advocate can assist in the process. The test looks at the following:

Physical work:

• Sitting
• Standing
• Walking
• Lifting
• Carrying
• Reaching
• Bending over

Mental work:

• Reading
• Remembering procedures
• Following directions

The goal is to determine what type of work can be performed to hold a job. In this case, approval is only provided if you are unable to perform any work at all.

Applying for benefits for PTSD can be a very intimidating process. Considering more than two-thirds of those applying for SSDI are denied, it is best to have a disability advocate involved in the application process. They will ensure all the relevant information is collected and presented to the SSA. As a result, your case is more likely to be approved the first time around, avoiding the stress of an appeal or having to undergo an RFC.

Princeton Disability is here to assist with your PTSD-related SSDI application. Reach out to our team today to set up a free consultation.