If you are unable to work due to a disability, you may qualify for benefits through the Social Security Administration (SSA). Depending on your situation, this may include Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). For SSDI/SSI purposes, mental health conditions such as Post-Traumatic Stress Disorder (PTSD) may qualify as a disability.
PTSD is a mental health disorder that often occurs in people who have either experienced or witnessed a traumatic event. If you experience severe symptoms related to Post-Traumatic Stress Disorder, then you may qualify for disability benefits. To be approved for Social Security benefits, you will need to prove that you are unable to work because of your PTSD using medical records and other types of evidence.
At Bross & Frankel, we help individuals with disabilities get the benefits that they are entitled to under the law. We represent people who have been diagnosed with all types of conditions, including mental disorders. If you believe that you may qualify for disability benefits based on your PTSD diagnosis, reach out today to schedule a free claim review.
Can You Get Disability for PTSD?
Post-Traumatic Stress Disorder can be disabling. It is often triggered by a traumatic event that causes feelings of intense fear and helplessness. While PTSD is commonly associated with combat veterans, there are many situations other than war that may cause this condition, such as a natural disaster, sexual assault or rape, physical assault, or childhood abuse.
People with PTSD may experience a variety of symptoms, including:
- Recurrent, intrusive thoughts about the traumatic event
- Flashbacks
- Troubling dreams about the event
- Severe emotional or physical reactions to things that remind them of the traumatic event (triggers)
- Avoiding people, places, or activities that remind them of the traumatic event
- Feelings of hopelessness
- Memory issues, especially related to the traumatic event
- Depression
- Difficulty maintaining close relationships
- Being easily startled or frightened
- Irritability
- Self-destructive behavior, including drinking too much or abusing drugs
PTSD is typically diagnosed after a physical examination to rule out other potential causes of these symptoms. A psychological evaluation is then conducted to determine if the person meets the criteria for a PTSD diagnosis per the criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
If PTSD symptoms are severe enough, then it may be considered a disability. Generally, for purposes of SSDI/SSI benefits, if you meet the criteria in the SSA’s Listing of Impairments (Blue Book), then you will qualify for disability benefits. However, even if you don’t meet this Blue Book listing, you may still be eligible for benefits through the SSA’s five-step sequential evaluation:
- If you are working, then you cannot earn more than a set amount, known as substantial gainful activity (SGA). For 2022, SGA is $1,350 for people who are not blind.
- Your impairment or combination of impairments must significantly limit your ability to perform basic work and is either expected to last for a year or longer or to result in death.
- Your impairment must either meet or exceed all of the requirements on the SSA’s listing of impairments (blue book), or it must have other factors that equal a listed impairment.
- If your impairment does not meet or exceed these criteria, then it must prevent you from performing any of your past work.
- You must not be able to perform any other type of work, based on your condition, age, education, past work experience, and job skills.
Disability Rating for PTSD
An individual with PTSD may qualify for disability benefits under the Blue Book’s listing for trauma- and stressor-related disorder. There are two separate listings for these disorders, based on whether the applicant is an adult (Listing 12.15) or a child (listing 112.15). If you meet or exceed the Blue Book criteria for a PTSD rating, then you may receive disability benefits.
There are three subsections – A, B, and C – in the listing for trauma- and stressor-related disorders. To qualify for a PTSD rating, you must meet the criteria in either A and B or A and C:
- Medical documentation of all of the following:
- Exposure to actual or threatened death, serious injury, or violence;
- Subsequent involuntary re-experiencing of the traumatic event (i.e., flashbacks or dreams);
- Avoidance of external reminders (triggers) of the event;
- Disturbance in mood and behavior; and
- Increases in arousal and reactivity (such as sleep disturbance and/or an exaggerated startle response).
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
- Understand, remember, or apply information;
- Interact with others;
- Concentrate, persist, or maintain pace; and/or
- Adapt or manage oneself.
OR
- Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support, or a highly structured setting that is ongoing and diminishes the signs and symptoms of your mental disorder; and
- Marginal adjustment (minimal capacity to adapt to changes in your environment or to demands that aren’t already part of your daily life).
If you have a PTSD diagnosis and you can match two of these sections (A and B or A and C), then the SSA may consider you to be disabled. If you cannot work because of your PTSD, then you may be able to obtain disability benefits.
Importantly, because PTSD is linked to other health conditions – including depression and anxiety, substance abuse disorder, eating disorders, and suicidal thoughts and actions – it may be possible to qualify for Social Security disability benefits even if you don’t meet the criteria for a PTSD rating. If you can’t work because of PTSD and/or another condition, reach out to a disability attorney to schedule a free consultation.
Getting Disability for PTSD
If you have been diagnosed with PTSD, you can apply for Social Security benefits. This may include SSDI and/or SSI. The process involves filling out an application and submitting it along with supporting documentation, such as medical evidence.
To file for Social Security disability, you will need the following:
- Birth certificate;
- Social Security number;
- Proof of citizenship;
- Work history, including pay stubs;
- Information on any recent work;
- Contact information for any treating medical professionals, including doctors, psychologists, therapists, and treatment centers;
- A list of the medications that you currently take;
- Any medical records that you have; and
- An adult disability report.
Once you have put together this documentation, you can fill out the forms and submit an initial claim. You can file your application online, over the phone, or at a local Social Security field office. The application will be processed through a local Social Security office and a state agency known as Disability Determination Services, or DDS.
In most cases, you will receive a response from the SSA within 3 to 5 months. It may take more or less time to get an approval or denial based on the facts of your case and the SSA’s ability to access medical evidence. If your claim is approved, then you will start to receive monthly disability compensation from the SSA.
Most initial disability claims are denied by the SSA. This may be due to technical errors or simply not providing enough medical evidence to support your claim for disability. This is not the end of the road. You can still appeal a denial with the help of a disability benefits lawyer.
There are four levels of appeal: request for reconsideration, a hearing before an administrative law judge (ALJ), review by the SSA Appeals Council, and a federal court lawsuit. As a general rule, you have 60 days from receiving a notice to file an appeal.
I Don’t Meet the Medical Listing for PTSD. Can I Still Get Benefits?
You may still qualify for Social Security benefits through the medical-vocational allowance. This process starts by establishing your residual functional capacity (RFC), or the level of work that you can do given your disability. If you cannot perform our past work or other available work, then you may be eligible for benefits.
These types of cases can be challenging. If you have been diagnosed with PTSD, our law firm can help. Give Bross & Frankel a call today for a free claim review.
I Have PTSD from Military Service. Can I Get VA and Social Security Disability Benefits?
Yes. If you qualify for both veterans’ disability and Social Security disability benefits, then you may be eligible for both types of disability benefits. The criteria for these benefits is slightly different, so it is important to work with a skilled disability attorney who has experience handling both VA and SSA benefit applications.
The legal team at Bross & Frankel helps people obtain all types of disability benefits, from long-term disability through private insurance to SSDI, SSI, and veterans’ disability compensation. Call our law office today to schedule a free initial consultation with a seasoned disability lawyer.
Is It Helpful to Submit Statements from Friends and Family about How My PTSD Affects My Ability to Work?
Yes. Your friends, family members, former bosses, and co-workers may have the best perspective on how PTSD affects your daily functioning and social functioning. They can write statements about their observations of you and interactions with you, which can be used to show that your post-traumatic stress disorder affects your ability to work. These letters should not address the medical aspects of your condition.
A skilled disability benefits attorney can help you assemble medical evidence and other documentation to support your claim. This can improve the likelihood that your initial application will be approved. Reach out to Bross & Frankel to learn more about how we can help.
How Our Attorneys Can Help
If you have been diagnosed with PTSD, you may be eligible for disability benefits. The process of applying for benefits can be overwhelming, particularly if you are already struggling. Our law firm can help.
Based in Cherry Hill, the attorneys of Bross & Frankel represent people with disabilities throughout New Jersey and Pennsylvania. We have substantial experience in all aspects of disability law and work hard to help our clients get the best possible outcome. To learn more or to schedule a free claim review, call our law office at 866-861-5942 or fill out our online contact form.