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Can I Qualify For Disability and Receive Benefits based on Depression?




 
Any mental or physical condition can qualify a person for disability because Social Security does not look so much at specific conditions as it does how the condition limits an individualís ability to work. The Social Security definition of disability clearly states the importance of work or the lack thereof.

There are two main factors for all disability determinations: work and residual functional capacity (what a person is able to do despite the limitations imposed upon them by the condition). So how can an individual with depression qualify for disability?

To be awarded disability benefits based on depression or any other impairment, the condition must be so severe that it has prevented the claimant from working at substantial gainful activity (SGA) for twelve continuous months, or it must be expected that the condition will prevent the performance of SGA for twelve continuous months.

SGA is just a monthly earnings amount that Social Security has deemed to be substantial work activity (to see the current amount: What is SGA and how does it affect Social Security Disability?).

If an individual has stopped working or reduced their hours of work, due to their depression, so that their earnings are under the SGA monthly earnings amount, they should file for disability with Social Security.

Once they file their disability application, their disability claim will be sent to a state disability agency for a medical decision. This agency is known in most states as Disability Determination Services and it is where a claim is assigned to a claim processing specialist known as a disability examiner.

Once the disability claim is assigned to a disability examiner, the examiner send out for medical records from the treating sources the individual listed at their disability interview.

If an individual alleges that they are disabled due to depression, it would be helpful to have medical records from an acceptable mental health treatment source. Acceptable mental health treatments sources might include licensed or certified psychologists, or licensed physicians including psychiatrists, or hospitals.

If a claimant does not have a history of medical treatment, or does not have current medical treatment to address their depression, their disability case may be determined by a consultative examination (a one time examination performed by a physician who is paid by Social Security). However, this does not generally lead to an approval for disability benefits.

There are reasons why consultative examinations do not lead to an approval for disability benefits. If the examining doctor has never seen the individual prior to the examination and the examination is just to give a basic status of the condition, it would stand to reason that they have no way of really determining how an individualís depression limits their day to day life.

The point being made here is that if an individual is filing for disability based on depression or any other condition, it really helps their chances of winning their disability case if they have an established history of treatment, and the corresponding records to document the severity of their condition and the ways in which they are consequently limited.

For cases in which depression is alleged, the disability examiner will use the criteria listed in impairment listing 12.04 to evaluate the severity of their condition. Without listing entirely the criteria of the entire impairment listing, it should be stated that an individual usually has to have definable symptoms that are medically documented to be either continuous or intermittent.

Note: Listings are contained in the social security administration's blue book which is available online and has in the past been published under the title "Disability Evaluation under Social Security; most conditions are not listed in the blue book and most approvals are not made on the basis of satisfying the requirements of a listing, but, rather on determining whether or not a claimant can return to their past work or perform some type of other work.

The claimant's symptoms must cause more than minimal limitation of ability to do basic work activity. Generally, to meet or equal the criteria of impairment listing 12.04, the listing which pertains to depression, the following must be satisfied:

1. An individual must suffer from episodes of decompensation of an extended duration, or

2. Have a disease process in which even minimal changes in mental demands, or a change in environment, could cause the individual to decompensate, or

3. Their depression has caused them to be unable to function outside a very supportive living arrangement and it appears there is a continued need this arrangement.

Even if symptoms or limitations of an individualís depression do not meet or equal the impairment listing, they still may qualify for disability. Disability examiners must use a five-step sequential evaluation process that first involves determining if an individual is working at an SGA earnings level. If the claimant is not working and earning what is considered to be a substantial and gainful income, social security must determine if the individual has a medically determinable mental or physical impairment. If they do have a definable impairment, the examiner must determine if the impairment is severe versus non-severe (some impairments are considered non-severe; an example would be a sprained wrist).

At this point, if an individual does not meet the criteria of the mental impairment listing that would cover depression, the disability examiner must continue to the fourth step of the sequential evaluation process. The fourth step is to evaluate an individualís past work to determine if the person can do any of their relevant past work (jobs they have held in the past 15 years). If it is determined that the claimant does not have the residual functional capacity to return to any of their former jobs, then the evaluation process moves to the fifth and final step.

The last step is an evaluation of the individualís ability to perform types of "other work". Other work is a hazy concept, but, essentially, this is where SSA considers whether or not a claimant can switch to some new type of work they have never done, based on their age, education, job skills, and remaining physical and mental capability.

When disability examiners determine if a person can do their past work, or even other work, they must consider the individualís residual functional capacity. If an individual cannot perform any of their past work due to the limitations imposed upon them by their condition, in this case depression, the disability examiner must consider if these limitations rule out other work as well. And, if the disability examiner finds that the individualís limitations preclude all substantial work activity (doing a former job or doing some type of other work), the disability applicant may qualify for a medical vocational approval.

Medical vocational approvals take into consideration an individualís age, education, medical or mental conditions, and their residual functional capacity. Medical vocational allowances actually form the basis for most approvals versus meeting the requirement of a listing in the SSA blue book.

In summary and to simplify, depression or any other mental or physical condition may qualify an individual for disability as long as it has prevented them from performing substantial gainful activity (SGA) of twelve continuous months, or is expected to prevent them from performing SGA for twelve months.

Translation: if the condition is severe enough to prevent a person from working at any job while earning a substantial and gainful gross monthly income, then the social security administration will consider that person disabled and eligible for disability benefits.















Return to:  Social Security Disability Resource Center, or read answers to Questions





























Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI


These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria