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

Claiming depression as a disability

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 (for example, they have depression but have never been formally treated for it), or does not have recent medical treatment to address their depression, their disability case may require a consultative examination, or CE. What is a CE? A consultative exam is (a one time examination performed by a physician who is paid by Social Security. It generally does not 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 "current" status of the condition, it would stand to reason that they have no way of really determining how an individual's 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. In other words, if depression will be on your disability application, seek treatment so your condition can be documented with medical record evidence.

Winning disability for depression using the listings

For cases in which depression is alleged, the disability examiner will use the criteria contained in impairment listing 12.04 to evaluate the severity of their condition. Without listing all the criteria of the impairment listing for depression, 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.

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.

What if you don't meet the listing for depression?

Satisfying the listing for depression is difficult. In fact, getting disability through any of the listings can be hard because they are so specific in their criteria. However, even if the symptoms or limitations of an individual's depression do not meet or equal the impairment listing, they still may qualify for disability under SSD or SSI.

Even if you don't qualify through a listing, a disability examiner will use a process that uses your medical records to decide what you can, and cannot, do. This is your residual functional capacity. This will be compared to the requirements of your past jobs and the requirements of any other jobs you might be expected to do based on your age, education, and skills. If you can't do other work, or your past work, you may be approved for disability.

This type of approval is a medical vocational allowance approval.

Medical vocational approvals take into consideration an individual's 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.

Once again, 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 individual's ability to work. The Social Security definition of disability clearly states the importance of work or the lack thereof.

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.

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