Filing for Social Security Disability or SSI with Bipolar Disorder

First, a bit about the condition

Bipolar disorder affects about 6 million people age 18 (bipolar disorder can affect younger children as well) and older each year, or roughly 2.5 percent of the American population. Nearly two-thirds of those diagnosed with bipolar disorder have a near relative who has been diagnosed with bipolar disorder or unipolar depression, which suggests that there is a heritable component to this condition.

Studies conducted during the last few years seem to indicate that many individuals with bipolar disorder never receive proper treatment or go untreated. Individuals who suffer the ups and downs of this condition have the highest suicide rate of among all the mental disorders; recent statistical information indicates that one in three people diagnosed with bipolar disorder attempt suicide, while one in five of those who attempt suicide are successful.

People with bipolar disorder often have other issues such as alcohol or substance abuse along with their condition (self medication is very prevalent). Even without alcohol or substance dependence, bipolar disorder may contribute to obesity (about 35 percent suffer from obesity), diabetes (people with BP are three times more likely to have diabetes), heart disease, or strokes (they are about two times more likely to have a stroke or heart disease). Considering the increased risk of additional physical and/or mental conditions along with the depressive and manic symptoms of bipolar disorder, it is not difficult to imagine why bipolar disorder can be so disabling.

Filing for disability with Bipolar disorder

Social Security recognizes that bipolar disorder is a severe medical condition that could prevent an individual from performing work activity at the SGA (substantial gainful activity) level. The Social Security definition of disability maintains that a disability is any medically determinable mental or physical condition that has prevented an individual from working and receiving earnings equal to the SGA limit, or is expected to prevent the performance of SGA-level work activity for twelve continuous months, or is expected to result in their death.

The Social Security Disability guidebook evaluates the severity requirements needed to be approved for disability on the basis of bipolar disorder under mental impairment listing 12.04 Affective Disorders, section A 3. The listing requires that an individual have a history of episodic periods, documented by the full symptomatic range of both manic and depressive syndrome symptoms (the current episode may be characterized by either or both syndromes). Symptoms of both depressive and manic syndromes are listed below; along with the requirements criteria listed in section B or C of the impairment listing.

Depressive syndrome symptoms might include, but are not limited to:

  • Sleep disturbance
  • Difficulty concentrating or thinking
  • Suicidal thoughts
  • Feelings of worthlessness or guilt
  • Lack of energy or fatigue
  • Appetite disturbances (weight gain or weight loss)
  • Anhedonia (loss of interest in most activities)
  • Delusions
  • Paranoid thinking

Manic syndrome symptoms might include, but are not limited to:

  • Hyperactivity
  • Decreased need for sleep
  • Flight of ideas
  • Inflated self esteem
  • Pressured speech
  • Easy distractibility
  • Hallucinations
  • Delusions
  • Paranoid thinking
  • Involvement in activities that are likely to cause painful consequences without realizing it

With all of these potential symptoms, bipolar disorder could easily cause an affected individual significant difficulties with daily living activities, including work activity.

Section B states that the bipolar condition must result in a significant restriction of daily activities; or severe difficulties maintaining social functioning; or repeated instances of decompensation that last for extended periods of time; or significant difficulties with persistence, concentration, or pace.

Section C states that there must be a medically documented history of chronic affective disorder (in this case bipolar disorder) of at least two years duration that has caused more than a small limitation of the individual's ability to perform basic work tasks, even with symptoms being controlled by medication or psychosocial support with one of the following:

  • Repeated decompensation episodes of extended duration
  • A residual disease process that has resulted in such marginal adjustment that even a small change in environment or increase in mental demands could be predicted to cause the person to decompensate, or a current one year or more history of a failure to function outside of a very supportive living environment with a projected continued need for the supportive living arrangement

Even if a person does not meet or medically equal the severity requirements of impairment listing 12.04 A3, B, or C, they still may be able to be approved for disability benefits.

If a person does not meet or equal the criteria of an impairment listing, disability examiners will consider the following factors: the claimant's age, their education, their past work (jobs performed for three months or more while earning SGA during the previous fifteen years), the transferability of their job skills, their residual functional capacity (what they are able to do despite the limitations imposed upon them by their impairment), and their ability to perform other types of work when their limitations are considered.

These factors are taken into consideration so that a medical vocational determination can be made. If the disability examiner finds that a person is unable to perform past work or any other work because of their bipolar disorder, or any other impairment, they may be approved for disability benefits. Note: most disability claims are approved on the basis of a medical vocational allowance and this is why it is very important to have full access to a claimant's medical and work history.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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