Facts about Bipolar Disorder and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1) Bipolar disorder is a mental illness of various mood disorders, ranging from mild and severe depression, to mild and severe mania usually, but not always, separated by periods of 'normal' mood.
2) Although about one percent of the population has been diagnosed, many health experts think the number of people who have the illness is probably around 6 percent of the population.
3) The number of episodes of bipolar disorder per year can vary greatly from individual to individual, although most people with the mental illness will experience a an episode every three to six months.
4) There is a bipolar spectrum, which describes the range of bipolar episodes and works toward determining different bipolar types, though it is hard to say just how many types of the disorder exist. The spectrum involves Bipolar I, Bipolar II, Cyclothymia, Rapid Cycling, and Bipolar Disorder NOS (Not Otherwise Specified), which is a type of bipolar disorder created to be a 'catch all' for the cases of bipolar disorder that simply do not fit into any of the other categories.
5) If there are no periods of 'normal mood' in between periods of depression and mania, it is called rapid cycling. Those with rapid cycling experience at least four episodes in a year, but there are also people who will have mood episodes that change within a day or two. Those very fast episodes of bipolar disorder are called ultra-rapid cyling or ultra-ultra rapid cycling.
6) Oftentimes those with bipolar disorder will turn to drugs and alcohol to self medicate without knowing they have the mental illness, which makes diagnosis very challenging.
7) Unfortunately, many people go undiagnosed and do not realize they are experiencing mania in between periods of normal mood and depression. During the mania stage of bipolar disorder, the sufferer may be extremely creative, motivated, sociable, and productive, making them think that they only get depression and are healthy during their manic stage.
8) The cause of bipolar disorder is unknown though studies have shown that it may be genetic, can be biochemical and possibly due to hormonal imbalances, and related to environmental factors such as stress and drug use.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
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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