Does a Trauma-Related Disorder Qualify You for Social Security Disability?

Have you been a victim of a violent trauma or an accident that resulted in severe injury or a near-death experience?  Often a person can develop a trauma-related disorder as a result of those situations. Psychological disorders can change how someone interacts with the world and impact their ability to function in everyday life like being able to hold a job. If you have a trauma-related disorder which prevents you from working full-time you may qualify for Social Security disability benefits. 

There are two disability programs: Social Security Disability Insurance, which is known as SSDI, and Supplemental Security Income, commonly referred to as SSI. SSDI pays benefits to you and certain members of your family if you are disabled, and you worked long enough and paid Social Security taxes recently enough. SSI, on the other hand, is based on financial need. The Social Security Administration (SSA) says, “It is designed to help aged, blind, and disabled people, who have little or no income.”

To determine if you are medically eligible for disability benefits, Social Security has a set of procedures in place. These procedures are published in a handbook known as the “Blue Book,” and it includes a list of various disabling conditions known as “listings.”  The criteria for traumatic-related disorders can be found  in Listing 12.15 of the Blue Book.

Here are the requirements for meeting the standards of the listing:

1. ”Medical documentation of all of the following:
1. Exposure to actual or threatened death, serious injury, or violence;
2. Subsequent involuntary re-experiencing of the traumatic event (for example, intrusive memories, dreams, or flashbacks);
3. Avoidance of external reminders of the event;
4. Disturbance in mood and behavior; and
5. Increases in arousal and reactivity (for example, exaggerated startle response, sleep disturbance).

AND

2. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
1. Understand, remember, or apply information (see 12.00E1).
2. Interact with others (see 12.00E2).
3. Concentrate, persist, or maintain pace (see 12.00E3).
4. Adapt or manage oneself (see 12.00E4).

OR

3. 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:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 12.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 12.00G2c).”

Only a very few people will meet the Blue Book standards, but there is a second way to qualify by demonstrating that the symptoms of your impairment prevent you from sustaining full-time competitive employment on a consistent and reliable basis. To prove that your impairment prevents you from maintaining full-time employment, you must start with a diagnosis through an exam by a licensed doctor, psychologist, or psychiatrist. (the evaluation by a psychiatrist will carry more weight.) However, it is important to know that a diagnosis alone is not enough to qualify you for benefits. You will also need proof of how your medical conditions limit your ability to work. This is usually done using a form called the “Residual Functional Capacity” (RFC) form. The RFC form is separate from the medical records and helps your care provider to explain your limitations. To decide whether you qualify for Social Security disability benefits the Social Security Administration will consider the RFC form along with other medical evidence.

All qualifying disabilities must be expected to last and keep you out of work for at least 12 months.

If you have other impairments in addition to a trauma-related disorder, you should also include these in your application for benefits. The Social Security Administration must take into consideration all your impairments when deciding whether you qualify for disability benefits.

If you have a disabling injury or illness and your condition has made it impossible for you to hold a job, contact us at Cuddigan Law for a free evaluation of your situation. We can help you navigate through the complex SSA disability claims process and guide you on the best path forward. We only get paid when you win your case.

You are 3 times more likely to be awarded disability benefits if you have a representative such as a disability attorney who will fight for your rights than if you have no representation at all, according to a Government Accounting Office study.