Depression is the second-most common medical condition listed on Social Security disability software. Depression in its various forms (major depression, dysthymia, and persistent depressive disorder) is a type of mood disorder characterized by gloom, sadness, and feelings of hopelessness and inadequacy. Concurrent with these emotions, a person with depression frequently suffers from feelings of fatigue and decreased energy levels. In bipolar disorder, there is an expansive and elated mood (mania) that may cycle with depression.
Three Types of Major Depression
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), on which Social Security bases its handicap listings, describes three distinct depressive disorders which can be debilitating and interfere with an individual’s ability to work, attend school, or interact socially with others.
Major Depressive Disorder
The first type of major depression listed in the DSM is a significant depressive disorder. According to the DSM, for a diagnosis of clinical depression, symptoms such as feelings of guilt or worthlessness, changes in appetite and sleep patterns, difficulty concentrating, fatigue, suicidal thoughts, and/or constant sadness must be present every day for at least two weeks.
The second sort of depression recorded is dysthymia. This sort of depression has many of the same symptoms as Major Depressive Disorder, but the symptoms are usually less severe and occur over a period of at least 2 years.
The third type of depression described in the DSM is manic depression, also called bipolar disorder. Manic depression is characterized by periods of mania and depression, or intense highs and lows. Manic episodes cause an inflated sense of self-esteem, lack of sleep, extreme talkativeness, racing thoughts, irritability, and increased participation in risky behaviors (sex, drugs, and alcohol, for instance). Mania may or might not be followed by a period of depression. Symptoms of this kind of depression might require hospitalization and can be severe enough to cause psychotic episodes such as hallucinations and delusions.
How Depression Can Be Disabling
Many people suffer from major depression associated with emotionally painful situations (the death of a loved one, divorce), but for the most part, these periods of depression will be situational and short lived. However, if a person has an episode of depression with severe daily symptoms continue for two weeks or more, their condition may be considered to be major clinical depression. Major depression interferes with a person’s ability to cope with daily stresses and obligations, often rendering an individual unable to operate in their everyday life, including work and family activities.
What causes depression? There seem to be genetic and biological factors, as well as environmental factors. Individuals can be predisposed to depression and the condition is seen among several members. Pressure and other factors can also be linked to depression.
Disability Benefits for Major Depression
To qualify for disability benefits, an individual with depression must either fulfill certain specific disability criteria (found in Social Security’s impairment listing manual), or be granted a medical-vocational allowance based on the severity of their depression and a combination of other factors (like other impairments, work history, age, and level of education).
Disability Listing for Major Depression
Social Security publishes a list of serious illnesses that qualify for disability if they meet the criteria. The objective of the list is to be able to grant disability fast for impairments that are severe. Major Depression is covered in Social Security’s impairment listing 12.04, Depressive, Bipolar and Related. The listing has a list of problems and a list of symptoms you must have. First, you must show by having at least five of the following symptoms, you have serious depression to qualify for Social Security disability or SSI disability benefits on the basis of depression:
- depressed mood
- Decreased interest in almost all activities
- Appetite disturbance (poor appetite or overeating) resulting in a change in weight
- sleep disturbance (insomnia or oversleeping)
- Difficulty concentrating or thinking
- Feelings of worthlessness or guilt
- Thoughts of death or suicide, and/or
- A slowing of physical movement and reactions, including speech, or disturbance that is increased, such as hand wringing or pacing.
In addition to having at least five of the above symptoms, you must also meet “functional” criteria to show that you have a loss of abilities due to the mental disorder. Generally, you need to have an extreme limitation in at least one of the following areas, or a “marked limitation in at least two of these areas:
- Understanding, remembering, or applying information (the ability to understand instructions, learn new things, apply new knowledge to tasks, and use judgment in decisions)
- Interacting with others (the ability to use socially appropriate behaviors)
- Concentrating, persisting, or maintaining pace in performing tasks (the ability to complete tasks), and/or
- Adapting or managing oneself (having practical personal skills like paying bills, cooking, shopping, dressing, and practicing good hygiene).
Alternately, if you can’t show that you currently have the functional limitations above because you have been living in a situation that is structured or protected or experiencing therapy, you may have the ability to fulfill the set of criteria. You can do this if your disorder has been medically documented as serious and persistent over a period of at least two decades and you can show that you have lived in a highly-structured setting or receiving ongoing medical treatment, mental health therapy, or psychosocial support that diminishes the signs of your mental disorder. You must also demonstrate that you have minimal capacity to adapt to demands which are not already part of your everyday life or to changes in your environment.
Qualify For Disability and Receive Benefits based on Depression
There are two main factors for all disability determinations: work and residual functional capacity (what a person is able to do despite the limits 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 the 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.
If an individual has stopped working or reduced their hours of work, because of their depression that their earnings are under the SGA earnings amount that is monthly, they should file for disability.
Their disability claim will be sent to a state disability agency for a medical decision as soon as their disability application files. This agency is known in most states where a claim is assigned to your claim processing specialist and it is.
Once the disability claim is assigned to a disability examiner, the examiner sends out for medical records from the sources that are treating the person.
If a person alleges that they are disabled due to depression, it would be helpful to have medical records from a health treatment source that is acceptable. Acceptable mental health treatments sources might include hospitals, or doctors including psychiatrists, or psychologists.
If a claimant does not have a history of medical treatment or doesn’t have current medical treatment to address their depression, their disability case could 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 acceptance of disability benefits.
There are reasons why examinations don’t lead to an approval for disability benefits. If the examining doctor has never seen the person prior to the examination and the assessment is merely to give a basic status of the status, it would stand to reason that they have no way of really determining how an individual’s depression limits their day to day life.
Appealing a Denial of Benefits for Major Depression
You have been denied benefits and feel your case is strong enough to win an appeal, if, consider contacting a disability lawyer. Applicants who go to an appeal hearing represented by a lawyer have a better acceptance rate than candidates who represent themselves.
Major Depression is highly treatable, with antidepressant medications and psychotherapy has proven successful. Therapies include changes in diet and level of exercise, exposure to sunlight, such as becoming a member of a social group, and social changes.