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Why Is It So Difficult To Get Disability Benefits For Depression?




Anyone who's suffered from depression knows how debilitating it can be. Severe enough depression can create a vicious cycle of shutting down your ability to cope with the very problems driving the depression in the first place. Thankfully, many people can be treated for depression and begin the path back to normalcy. Others may need more help along the way. The Social Security Administration understands this, which is why they list depression as one of the medical conditions covered under disability benefits.


Unfortunately, meeting the requirements for disability places some hurdles for those suffering from depression and other mental illnesses. Unlike physical impairments, mental problems can be hard to quantify. The diagnosis is based upon self-reported symptoms. It would be easier if you could see depression in an x-ray report or laboratory test. How severe the depression is and how long it will take to recover from it is not something that can be answered simply. Yet, these are the exact types of questions the Social Security Administration needs answers to when evaluating a disability claim. At Kapor Davis, we know exactly what the Social Security Administration is looking for and how to get the answers they need documented.


To better understand how disability benefits work for depression, a good place to start is by looking at the Social Security Administration’s own regulations. These can be found here.


In this link you will find the symptoms the Social Security Administration is looking for and how they assess the severity of your symptoms. The requirements for disability benefits due to depression are laid out in section 12.04 of the SSA's Bluebook. That section requires medical documentation for five or more of the following symptoms:


  • Depressed mood

  • Diminished interest in almost all activities

  • Appetite disturbance with change in weight

  • Sleep disturbance

  • Observable psychomotor agitation or retardation

  • Decreased energy

  • Feelings of guilt or worthlessness

  • Difficulty concentrating or thinking

  • Thoughts of death or suicide


In addition, you must also have a history showing that the condition is serious and persistent. That SSA will look for a documented history of the illness lasting two years or more and limited signs of improvement during that time.


As an alternative to a persistent history of the illness, you can show that you have a severe limitation in one of the areas below or a marked limitation in two of the areas:


  • Understand, remember, or apply information

  • Interact with others

  • Concentrate, persist, or maintain pace

  • Adapt or manage oneself


How Eligibility is Determined for Depression


After applying, you'll need to prove to the SSA that eligibility. For depression, they will largely be looking at four areas of interest to determine whether or not to grant your benefits.


  • Clinical evidence - Because it is a medical disability, you can't just claim that you suffer from depression and have the SSA take your word for it. Instead, they'll need to see medical documentation that supports each of the requirements listed above.

  • History of treatment - Your treatment history will provide the SSA with two useful pieces of information; first, the level of treatment, including frequency and duration of treatment will give them an indicator of how serious the problem is. Second, it will allow them to see whether or not you have been following the recommended treatment plan.

  • Prognosis - Depression can be something that stays with a person for life, something that comes and goes, or something that resolves itself after a short period of time. To be eligible for benefits, it can't be a condition that you will quickly recover from with treatment.

  • Activities of daily living - The SSA will examine the impact of your depression on your ability to engage in normal activities of daily living. They will carefully look for conflicts. For example, a claimant’s often state in the initial forms that they spend most of their time lying in bed in their bedroom and rarely leave the house. Yet they report to their treating sources that they drive weekly, socialize with a few friends, go to the grocery store, clean their house and attend their children’s school programs


How to Improve Your Chances


As you can see, there are a number of qualifications you must meet in order to receive disability benefits. In addition to being harder to quantify, these requirements can be difficult for people with depression to meet because those suffering from it very often don't reach out for medical help as early as they should. Keeping that in mind, we can examine three things you can do that will greatly improve your chances of getting your disability claim approved.


  • Get a medical diagnosis - This is an absolute requirement of the program. While your best bet is to have a lengthy record of medical care for depression, there are circumstances outlined above where a doctor can assess your symptoms as being serious enough to qualify with a shorter medical history. We recommend that you report your symptoms to your treating sources in writing

  • Do as the doctor says - When the SSA looks at your treatment history, they will want to make sure that you have done what your doctor ordered and are compliant with treatment.. Failure to take the appropriate steps to improve your condition can also cast doubt on how serious you actually think it is.

  • Have a lawyer help you - Going into a disability claim with little experience in the process or what is required can be a confusing experience. This lack of certainty can be worse for those who have severe depression. Consulting with a lawyer will help you to ensure that you have gathered all the correct materials and filled out the application properly and obtained proper support from your treating sources. It can also help prevent you from feeling overwhelmed by dealing with it all on your own.


At Kapor Davis Law, we will work with you during every step of the process. From the earliest stages, we will go over the information presented here and explain in greater depth:


  • The actions you must take while your claim is processing

  • How to obtain the support you need from your treating sources

  • The actions needed to ensure that your symptoms and impairments are properly and persuasively documented by your treating sources.


What you can expect throughout the process until your final acceptance into one of the programs. At Kapor Davis, we will work with you from those early stages to lay a strong foundation for a successful claim. To get started on your path to disability income, contact us today.


Image Source: Aonprom Photo / Shutterstock

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