Understanding how to get disability benefits for PTSD (post-traumatic stress disorder) is crucial before filing paperwork with the Social Security Administration (SSA). Claims are commonly denied due to errors in form completion and filing. Speak with a local Social Security lawyer before submitting your PTSD disability claim. They may provide valuable insight that helps with your approval.
What is Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is a mental health condition triggere<d after witnessing a traumatic event, such as war, natural disasters, physical or sexual assault, and other violent crimes. Although PTSD is a serious mental health condition with a myriad of symptoms, not everyone who applies is eligible to receive disability benefits for PTSD.
SSA statistics demonstrate that the final award rate for disabled worker applicants varies with time. However, on average, they deny 67 percent of disability claims. Denials occur when there is insufficient medical evidence and diagnosis or clerical errors when filing. Your chances of being approved significantly increase with the help of a knowledgeable SSDI lawyer.
Types of PTSD
Several types of post-traumatic stress disorder (PTSD) may make you eligible to get disability benefits for PTSD. Four types of PTSD that may qualify you for disability benefits through the SSA include:
- Uncomplicated PTSD: Uncomplicated PTSD is linked to a single traumatic event versus multiple traumatic experiences. Symptoms present as having heightened reactions, adverse changes in mood, nightmares or flashbacks resubjecting you to the traumatic experience, and avoidance of any reminders of the trauma.
- Complex PTSD: Complex PTSD occurs after exposure to prolonged or repeated traumatic events. These events may include car accidents, ongoing abuse in a relationship, being held in captivity, or exposure to war. It’s characterized by a combination of PTSD symptoms and additional symptoms that are not conducive to a traditional PTSD diagnosis. These symptoms can include identity issues, relationship problems, emotional dysregulation, and suicidal feelings.
- Dissociative PTSD: Dissociative PTSD is a subtype that includes all the symptoms of PTSD in addition to depersonalization or derealization. Depersonalization encompasses a feeling of detachment from your body or mental processes. Derealization is a feeling of unreality in your surroundings.
- Comorbid PTSD: PTSD has a high occurrence of comorbidity (co-occurrence) with other mental disorders. These commonly occur with major affective disorders, anxiety disorders, personality disorders, dysthymia, and substance abuse disorders. However, dementia can also co-occur.
PTSD symptoms may take a few months to develop after a traumatic event. However, it may present years after trauma. You must obtain a proper diagnosis and documentation of your PTSD condition from a licensed medical professional.
Social Security’s Process for Determining Eligibility for PTSD
The SSA has a five-step process they use to determine eligibility for PTSD and other disabilities. An experienced Social Security lawyer will thoroughly prepare you for the questions you may face during your SSA hearing, including the five-step evaluation process. These five questions are as follows:
Are You Working?
The SSA uses guidelines to evaluate whether your work activity complies with substantial gain activity (SGA). The SGA limit in 2024 is $1,550 monthly or $2,590 if you’re blind. If your earnings exceed these figures, you generally will not be considered to have a disability or receive benefits for PTSD.
Is Your Condition Severe?
To qualify for disability, your condition must significantly limit your ability to perform basic work-related duties and activities for at least 12 months. Basic work-related activities include sitting, standing, lifting, and remembering. If your PTSD affects these activities, SSA moves on to step three.
Is Your Condition Found in the List of Disabling Conditions?
Is your condition on SSA’s list of impairments or disabling conditions, and is it severe enough to prevent you from performing substantial gainful activity? If medical criteria are unmet, SSA will determine your Residual Functional Capacity (RFC). An RFC entails what you’re capable of performing despite your PTSD.
Can You Do the Work You Did Previously?
At this step, SSA will determine if your PTSD prevents you from performing any of your work-related tasks from previous work. If it does not, they will disqualify you from receiving disability. If it does, they will continue to step five of the eligibility determination process.
Can You Do Any Other Type of Work?
Finally, are you capable of performing other work tasks? The SSA will consider factors such as age, education, past work experience, medical conditions, and transferable skills you possess. If your PTSD prevents you from completing other work, your claim will be approved. However, if it is shown that you can do other work, your PTSD disability claim will be denied.
There can be special considerations for some applicants. For example, if you are blind, a survivor, a wounded warrior, or a veteran. Speak to a local disability lawyer to determine eligibility and help process your SSA claim.
Social Security Lawyers Help You With How to Get Disability Benefits for PTSD
Hiring a disability attorney who will file everything properly, completely, and on time keeps the process on track. These claims processes tend to be complicated, with a significant denial rate, especially for those without legal representation. A Social Security lawyer can improve your chances of getting disability benefits for PTSD in the following ways:
- Collecting Evidence: Your disability attorney will secure detailed medical records from your treatment providers, such as your PTSD diagnosis, PTSD treatment plans, therapy notes, and other documentation demonstrating how your PTSD affects your work capabilities and daily life.
- Creating a Compelling Case: After carefully reviewing your medical records, your lawyer can help you write a detailed statement expressing the traumatic event leading to your PTSD, your symptoms, and how they impact your ability to function at work and in your daily life.
- Identifying Legal Arguments: Experienced Social Security lawyers are familiar with the medical criteria required to receive disability benefits from SSA based on PTSD. They can help identify the proper legal arguments to support your PTSD disability claim.
- Preparing for Hearings: If your initial claim is denied, an attorney will prepare you to testify before an administrative judge at a hearing. This preparation helps ensure you answer the questions precisely and communicate the severity of your PTSD condition.
Finally, if your PTSD disability claim is denied, your disability attorney will guide you through the appeals process. Appeals come with substantial paperwork and filing deadlines to meet. They will represent your legal interests through the appeals process. Consult a disability lawyer to get help completing and filing your claim to get disability benefits for PTSD.
