Disability Benefits for Post Traumatic Stress Disorder (PTSD)

 
Post Traumatic Stress Disorder (PTSD) is a mental illness caused by experiencing or seeing a horrific event. The symptoms of this disorder can significantly interfere with an individual’s ability to function in a work environment. An individual who is unable to successful perform work activities because of PTSD may qualify for one of the main disability programs, either Supplement Security Income (SSI) or Social Security Disability Insurance (SSDI).

 

About Post Traumatic Stress Disorder

As stated above, Post Traumatic Stress Disorder (PTSD) once known as shell shock or battle fatigue syndrome, is a serious mental disorder that develops after an individual experiences or witnesses a horrific event. PTSD is the lasting repercussion of a traumatic experience in which serious physical and/or mental harm occurred. Such events include war combat, sexual abuse, natural disasters, witnessing a murder etc.

It is good to keep in mind that most people experience a traumatic event during their lifetime that can cause shock, fear, or guilt. However, this does not mean they have PTSD as these reactions are normal and will go away with time. It is much different for someone with PTSD because the feelings do not go away and actually tend to get much worse. The symptoms can become so bad that it interferes with a person’s activities of daily living and occupation.

The symptoms of PTSD are grouped into three categories:

Intrusive or Re-experiencing Symptoms:

  • Reoccurring, undesired memories of the horrific event
  • Flashbacks or reliving the event as though it was happening again
  • Nightmares and disturbing dreams about the event
  • Emotional and physical distress to anything that reminds the person of the event

Avoidance Symptoms:

  • Individual attempts to avoid talking or thinking about the event
  • Individual avoids people, places and activities that remind them of the event
  • Detachment and isolation from friends and family

Hyper-arousal Symptoms:

  • Difficulty with concentration
  • Disturbed sleep
  • Aggressive behavior
  • Self-destructive behavior (alcohol & drug abuse)
  • Intense feelings of shame or guilt

 

Qualifying for Disability Benefits with PTSD

The Social Security Administration has a guide that lists the requirements for particular impairments to qualify for disability benefits known as the Blue Book or the Disability Evaluation Under Social Security. Chapter 12 of the Blue Book is related to mental conditions and section 12.06 Anxiety-related Disorders describes the requirements needed for an individual to qualify with PTSD. An applicant with PTSD filing for disability benefits must satisfy the severity levels for requirements A and B or requirements A and C.
 
Requirement A

Applicant must have documentation of one of the following:

  • Persistent severe anxiety with various symptoms
  • Reoccurring, intrusive, stressful memories of a traumatic event
  • Consistent irrational fear of a particular object or situation
  • Reoccurring severe panic attacks happening on average once a week
  • Consistent compulsions or obsessions that causes distress

 
Requirement B

Applicant must have documentation of at least two of the following:

  • Marked restriction of activities of daily living
  • Difficulty with maintaining social functioning
  • Difficulty with maintaining concentration, persistence or pace
  • Repeated episodes of decompensation of extended length

 
Requirement C

Applicant must have medical evidence that proves they are completely unable to function independently anywhere outside the area of his or her home.
 

Mental Residual Functional Capacity

One of the best ways to increase an applicant’s chances for approval with a mental illness such as PTSD is to have his or her treating doctor fill out a mental residual functional capacity (RFC) form. Typically when an applicant initially files for disability benefits, a medical examiner from the SSA will fill out a mental RFC based on the applicant’s medical documentation. This form is an assessment of an individual’s mental limitations caused by his or her disabling condition. The SSA will use this assessment to determine if the applicant is capable of working despite his or her limitations. If the applicant is seen as unfit for employment, the SSA will award the applicant Social Security Disability benefits.

However, this medical examiner makes a medical decision without even seeing the applicant in person. Because of this, the SSA gives more creditability toward a RFC filled out by the applicant's treating doctor since the doctor has direct experience with the applicant's disabling condition. To learn more, visit our page about Residual Functional Capacity.