How Much SSDI Can You Receive for PTSD?

PTSD, also known as post-traumatic stress disorder, can make it challenging for people suffering from it to retain employment. You might be eligible for monthly payments and healthcare benefits if your PTSD interferes with your ability to work. In 2021, the Social Security Administration (SSA) awarded benefits to 345,220 workers suffering from mental disabilities, including PTSD and other disabilities linked to stress and trauma. 

The amount of Social Security Disability Insurance (SSDI) benefits a person suffering from PTSD may be eligible for depends on multiple factors, such as job history and income. The average lifetime earnings of the recipient are used to determine how much money they will get each month from SSDI, with some maximum limits specified by the SSA.

This article will describe how the SSA classifies PTSD, whether you may be considered for benefits, how to submit an application for disability to assist with your PTSD, and how to help you determine if you are eligible.

Does the SSA Consider PTSD a Disability?

When PTSD significantly impairs your ability to self-care and maintain employment, the SSA  classifies it as a qualifying disability.

SSA’s Definition of PTSD

People who have experienced a traumatic event may experience the effects of PTSD, which can manifest physically, emotionally, or psychologically. While PTSD is commonly associated with war veterans, the SSA classifies it as a trauma- and stressor-related disorder.

The SSA considers symptoms, including uncontrollable flashbacks to the traumatic incident, changes in mood or behavior, and enhanced responsiveness, when assessing PTSD.

Different Types of PTSD

People frequently experience a wide variety of PTSD symptoms, and these symptoms are divided into the following five subtypes:

• Acute Stress Disorder (ASD)
• Complex PTSD
• Uncomplicated PTSD
• Comorbid PTSD
• Normal Stress Response

Getting Disability Benefits for PTSD

If you have PTSD, you may be eligible for disability compensation. The SSA has strict requirements for diagnosing PTSD, similar to other mental health problems, so eligibility is not always straightforward.

Suppose you also have other related diagnoses, such as sleeplessness, depression, or anxiety, in addition to your PTSD. In that case, the SSA may be more inclined to approve your claim. 

If the incident that caused your PTSD also caused physical harm, that may help you be eligible if the injury prevents you from working.

You must prove that your PTSD meets all SSA requirements to be eligible. Your chances of being accepted may also be improved by seeking help or working with a disability attorney.

Qualifications for PTSD Disability

All mental disabilities, including PTSD, must meet specific requirements, according to the SSA. You must show that your PTSD is severe and ongoing and prevents you working to be eligible for disability compensation.

Think about whether or not your PTSD meets the requirements below before applying. The SSA will verify that you meet the prerequisites listed below:

1. You have all of the following medical records:
   1. You were threatened with or subjected to violence, serious injury, or death.
   2. Through intrusive recollections, nightmares, or flashbacks, you unintentionally relive the incident.
   3. You try to forget about the incident.
   4. Your emotions and actions change.
   5. You have trouble falling asleep and are more irritable, including a stronger startle reaction.

Along with the prerequisites listed above, you must also meet one of the requirements listed below:

2. You are significantly constrained in two or more of the following areas or severely constrained in at least one of them:
   1. Interacting with people
   2. Understanding, retaining, or applying information
   3. Paying attention, persevering, or moving steadily while performing work-related tasks
   4. Modifying or controlling your emotions and behaviors

Or

3. You have proof that your PTSD has persisted for at least two years:
   1. You have established highly regimented environments or obtained medical treatment, therapy, or support that reduces your PTSD symptoms.
   2. You have difficulty adapting to obligations that aren’t already part of your routine.

It is important to remember that the SSA defines extreme limitation as the inability to work independently, appropriately, effectively, and sustainably. You may still be able to function independently, but your abilities are significantly diminished or erratic.

Important Questions to Ask Yourself Before Applying for SSDI Benefits

If you can affirmatively respond to the following questions, you may be eligible for disability benefits:

• Do you avoid individuals or locations that make you think of upsetting or unpleasant memories from the past?
• Do you easily become agitated or startled?
• Do you experience nightmares, intrusive recollections, or flashbacks?
• Do you find it difficult to accept criticism and comments at work?
• Do you find it challenging to interact with others?

PTSD Meets Conditions: Post-Steps

Applying for disability payments is the next step if your PTSD meets the SSA criteria. You can apply even if you are unsure if you will be eligible, but doing so takes time. It may only be worthwhile when your chances of being accepted are better and if you meet the requirements. 

Here’s some guidance:

Apply immediately if: 

• You were diagnosed with PTSD 
• You often replay the incident
• You have trouble focusing, regulating your mood, and interacting with people.

OR

• You have experienced PTSD for at least two years, and you have shown that you have trouble adjusting to environmental changes.

Wait in case either of the following applies to you:

• You have PTSD, but your doctor believes your symptoms may subside within the next year.
• Despite your fears, having PTSD has not prevented you working.

Avoid Applying if:

• Working is not difficult for you, despite having PTSD
• Your monthly income exceeds $1,400 when you are employed.

Which Disability Benefits Should Someone with PTSD Apply for?

PTSD is frequently considered a disability, and the amount of money you get each month in benefits depends on each individual’s situation.

The SSDI program is intended for people with a lengthy employment history, often five out of the previous ten years or more. Supplemental Security Income (SSI) is available to people with little to no job history, a low monthly income, and few to no assets. 

Since both programs use the same application, you can submit applications for both to see which you might be qualified for. Additionally, receiving SSI and SSDI at the same time is also possible.

What Is The Amount of a PTSD Disability Check?

Although the SSA doesn’t provide a specific monthly benefit for PTSD, the average disability benefit for conditions that are related to PTSD is $1,229.06. Your benefits amount will depend on your employment history, income history, and the benefits program you qualify for. 

In 2023, the maximum SSDI and SSI disability benefits are $3,627 and $914, respectively.

Failure to Meet The Requirements for PTSD

Suppose your PTSD interferes with your capacity to work. In that case, the application may still be worthwhile even if you don’t meet all the requirements. Even if you have had trouble keeping a job, it might be challenging to prove your disability; only 20% of candidates are approved the first time they apply for benefits. 

But if you are denied, you can submit an appeal and present your case to the judge. More than half of the applicants who present their appeals to judges are successful. Additionally, applicants with a disability attorney may have an increased chance of receiving benefits since disability attorneys are well-versed in the requirements, paperwork, and deadlines for applying.

How to Apply for Disability Benefits: Step-By-Step Process

Following are the steps you will probably go through as you file for disability benefits:

Step 1: Apply For Benefits

1. Analyze Your Circumstances

Does your condition qualify as a disability in the eyes of the SSA? Unfortunately, not everyone battling a medical condition qualifies for disability compensation. If your condition is seen as impairing by the SSA, it must:

• Be associated with a condition or disability that a doctor has diagnosed
• Expected to last for at least a year (or expected to end in death)
• Make you unable to perform your existing job
• Prevent you from performing other types of work

Compassionate Allowance Conditions

Compassionate allowance conditions refer to certain disabilities or conditions, such as terminal cancer. People with certain cancers may be eligible for a Compassionate Allowance. 

Compassionate Allowances are cases where individuals have medical conditions so severe they obviously meet Social Security’s disability standards, allowing us to process the cases quickly with minimal medical information.

Suppose you are dealing with one of them. In that case, your disability application will likely be processed considerably faster than if you are dealing with PTSD.

2. Choose the Program You Want to Apply For

Most people will either be eligible for SSI or SSDI, but some people may be eligible for both. SSDI is based on your work history, with payments determined by your past earnings. Usually, SSDI benefit amounts are higher than SSI benefits. Benefits from SSI are significantly lower and subject to more limitations since they are based on financial need and not work history.

3. Paperwork and Records

Examine the application and keep in mind what supporting documents, records, and papers the SSA needs to verify your impairment. All of these materials should be prepared before you file your application.

The SSA may request supporting documentation, such as:

• Medical records
• Proof of address
• Work History records
• Information on how to reach your doctor
• Financial records

Another option is to keep a symptom diary and ask your doctor to record the notes in your medical files. Later on, this could become important documentation.

4. Complete and Send Your Application

The application forms for SSI and SSDI are fairly detailed. They require a lot of time to fill out and might be up to 30 pages long. That is why proficiency is important before beginning the application.

You can also get a lawyer’s assistance or an advocate to ensure the forms have been correctly filled out. You can submit the paperwork in person, via phone, or through the SSA website.

5. Add Additional Information

No matter how cautious you are, the SSA may reply to your application by requesting further supporting documentation or evidence. However, this is not cause for concern. The SSA is merely attempting to understand your circumstances better.

Gather and send the data they request. It frequently entails turning in extra records and paperwork. The SSA may also ask for a checkup with one of their medical professionals.

Tips for Passing the SSA Medical Exam

A medical exam is nothing to be afraid of. However, you must carefully discuss your illness with the examiner. Here are some pointers to help you succeed: When asked about your symptoms, explain them in detail and how they are in general most days, rather than how you feel at that moment. 

Tell the doctor again, if necessary, why you are there so they can ask pertinent questions. Reaffirm that your problem is mental, not physical, for instance, if they solely conduct a physical examination while you are experiencing depression.

At the end of the examination, get a copy of your medical record to confirm that the information you provided has been recorded.

6. Wait for the Final Decision

Once your application is finished, wait for the SSA’s decision; if you aren’t approved for benefits, go through the hearings and appeals process.

Step 2: Hearings And Appeals

1. Get Your Verdict

Your initial application may be denied if you don’t have a condition that qualifies under the SSA’s listing (ALS, stage 4 cancer, etc.). However, don’t lose hope; this is a normal step in the process. Currently, just 20% of applications are approved, and most have fast-track requirements.

Additionally, if your application is denied, submitting it again is unnecessary. You can challenge the judgment and pursue more hearings with the assistance of an attorney if necessary, strengthening your case each time.

2. Requesting Reconsideration of Your Appeal

If your application is denied, you have 60 days to request a reconsideration with the SSA. But again, rejection at this stage is common unless they overlook something crucial. Just 10% of applications are accepted after reconsideration, but don’t give up.

3. Hearing

Following reconsideration, you and your attorney will request a face-to-face or telephone hearing to present your disability claim to a court. Once more, you have 60 days to request a hearing, starting from the date of your previous decision. 

The hearing will convene with several key individuals in attendance, including a judge, a vocational expert, you (if you have a disability lawyer, they will be in attendance too), a hearing reporter, and sometimes a medical professional. When you present your case, justify your need for benefits.

Your chances are substantially better if the hearing stage is reached. Approximately 50% of applications are approved after the hearing, and your chances of success may increase if you have legal representation.

4. Appeal

Even if your application is rejected, you can still appeal; many successful applicants do so repeatedly. If your application is denied after a hearing, you can appeal again and set up more hearings to present your case.

5. Get Approved

Once approved, you will receive an award letter with the amount you will receive in benefits, the program you qualified for, how much you made according to your work history, and whether you are eligible for back pay. Back pay is a one-time payment for when you were disabled but weren’t yet receiving benefits.

Knowing the prerequisites and documentation requirements is very important when applying for SSDI for PTSD. The key to receiving benefits is demonstrating how severely PTSD affects your capacity to work.

While there may be hearings and appeals along the way, the chances of a successful application may be increased by speaking with a disability attorney, especially if you have a disability that is not easy to see or where it’s not so easy to prove your disability, such as PTSD or other mental disabilities.