Social Security Disability Insurance (SSDI) is a federal program that provides financial support to individuals who are unable to work due to a disability, whether it be physical or mental.
However, many people living with a mental disability are not aware that they may be eligible for SSDI benefits.
Depression is one of the mental conditions listed in the Social Security Blue Book, which means it is a condition that can qualify for SSDI benefits. However, the process of getting approved for SSDI benefits based on depression can be challenging as it requires substantial medical evidence.
If you’re curious about how to meet the SSDI eligibility criteria for depression, this guide will provide you with essential information.
What Is Depression?
Depression is a common mental health condition that can lead to feelings of sadness or a lack of interest in day-to-day activities. It can affect how you think, feel, and act.
According to the World Health Organization (WHO), approximately 5% of adults worldwide experience depression in some form.
In the United States, research conducted by the National Institute of Mental Health (NIMH) in 2021 indicated that 8.3% of adults, or almost 21 million people, had at least one major depressive episode in the past year.
The NIMH primarily relied on the DSM-5 criteria for major depressive disorder for this survey. According to these criteria, a person is considered to have a major depressive episode if they exhibit a depressed mood, a lack of interest or pleasure in daily activities, and other symptoms for two weeks or longer.
Is Depression Considered a Disability?
Depression is recognized as a disability by both the Social Security Administration and the Americans with Disabilities Act (ADA). It can severely impact your ability to perform day-to-day tasks, including working at your job.
If you are unable to work due to severe depression, the Social Security Administration may consider your condition as a disability and grant you disability benefits.
To be eligible for disability benefits, you must have supporting medical documentation that demonstrates the following:
- You meet the criteria of a Blue Book listing.
- You have been unable to work for a minimum of twelve months.
- You have earned sufficient credits to qualify for SSDI (generally, you need to have worked full-time for at least five of the last 10 years.
The Social Security Administration will require you to provide a comprehensive job history, your driver’s license or another form of photo identification, your Social Security card, and further documentation, such as a birth certificate, to verify your identity.
You will also need to provide evidence to back up your claim, such as a residual functional capacity (RFC) form that your physician has filled out. The RFC will specify all of your limitations to help the disability examiner decide whether you can work and, if so, what kind of job you could undertake.
It is recommended that you continue to receive medical care and provide a list of healthcare professionals to back up your claim. Medical records from various professionals, such as psychiatrists, therapists, and doctors, can be valuable in strengthening your disability claim for depression.
Medical Criteria for SSDI
Depression can significantly impact a person’s life. It can cause a range of symptoms, including persistent feelings of sadness, hopelessness, and a lack of energy. Depression can also result in changes in appetite, sleep patterns, and concentration, which can make it difficult to perform everyday tasks or work-related activities.
In order to be eligible for benefits, it is necessary for you to prove that your depression is severely impacting your ability to work and perform daily activities. To demonstrate this, you will need to submit medical evidence and documentation from your healthcare providers that clearly indicates how your depression affects your daily functioning and ability to work.
To qualify, you must meet the conditions established by the Social Security Administration. Those requirements are included in the listing for depression that is contained in the Social Security Blue Book.
It specifies that a person seeking disability payments due to depression must demonstrate the presence of five or more of the following symptoms:
- Feeling sad or having a low mood
- Losing interest in almost all activities
- Changes in appetite, such as not feeling hungry or overeating, which can lead to weight gain or loss
- Difficulty sleeping or sleeping too much
- Having trouble concentrating or thinking clearly
- Having thoughts of death or suicide
- Feeling worthless or guilty
- Physical symptoms such as restlessness, hand-wringing, or slowed movements and speech
To qualify for disability benefits due to depression, you must provide evidence that shows a severe impairment in either one or more of the following areas:
- Understanding, retaining, or applying information: This includes the ability to comprehend instructions, learn new things, apply them to activities, and make decisions based on one’s judgment.
- Interacting with others: This involves representing oneself suitably in social situations.
- Being able to adapt or manage oneself: This includes having practical personal skills like paying bills, cooking, buying, dressing, and maintaining good hygiene.
- Concentrating, persisting, or maintaining pace while carrying out tasks.
It may be challenging to provide medical evidence that meets the listing requirements. However, you can use statements from a psychologist, former employers or coworkers, family members, social workers, or other individuals who can attest to the impact that your depressive symptoms have had on your ability to work.
Technical Criteria for SSDI Benefits
To qualify for SSDI benefits, you need to have earned enough work credits. You must have worked and paid into the Social Security system in the last 10 years.
The number of work credits required depends on your age and yearly income. You can earn up to four work credits for each year of work, one for every quarter of employment.
The amount of money you need to earn to receive a work credit changes every year. The number of work credits you need to qualify for SSDI depends on your age when you apply for benefits.
To check your work credits, review your job history. Create a MySSA account on the Social Security Administration’s website to access all your personal and work information. It takes only five minutes to create an account.
Qualifying Through Medical Vocational Allowance
While not impossible, receiving disability benefits for depression can be challenging, as the bar of evidence is quite high. In some cases, even if you are unable to work, you may not reach the required threshold. However, the good news is that you may still be able to qualify for disability benefits through a Medical Vocational Allowance.
If you want to qualify through an RFC evaluation, you will need to download the RFC evaluation form from the Social Security Administration website. This form needs to be filled out by your physician or psychologist, who should provide specific information about your medical condition and the limitations you experience as a result of that condition.
After reviewing the RFC evaluation, the Social Security Administration will consider your employment background, skill set, and limitations resulting from your condition.
They will then attempt to locate a job that you are capable of performing in light of your skills and limitations. If they are unable to locate any kind of work that you are capable of doing, then you will be eligible for disability benefits from the Social Security Administration.
Applying for SSDI benefits
You can apply for disability payments due to depression through various methods, including online, in-person at your local office, or by calling (800) 772-1213.
Here are six important steps in the process:
Step 1: Collect the Necessary Data
You may be required to provide the following details when applying:
- Date of birth, social security number, and marital status
- Information about your financial institution
- Details about your healthcare provider to confirm a diagnosis
- Specifics of the impairment you are dealing with and any treatments you have received
- Information on current or past benefits
- Official documents such as a birth certificate, a military identification card, a W-2 form, and any benefit certificate that has been delivered to you should also be submitted.
Step 2: Apply for the Program.
Make sure to complete and submit your Social Security Disability application.
Step 3: Review
After submitting your application for SSDI benefits, the Social Security Administration will review it to ensure that you meet the required disability conditions. During the review process, your work history will be examined to determine your eligibility for benefits and whether you are currently employed.
Step 4: Application Processing
If your application is accepted, it will be sent to the office of Disability Determination Services in the state where you reside, which will make the final decision regarding your benefits.
Step 5: Notification
The decision on disability benefits for depression will be sent via mail. Track progress online or by calling 800-772-1213 (TTY 800-325-0778).
Step 6: Appeal
If your application is rejected, you have the option to file an appeal in order to have it reviewed.
How Much Can I Get in Disability Benefits for Depression?
As of 2024, the average monthly SSDI payment for an individual is $1,537. The maximum payout depends on the type of benefits a person is eligible for.
SSDI offers a maximum monthly payout of $3,627. Supplemental Security Income (SSI) benefits pay a maximum of $943 per month.
The severity of the disability doesn’t directly affect the maximum payment amount, but it does play a role in determining which program a person is eligible for. Other factors like income and work history can affect the actual amount received.
If you’re applying for SSDI, your employment history will determine your exact disability benefit amount. On the other hand, if you’re eligible for SSI, your other income sources will be considered.
It’s also worth mentioning that some claimants may be eligible for both programs. If you’re struggling with depression or related conditions and are unable to work, it’s crucial to explore your options for disability benefits.
Maximizing Chances of Approval when Applying for Disability Benefits
You can improve your chances of winning disability benefits by doing the following:
Seek Regular Treatment
The Social Security Administration will assess the seriousness of your medical condition by verifying if you are undergoing treatment for it. Consistent consultations with a therapist, counselor, or psychiatrist will show the Social Security Administration that you are trying to improve your health condition.
Without these regular appointments, your likelihood of being approved for Social Security disability benefits may be reduced.
Gather Medical Records
It is important to collaborate with your physician and ensure that your medical records include a comprehensive description of any physical symptoms you have had, such as fluctuations in weight or any adverse health effects caused by your condition.
Consult a Disability Lawyer
People with disabilities who have legal representation are three times more likely to win their case than those who don’t.
Filing for Appeal
If your initial claim for SSDI is rejected, you have several options to contest the decision. Although the appeals process is quite lengthy, there are still chances of success.
The appeals process consists of four steps:
1. Reconsideration
Disability Determination Services are agencies at the state level that evaluate medical eligibility for disability benefits provided by the Social Security Administration. If your claim is denied, you can request a reconsideration from the Social Security Administration.
You can submit your reconsideration request online or complete forms SSA-561, SSA-3441, and SSA-827 and mail or fax the completed forms to your local Social Security office.
2. Administrative Law Judge Hearing
If the Department of Social Services does not alter its decision, you have the option of requesting a hearing with an administrative law judge (ALJ) who will examine the evidence pertaining to your case and consider your testimony, as well as the testimony of any expert witnesses.
Fill out and submit form HA-501 to request a hearing.
3. Appeals Council Review
If you disagree with the ALJ’s decision, the next step is to submit a request to the Appeals Council of the Social Security Administration for a review.
You can request an Appeals Council review online or by mailing form HA-520 to Social Security.
4. Federal Court Review:
If the Appeals Council denies your claim, you can file a lawsuit in federal court. You must file a lawsuit within 60 days of receiving the Appeals Council’s decision.
Conclusion
To qualify for SSDI based on a mental health condition such as depression, you will need to provide extensive medical evidence that demonstrates the limitations caused by your condition.
The Social Security Administration requires well-documented medical records of your illness, laboratory investigations, and treatment administered for at least two years. The medical reports should indicate that your depression is affecting your work performance.
Please note that the process of applying for SSDI can be complex and time-consuming. It’s advisable to seek help from a qualified attorney or advocate to guide you through the process.
