A lot of people receive Social Security Disability Insurance (SSDI) benefits based on a mental illness or disability. And sometimes, depending on the severity, mental health disorders warrant hospitalization. Therefore, SSDI recipients getting admitted to a psychiatric facility is not unheard of. But what happens to their benefits in such a case?
The vast majority of SSDI beneficiaries who get admitted to a psychiatric facility continue to receive and stay eligible for benefits. In fact, SSDI beneficiaries can be eligible for benefits at any institution unless they are there in connection with a crime.
Is Mental Illness a Disability?
The Social Security Administration (SSA) defines a disability as an impairment that substantially limits one or more major life activities and that results in a person being unable to engage in any substantial gainful activity (the maximum monthly salary that can be earned by people who qualify for Social Security disability benefits).
When determining whether or not an individual satisfies the requirements to be eligible for Social Security Disability Insurance or Supplemental Security Income (SSI) benefits, representatives from the SSA consult the Blue Book. Mental health and Social Security Disability claims are a bit trickier since the mental disorder a person suffers must be classified as a disability per the SSA.
The Blue Book provides a list of a wide variety of mental disorders and classifies them into 11 different groups. The following are some of the categories that are detailed in the Blue Book:
- Neurocognitive disorders
- Schizophrenia spectrum disorder and other psychotic disorders
- Depressive, bipolar, and related disorders
- Intellectual disorder
- Anxiety and obsessive-compulsive disorders
- Somatic symptoms and related disorders
- Personality and impulse-control disorders
- Autism spectrum disorder
- Neurodevelopmental disorders
- Eating disorders
- Trauma and stress-related disorders
In order to qualify for disability insurance for a mental illness, either you or a member of your family will need to meet a number of requirements listed in the Blue Book.
The Blue Book details the medical records that you or a loved one must provide for every group in your medical documentation. In addition, it details the criteria that are used for each category to evaluate how your mental disease affects up to four aspects of your day-to-day functioning.
In order to qualify for benefits, a person’s condition must cause them to have “extreme” or “marked” difficulty in at least two major life activities. Evidence showing that the condition has not improved despite medical treatment is also important.
SSDI for Mental Illness
With sufficient proof, you or a loved one may apply for and receive Social Security disability benefits due to a mental illness. Benefits for people with disabilities are available through two programs, including Social Security Disability Insurance and Supplemental Security Income. The only people eligible for SSDI are those who have worked in the past and paid into the Social Security system.
Although mental diseases may be harder to prove than physical ones, applying for and getting Social Security disability benefits is ultimately the same process for both. In each case, qualification will be based on how significantly a condition interferes with both everyday life and the ability to work.
An individual can apply for Social Security Disability Insurance benefits in three different ways: over the internet, in person at a Social Security Administration office, or by phone. The SSI application process is available both in-person and over the phone.
Can I Get SSDI While in a Psychiatric Facility?
People experiencing mental health issues may find it difficult to maintain gainful employment, increasing the likelihood that they will go uninsured or lose health benefits due to their condition.
For some people, it might be difficult to prove that their problems are the result of a genuine disability because they have not received consistent treatment from a mental health expert for their symptoms.
Thus, the SSDI application process can be trickier for those with qualifying mental health disorders, although there are exceptions, such as the need for inpatient mental health care, that could speed up the process.
Inpatient treatment for mental health disorders might make it more clear how problems like depression or disassociation have affected a person’s capacity to care for themselves, work, and make ends meet. A person’s ability to receive SSDI benefits will not be jeopardized if they need to enter a mental health facility.
Individuals receiving SSDI benefits who are institutionalized (for example, in a hospital or psychiatric facility) do not lose eligibility for payments unless they are in that setting because they have committed or are instruments of a crime; for instance, if someone is detained in a correctional facility or jail, their Social Security Disability Insurance benefits may be suspended.
How to Fill the Application
When you apply for benefits through the Social Security Administration, the SSA will request a great deal of documentation from you. Gathering the required information before beginning your application will help you stay organized throughout the process. You need to include the following:
- Your medical history from the last 5 years, including notes from any visits to a mental health professional.
- Evidence of any inpatient or outpatient care you’ve had as a result of your health condition and a history of hospitalizations to back up your claim of severe impairment will aid your disability case. Make sure to disclose any history of mental illness or frequent visits to the emergency room.
- Prescription history connected to your illness, including who prescribed the medications.
- All of your providers’ contact information (names, addresses, phone numbers, patient ID, and dates of tests and procedures).
Do not submit information from doctors like a chiropractor or podiatrist who did not treat your mental health condition, unless you are unable to work due to those other conditions as well. Make sure you have backups of your medical files. The SSA frequently loses items, so it’s smart to keep extras on hand.
Common Mistakes to Avoid
Never exaggerate your symptoms; be honest at all times. Disability cases involving mental health disorders heavily weigh on the credibility of the claimant. The SSA and its administrative law judges see a lot of applications every year, and they know when someone is trying to get benefits by lying about their health.
Instead, include as much detail as you can on how your illness impacts your daily life. Explaining the full extent and severity of your disability to the Social Security Administration and the judge through specific examples will strengthen your case without calling into question your credibility.
Conclusion
So, if you or someone you know has been admitted to a psychiatric facility, then rest assured that you will remain eligible for your Social Security Disability Insurance benefits. For more information on whether you qualify for SSDI, contact a disability attorney.
