Anxiety Disorders and qualifying for Social Security Disability Insurance

Summary: Can I get disability benefits if I am suffering from the effects of an Anxiety Disorder?

Living with an anxiety disorder is challenging and frustrating. Anxiety is a normal emotion that everyone experiences at one time or another; people can worry about their job, making an important decision or taking a test. Anxiety is the brain’s way of reacting to stress and alerting a person to potential danger. Occasional feelings of anxiety are okay, but anxiety disorders are something quite different; they are mental illnesses that cause overwhelming fear and cause a person to avoid work and social situations. If you are suffering from the effects of an anxiety disorder you may qualify for disability benefits.

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The SSA specifically defines anxiety-related disorders as potential reasons for a claimant to legitimately receive federal disability benefits. Call 512-454-4000 and get help today.

The primary symptom of an anxiety disorder is excessive worry or fear, but anxiety also affects a person physically.

Symptoms vary depending on the type of anxiety disorder, but common symptoms include:

•    Panic and fear
•   Inability to remain calm
•    Obsessively avoiding feared objects or places
•   Constant worry or fear of danger
•   Shortness of breath
•   Insomnia
•   Hyperventilating
•   Heart palpitations
•   Nausea
•   Dizziness
•    Difficulty focusing
•   Recurring nightmares

Anxiety disorders are the most common emotional disorder, affecting approximately 40 million adults in the United States.

Though many people apply for SSDI, most cases are not severe enough to qualify. Only those applicants who suffer marked impact on their life will qualify.

Social Security recognizes four different anxiety disorders as impairments in its Blue Book under Section 12.06:

  Generalized anxiety disorder.

Individuals with this anxiety disorder worry about a variety of things for little or no reason. They may perceive a situation as life threatening when it isn’t, or are so worried about making a bad decision that they become unable to make any decision at all.

  Panic disorder.

This anxiety disorder is characterized by sudden, intense fear or a sense of impending danger. An individual may break out in a sweat, have chest pain or palpitations.

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  Social Anxiety Disorder.

People with this disorder have an overwhelming fear and self-consciousness about every day social situations. They may worry about appearing anxious and avoid social situations or experience extreme stress when a social situation cannot be avoided.

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  Obsessive-Compulsive Disorder.

In this disorder, a person experiences uncontrollable recurring thoughts or behaviors they repeat over and over. Examples include excessive hand washing due to an intense fear of germs or constantly rearranging objects in a particular order. Experts do not consider obsessive-compulsive disorder an anxiety disorder, but Social Security still evaluates it under anxiety disorders.

It should be noted here that PTSD (Post Traumatic Stress Disorder) is considered an impairment in Section 12.00 Mental Disorders, but it is listed separately under trauma and stressor related disorders, Section 12.15.

Qualifying for Disability for an Anxiety Disorder

Qualifying for Social Security with an anxiety disorder is very difficult and you must satisfy some rigid requirements regarding symptoms and functional limitations.

You must be able to prove that you have an anxiety disorder with at least three of the following symptoms:

•    Restlessness
•   Difficulty concentrating
•   Sleep disturbances, such as insomnia
•   Irritability
•   Muscle tension
•   Becoming tired easily

AND

You must have an “extreme” limitation in at least one of the following areas and a “marked” limitation in at least two of the following areas.

•    Understanding, remembering and applying information. For example, can you understand instructions, learn new things, and apply knowledge to tasks?
•   Concentrating, persisting, maintaining pace in completing tasks.
•   Interacting with others; using socially appropriate behaviors.
•   Adapting or managing oneself; being able to respond to demands, adapt to changes and understand acceptable work performance.

(“Marked” means seriously limiting and “extreme” not as severe as complete loss of an ability, but worse than marked. A Social Security psychiatrist or psychologist will decide if your limitations are marked or extreme when reviewing your medical evidence.)

Some people may not be able to meet the second set of criteria because they have special living arrangements which make their functional abilities appear better than they actually are.

Because they live in a highly supervised situation, like a group home or similar facility, their symptoms are not as obvious. In these cases, an applicant may be eligible if: 1) they have a medically documented disorder for over at least two years, 2) live in a highly structured setting or are receiving medical treatment that lessens symptoms; and 3) show a minimal capacity to adapt to situations outside their normal environment and daily life.

Social Security will review evidence provided by your healthcare providers describing your symptoms as well as results of any physical and mental exams.

Social Security will also seek information from family, friends, neighbors, co-workers, employers and caregivers who are familiar with your symptoms and how you interact with others on a daily basis. The agency will also want to know your limitations in adapting to new situations or changes in your environment.

You should be prepared to provide Social Security with the following evidence:

•    A diagnosis of an anxiety disorder
•   Notes from your psychiatrist, psychologist, or therapist
•   Results of any psychological testing
•   Records from as many people as possible
•   Records of medications you are taking including responses and side effects
•   Adult Function Report. This is an activities of daily living (ADL) form that you fill out explaining how anxiety affects your daily life and includes housework, meals, yard work, shopping, handling finances, and social activities. Be as detailed as possible and be sure to include how you feel and what happens when you have an anxiety attack at work. Do you make mistakes or forget instructions? Include any absences from work caused by anxiety.

If you have an anxiety disorder, but your disability does not match Social Security’s listing, you may still be eligible for Social Security Disability benefits if you have another impairment; for example, high blood pressure or asthma.

Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book, but if you have multiple medical conditions, Social Security must consider how those health issues, combined together, limit your ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical vocational assessment), taking into account whether or not you are able to drive, your age, and level of education.

To qualify for SSDI, an anxiety disorder must be so overwhelming that functioning at school, in relationships, and at work becomes difficult and even impossible.

If you suffer from an anxiety disorder, you may be eligible for Social Security Disability benefits, but know that the application process may be confusing, frustrating, and stressful, especially for an individual suffering from anxiety. You should consider consulting an experienced Social Security attorney who can review your case, guide you through the process and improve your chances for success.

If you are 55 or older or have another medical condition you may get approval.

Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant with no transferable skills might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.

Disability for those over 55 –>

Social Security also has basic financial requirements.

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements.

You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,550 per month in 2024 for nonblind applicants and $2,590 per month for blind applicants.

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury.

I have long-term disability insurance – should I file a claim?

Yes, you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) is coverage that protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. However, LTD coverage is good only as long as you are employed, so do not quit your job before you file a claim, and be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Additionally, be aware that long-term disability insurance companies can require a claimant to also apply for SSDI.

LTD Disability–>

How do I file for Social Security Disability benefits?

You can apply for Social Security Disability benefits online, over the phone, or in person at your local Social Security Administration office.

If your initial application is denied, don’t be discouraged. Approximately 65% of initial applications are denied, but you will have the opportunity to appeal.

How to Apply for SSDI –>

If you are suffering from an Anxiety Disorder and have been denied disability don’t give up! Most are initially denied. Just call 512-454-4000 for a free, no obligation consultation to learn your options and have your questions patiently answered.

There are four steps to the Social Security appeal process:

1.    File a Request for Reconsideration with the Social Security Administration to completely review the case.
2.    If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI cases and either uphold or overturn decisions to deny SSDI benefits. If you are not represented by an attorney at this point, now is the time to obtain legal counsel. This is a critical point in the process and will raise your chance for success.
3.    If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
4.    Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

SSDI Appeals Process –>

Do I need a disability attorney for SSDI?

Qualifying for Social Security Disability benefits is problematic because the requirements of Social Security’s impairment listing are very difficult to decipher.

Your chances for approval are increased significantly if you have an experienced disability attorney who can gather your necessary medical evidence and even write a brief explaining why you qualify. At each potential stage of the process, from the initial application stage, the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney will not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf and question any doctors or vocational experts selected by the ALJ to testify at the hearing. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

Do I need an SSDI attorney–>

Do I need a disability attorney for a long-term disability insurance claim?

Whether you have a long-term disability insurance policy purchased through a private insurance broker or a group policy purchased with your employer, filing a claim for long-term insurance is a complex process.

The wording of LTD policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in their procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.

Do I need an LTD attorney–>

One of our Cedar Park client’s treating physicians certified him as having a class 4 psychological functioning impairment.

He was advised to stop working due to “incapacitating anxiety”. When asked whether our client could return to work, this physician responded “No . . . currently his anxiety and depression are incapacitating and his treatment is just beginning.” Another physician stated that he suffered from Major Depression; recurrent, severe, Panic disorder with agoraphobia; and Dysthymic disorder. Accordingly, he was unable to perform daily chores, attend social functions, attend to legal needs, shop, or venture into the community and manage everyday financial affairs. Our client’s severe depression/anxiety interfered with his concentration, energy, self-confidence, decision making ability, and even his ability to leave the house.

Author: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court – all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.