Here is an explanation of Social Security's five-step process to determine if a depression patient qualifies for SSDI:
1. Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $980 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
2. Conclude the depression disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
3. Ask if the depression disability meets or equals a medical listing. Depression is listed under mental disorders. To satisfy the listing criteria for depression, a number of variables are considered:
- Anhedonia
- Appetite disturbance
- Sleep disturbance
- Psychomotor agitation or retardation
- Decreased energy
- Feelings of guilt or worthlessness
- Difficulty concentrating or thinking
- Thoughts of suicide and hallucinations
- Delusions or paranoid thinking
In assessing depression relative to a listing level impairment, the following areas of functioning are evaluated:
- Restrictions of activities of daily living
- Maintaining social functioning
- Deficiencies of concentration
- Persistence or pace
- Repeated episodes of decompensation--each of extended duration
An individual who has four symptoms present from the depressive syndrome list, as well as extreme limitation in two of the four functional areas, would probably be eligible for benefits.
4. Explore the ability of an individual to perform work they have done in the past despite their depression. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine depression disability, the SSA enlists medical-vocational rules, which vary according to age.
For example, a person with depression could be found disabled at any age. The inability to meet any of the basic mental demands of work would entitle a claimant to disability benefits.
Social Security Rulings 85-15 and SSR 96-9p both describe how an individual must, on a sustained basis, be able to understand, remember and carry out simple instructions; make simple work-related decisions; respond appropriately to supervision, co-workers, usual work situations and to deal with changes in a routine work setting.
A substantial loss of ability to meet any one of these basic work related activities would severely limit the potential occupational base for all age groups and justify a finding of disabled. A person who has a medically determinable severe impairment of depression and is unable to understand, remember or carry out simple instructions would be found disabled based on his/her mental residual function capacity.
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