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SSDI Evaluation

Post-Traumatic Stress Disorder (PTSD) and Social Security Disability Insurance

Post-traumatic stress disorder (PTSD) and Social Security DisabilityHere is an explanation of Social Security's five-step process to determine if a patient with post-traumatic stress disorder (PTSD) qualifies for SSDI:
 
  1. Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $1,040 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
     
  2. Conclude the post-traumatic stress disorder 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
 
  1. Post-traumatic stress disorder is listed within the diagnostic category of anxiety-related disorders under the impairment listing known as Mental Disorders - Medical Listing 12.06. The following criteria have been established indicative of the inability to engage in any substantial gainful activity, i.e., if one has a diagnosis of post-traumatic stress disorder and one of the following, a finding of disabled under the Social Security Act is warranted:

    In cases involving agoraphobia and other phobic disorders, panic disorders, and post-traumatic stress disorders, documentation of the anxiety reaction is essential. At least one detailed description of your typical reaction is required. The description should include the nature, frequency, and duration of any panic attacks or other reactions, the precipitating and exacerbating factors, and the functional effects.

    If the description is provided by a medical source, the reporting physician or psychologist should indicate the extent to which the description reflects his or her own observations and the source of any ancillary information. Statements of other persons who have observed you may be used for this description if professional observation is not available.

    In these disorders, anxiety is either the predominant disturbance or it is experienced if the individual attempts to master symptoms; for example, confronting the dreaded object or situation in a phobic disorder or resisting the obsessions or compulsions in obsessive compulsive disorders.

    The required level of severity for these disorders are met when the following requirements in both A and B are satisfied, or when the requirements in both A and C are satisfied.

    A. Medically documented findings of at least one of the following:
    1. Generalized persistent anxiety accompanied by three out of four of the following signs or symptoms:
       
      • Motor tension; or
      • Autonomic hyperactivity; or
      • Apprehensive expectation; or
      • Vigilance and scanning; or
    1. A persistent irrational fear of a specific object, activity or situation that results in a compelling desire to avoid the dreaded object, activity or situation; or
    2. Recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week; or 
    3. Recurrent obsessions or compulsions that are a source of marked distress; or
    4. Recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress; AND
     
    B. Resulting in at least two of the following:
     
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence or pace; or
    4. Repeated episodes of decompensation, each of extended duration. 
    C. Resulting in complete inability to function independently outside the area of one's home.
  1. Explore the ability of an individual to perform work they have done in the past despite their post-traumatic stress disorder. If the SSA finds that a person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
     
  2. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform.

Check out information regarding the prescription drugs used to treat post-traumatic stress disorder.

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