How People with Bipolar Disorder Get Social Security-SSI Disability Beneftis

The Social Security Administration (“SSA”) has a five-step process to determine if any medical problem, including bipolar disorder, or any combination of medical problems, cause you enough loss of function to qualify for Social Security/SSI Disability benefits.

STEP 1: Are you working - engaging in substantial gainful activity or “SGA” - according to SSA’s definition? Earning more than $900 gross in 2007 as an employee may be enough to disqualify you from receiving SSA’s disability benefits. (There are exceptions.)

STEP 2 asks whether your bipolar disorder and each other medical problem you suffer are “severe” enough to limit your ability to do basic work activities:

• walking, standing, sitting, lifting, bending, pulling, reaching, carrying or handling
• seeing, hearing and speaking
• using good judgment
• understanding and carrying out and remembering simple instructions
• responding appropriately to bosses, co-workers, the public and usual work situations
• dealing with changes in routine at work
• handling stress

Note: Any medical problem that would or will limit work in any way is probably severe and should be documented by your physician(s) and reported by you to SSA.

STEP 3: Is your bipolar disorder (and any other medical problem or combination of problems) severe enough to “meet or equal” a medical Listing? A “Listing” is a set of very specific criteria that must be found by medical tests, signs or diagnoses. Bipolar disorder has a Listing: 12.05(A)(3).

The Bipolar Listing criteria:

”The full symptomatic picture of both manic and depressive syndromes and currently characterized by either or both:

"Depression, with at least 4 of these:

• change in appetite (with weight change) or sleep disturbance
• psychomotor agitation or retardation
• decreased energy
• feelings of guilt or worthlessness
• difficulty concentrating or thinking
• thoughts of suicide or hallucinations or delusions or paranoid thinking
• anhedonia (the lack of pleasure for acts that normally would be pleasurable)

"Manic phase, with 3 or more of these:

• hyperactivity
• pressure of speech
• decreased need for sleep
• inflated self-esteem
• flight of ideas
• easy distractibility
• activities with a high probability of painful consequences that are not recognized."

SSA's Bipolar Listing also requires moderate loss of function in 2 of 4 areas (or severe loss in one):

• "Restrictions on activities of daily living
• Deficiencies in concentration, persistence or pace
• Difficulties maintaining social functioning
• Repeated (and extended) episodes of decompensation"

Tip: If your life has been substantially restructured to avoid stressors, you may meet the decompensation criteria even if you haven’t been hospitalized.

Social Security finds very few people “meet or equal” the bipolar Listing at Step 3. Tip: Don’t give up; Bipolar symptoms are the key at Step 5, below.

STEP 4: Can you perform the work you did in the past, on a full time, sustained and consistent basis - at SGA level - despite your bipolar symptoms and any other medical symptoms causing functional limitations? (8 hours a day, 5 days a week, week after week) If yes, SSA denies benefits. If no, then:

STEP 5 looks at your age, education, and your skills gained from work experience. SSA tries to determine your ability to function, despite all your physical and mental problems. SSA decides, with the aide of vocational experts, what other occupations, if any, you can do.

A person can get benefits at any age if their psychological and/or other impairments prevent even simple, unskilled work on a sustained and continuing basis. This means that if you can work some days but not other days, or some hours a day but not full time, you may be eligible for disability benefits.

There are easier rules for people age 50 up (and age 55 or 60 up). Step 5 is when good advocacy makes a lot of difference in winning a case.

The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadows of life, the sick, the needy and the handicapped. - Hubert H. Humphrey