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Social Security Disability Benefits For Post-Traumatic Stress Disorder (PTSD)

I have been diagnosed with post-traumatic stress disorder. Can I apply for Social Security disability benefits (SSD/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

If you already have a diagnosis of PTSD, it may be the start of your disability claim. However, the main focus in a Social Security disability claim is usually on the symptoms you experience from PTSD and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week (full-time).

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop in someone who has experienced or witnessed a life-threatening event such as war combat, a car accident, sexual assault, or a natural disaster. While it’s normal to feel distressed after such an event, this feeling of distress should normally disappear after a few months. But for a person who has PTSD, the symptoms last longer, may start later, or may come and go over a long time.

PTSD symptoms have four types. One is called reliving or re-experiencing, which involves flashbacks or nightmares about the traumatic event. Another is avoidance, in which the patient tries to avoid things, people, and situations related to the event. The third group of symptoms is about having more negative feelings and beliefs – for example, developing a new sense of guilt or believing that the world is dangerous. The fourth symptom type is called hyperarousal, which means being ‘keyed up’, jittery, irritable, short-tempered, and/or reckless.

Is PTSD covered under disability?

There are two ways to get approved for disability benefits based on PTSD. The first route is to pass the disability evaluation of the Social Security Administration (SSA). The second way is to obtain a “medical-vocational allowance”.

For the first route (evaluation), the SSA uses a 5-step process to decide if you are disabled:

Step 1. Are you working?

First, the SSA considers your work activity. If you are engaged in Substantial Gainful Activity (SGA) you will not be found disabled. The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your PTSD and any other physical or mental conditions are assessed.

Step 2. Is your medical condition “severe”?

The SSA aims to be sure that your medical condition significantly limits your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.

For the SSA to consider you disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits. If your condition is that severe, SSA goes to Step 3.

Step 3. Does your medical condition meet or equal the severity of a Listing?

The SSA has a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them.The Adult Listing for PTSD can be found here.

If you do not have an impairment that meets or equals one of the listings, or if the duration requirement is not met, the SSA determines your Residual Functional Capacity (RFC). In a nutshell, the RFC is what you’re capable of doing despite your impairments.

For your RFC, the SSA conducts a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments.

Step 4. Can you do any of the jobs you have performed in the past fifteen (15) years?

The SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If the SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity(SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, the SSA goes on to Step 5.

Still here at Step 4, you have the “burden of proof” or the requirement to present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.

For PTSD, some types of objective medical evidence that can support your claim are:

  • Medical documentation of ALL of these:
    • Exposure to actual or threatened death, serious injury, or violence
    • Subsequent involuntary re-experiencing of the traumatic event
    • Avoidance of reminders of the event
    • Mood and behavior disturbances
    • Arousal and reactivity increase
  • Medical records detailing a PTSD episode, including duration of panic attacks, frequency of symptoms, etc
  • Medical records showing how PTSD affects your ability to function.

Doctors and professionals who specialize in treating PTSD include:

  • Psychiatrists – medical doctors who can both prescribe medication and offer psychotherapy
  • Psychologists – doctors whose main focus is psychotherapy or talk therapy
  • Clinical social workers, therapists, and counselors – non-doctor but trained professionals who provide talk therapy.

Remember that if you are only seeing your family doctor or a primary care doctor for your PTSD, the SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).

Step 5. Can you do any other type of work?

At this step, the “burden of proof” moves to the SSA. If you cannot do your past relevant work, the SSA looks to see if you would be able to do other work. They evaluate your medical condition, your age,education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, the SSA will determine you are not disabled. If you cannot do other work, they will find you disabled.

After age 50, there are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.

If your PTSD does not satisfy the SSA’s five-step evaluation, the other option for you to get disability benefits is getting a medical-vocational allowance. Here, the SSA enlists a mental consultant to determine if your symptoms are severe enough to prevent you from working. The applicants who succeed through this route are typically those with other mental or physical problems alongside their PTSD.

Contact Gillette Law Group

Post-traumatic stress disorder can restrict your work and your life in insidious ways. While it can be difficult to apply for Social Security disability benefits, do not be discouraged. You may truly deserve assistance, and we at Gillette Law Group can help you obtain it. Our service has effectively helped numerous applicants make a successful disability claim, and we can do this for you, too.

Your application or appeal may have a deadline, so talk to us as soon as you can. Your consultation is free. Call us at (855) 873-2604 today.

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