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Does SSDI cover mental illness?

On Behalf of | Jan 11, 2023 | Social Security Disability

Many people in Northern Massachusetts suffer from one or more acute mental illnesses that prevent them from working. A common question asked by these individuals is whether Social Security Disability Insurance benefits (SSDI) cover their illness.

The answer is “probably,” but the requirements for collecting SSDI benefits for a mental illness involve many factors.

The basics

As with all claims for SSDI benefits, an applicant for coverage for a mental illness must demonstrate that he or she is permanently disabled by the condition.

“Disability” is defined in the SSA regulations as a mental or physical condition that will last at least 12 months or result in death. Very few mental illnesses result in death, and thus, an applicant seeking benefits for depressive, bipolar and related disorders must demonstrate that the condition will last at least 12 months.

The applicant must also prove that the condition prevents the applicant from engaging in any substantial gainful activity by reason of the medical condition

Coverage for specific conditions

SSA regulations list 11 categories of mental impairments that may be eligible for benefits. The list of categories and relevant qualifications is too long to include in this post, but examples of covered conditions include neurocognitive disorders, schizophrenia spectrum and other psychotic disorders, depressive, bipolar and related disorders, intellectual disorder, anxiety and obsessive-compulsive disorders, somatic symptom and related disorders, personality and impulse control disorders, autism spectrum disorder, neurodevelopmental disorders, eating disorders, and trauma and stressor-related disorders.

Each category contains a number of specific conditions related only to that category.

Supporting a claim

As with any claim for SSDI benefits, the claimant must provide evidentiary support. Evidence of a disabling injury or illness is usually provided by the written opinion of a medical professional. Evidence of disability is usually provided by financial records showing earnings below the allowed maximum. The advice of a lawyer with experience in handling SSDI claims can also be helpful.