Get Social Security Disability & SSI Benefits: Depression

Winning Your Case

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Social Security's Assessment of Depression

Depression is one of the most common mental health conditions Social Security evaluates. The two most common types of depression are major depressive disorder which is considered a severe form of depression, and dysthymia which is considered a moderate or mild form of depression. Other types of depression include psychotic depression (depression associated with psychosis), postpartum depression (depression after the delivery of a child), bipolar depression (the depressive phase of bipolar disorder), and seasonal affective disorder (depression during winter or dreary weather months).

It is difficult to win a depression case if it is your only impairment. This is for two reasons. First, Social Security does not consider that the vast majority of depression cases severe enough to warrant a finding of disability. Second, Social Security generally feels depression is within your control, you can overcome it with proper treatment, and you have a state-of-mind change. Generally, a winning disability case involves extreme depression.

In your Social Security disability and SSI case, the administration will review your medical treatment records. It will focus on your diagnosis, the severity of your symptoms (reported by both you and your medical provider), and your treatment regimen. In a Social Security disability case, it is best if you are being treated by a mental health specialist rather than a primary care provider (PCP). There are two primary reasons for this. First, Social Security does not give your primary physician the same evidentiary weight as a mental health provider. After all, depression is a mental health disorder. Second, in the case of your primary physician, the medical records regarding your depression are unlikely to be as detailed as those of a mental health provider, and they rarely provide the details about your depression Social Security needs to fully evaluate your functioning. For the same two reasons, it is best if you are being treated by a psychologist or psychiatrist rather than a mental health counselor. That said, the realities of modern medicine in America are that you likely will be treated by only a counselor. It is also best if you receive individual counseling rather than group counseling because group counseling rarely produces records about you and your symptoms. Without records, Social Security cannot understand the nature of your depression.

Social Security's first step in reviewing your medical records is determining your diagnosis. It is important your provider supports the diagnosis with mental health evaluations and findings.

Social Security's second step is evaluating your symptoms which typically include -

1. Sadness,
2. Loss of interest,
3. Low energy,
4. Isolation,
5. Poor concentration,
6. Confusion,
7. Lethargy,
8. Poor sleep, and
9. Crying spells.

With Social Security, your treatment for your depression is a huge factor in determining whether you are disabled. Treatment for depression is generally limited to individual or group counseling, and medications. Medications usually include antidepressants such as bupropion (Wellbutrin) or mirtazapine (Remeron); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), Lexapro, fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft); or serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), or venlafaxine (Effexor XR).

Some depression suffers undergo emergency room admissions and even in-patient psychiatric admissions. Both are of critical importance to any Social Security disability case because each circumstance is an indication of a severe level of depression.

Two additional treatments are available but rarely prescribed - electroconvulsive therapy (ECT) (electrical currents are sent into the brain), or transcranial magnetic stimulation (TMS) (magnetic pulses are sent into the brain). It is important you inform Social Security of all your treatment.

The Depression Social Security & SSI Listing

The Adult Listing 12.04 and Child Listing 112.04 require you or your child must meet section 1 and 2, or 1 and 3.

1. Depression with five or more of -
1. Dejected mood,
2. Reduced desire to participate in nearly all life domains,
3. Changes in appetite and weight,
4. Poor sleep,
5. Behavioral changes,
6. Poor energy level,
7. Emotions of regret or uselessness,
8. Poor focus and cognition, or
9. Suicidal ideation.
2. One of the following limitations that are extreme or two that are marked -
1. Dealing with information presented to you;
2. Dealing with people (yes, this is redundant from above);
3. Keeping focused on your activities; and
4. Taking care of yourself;
3. The depression is "serious and persistent" for two years or more, and both -
   1. Medical treatment that is, at least, partially helpful; and
   2. Minimal ability to deal with additional life responsibilities with which you are not already dealing.

A Depression Story - The Significance Of Suicide Attempts

Mr. Andrews was diagnosed with depression. She lived in Chicago, IL. He was denied benefits at both the initial and reconsideration levels. He hired counsel shortly thereafter. Counsel requested a hearing which Social Security scheduled about 13 months later.

We prepared for Mr. Andrews's case by obtaining his medical records from his treating mental health counselor and his primary provider, and two statements from his treating mental health provider that had been previously submitted to his private short-term disability insurance carrier. Mr. Andrews also had two suicide attempts - one by medication overdose and one wherein he cut his wrists. He was admitted to the ER on both occasions, but not thereafter to an in-patient psychiatric hospital. Mr. Andrews was initially unwilling to submit those records because he was embarrassed by the incidents. However, counsel was able to convince Mr. Andrews that the ER records demonstrated the severity of his depression, and eventually he agreed. We ordered and submitted those records. We also obtained a statement from his brother who wrote that Mr. Andrews suffered depressed mood, crying spells, low energy, difficulty getting along with others, poor hygiene, suicidal ideation, and most importantly, isolation wherein he would rarely leave the house.

At his hearing, Mr. Andrews testified he felt extreme depression and guilt after losing his job of 18 years due to downsizing. He received short-term disability but was denied long-term disability. He was unable to find another job that would allow him to support his family without his wife working. He cried when testifying about his wife going back to work, and his inability to help his daughter who was struggling in high school. He testified that he suffered significant isolation; and feelings of dread, hopelessness, and suicide. We took testimony from his wife of twenty years who testified that her husband was unable to get out of bed on most days, unable to do most household chores, and was unable to adequately care for their daughter.

A medical expert (ME) was scheduled to testify at the hearing. This occurs about 10% of the time. At the hearing, the ALJ organized the hearing so that Mr. Andrew's testified before the ME testified. Most of the time, the client testifies first. The ME was moved by Mr. Andrews's testimony and the strong medical record, especially considering the suicide attempts and mental health counselor statements. The ME testified that Mr. Andrews met Listing 12.04. The ALJ agreed with the ME, and notified Mr. and Mrs. Andrews at the hearing that he would issue a fully favorable decision.