If you have been diagnosed with bipolar disorder and are considering applying for Social Security Disability, you need to be aware of how the Social Security Administration evaluates bipolar disorder.
What is Bipolar Disorder?
Bipolar Disorder (a.k.a. Manic Depressive illness) can result in periods of mania followed by periods of dark depression (Mayo Clinic).
According to the American Psychiatric Association, there are different types of Bipolar Disorder; Bipolar I Disorder; Bipolar II Disorder and Cyclothymic Disorder.
Individuals diagnosed with Bipolar I Disorder experience manic episodes with some also experiencing depressed episodes.
A manic episode must last at least one week and during that time the individual will experience: unusual energy, racing thoughts, distractibility, and increased risk behavior.
Bipolar II Disorder requires a major depressive episode and at least one hypomanic episode. Anxiety Disorder or substance abuse disorder frequently accompanies Bipolar II Disorder and complicates treatment.
Cyclothymic Disorder is a milder form of bipolar disorder which involves mood swings.
My clients usually describe mania fondly. During mania you may feel great; spend money you don't have and make careless decisions. Marrying a stranger, shoplifting, and emptying one's bank account on frivolous spending are all actions my clients have taken during an episode of mania.
But when you cycle into depression, it's difficult for you to get out of bed and even the motivation to bathe is tough to muster. This change can happen unexpectedly and frequently.
Frequent cycling from Bipolar Disorder can leave a person disabled.
Treatment (medications and mental health therapy) can help with the symptoms of bipolar disorder. It may help elongate your cycles giving you periods of stability.
But some people with bipolar disorder do not respond to medication. It may take you several tries of different medications to find one that helps.
If you are following medical advice regarding your mental health condition, but are failing to improve, you should consider applying for Social Security Disability benefits.
Social Security Disability Benefits
The Social Security Administration offers two types (generally) of benefits for the disabled.
Social Security Disability Insurance (SSDI)
SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.
Supplemental Security Income (SSI)
SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2023, SSI is $914.00 per month for an individual and $1,371 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.
Before you are entitled to either benefit, you must be found disabled under SSA's Five Step Sequential Evaluation.
SSA's Five Step Sequential Evaluation
The Social Security Administration evaluates all applicants for disability under the Five Step Sequential Evaluation Process:
- Step 1 – Are You Working? The Social Security Administration defines work as “Substantial Gainful Activity” (SGA). SGA is roughly defined as work from earnings that average more than $1,470 (2023) a month. If you are making that amount you generally will not qualify for disability.
- Step 2 – Is Your Condition “Severe”? Severity is key when it comes to what qualifies as a disability. Severe is defined by the Social Security Administration as: your condition must interfere with basic work-related activities for your claim to be considered.
- Step 3 – Is Your Condition on the List of Disabling Conditions? The Listings are very hard to meet in most cases and not always interpreted as a common reading would suggest. If you meet a listing you are gravely ill. The listings are found here.
- Step 4 – Can You Do the Work You Did Previously? The Social Security Administration will look at your past work and determine if it was sedentary, light, medium, or heavy. They also will evaluate the skill level: unskilled, semi-skilled and skilled. For instance, an attorney would be sedentary skilled work. The Dictionary of Occupational Titles is found here.
- Step 5 – Can You Do Any Other Type of Work? If the Social Security Administration finds that you cannot do what you used to do, they then look to see if you can do anything else. This is where the “grids” come into play. The grids are the Medical-Vocational Guidelines. The grids are only for exertional impairments. Non-exertional impairments are not considered by the grids. If you are found to be capable of any other work, you will be found not disabled. Read The Grids and Your Social Security Disability Case.
Social Security Disability for Bipolar Disorder
The Social Security Administration evaluates bipolar disorder under Listing 12.04, Depressive, bipolar and related disorders:
Bipolar disorder, characterized by three or more of the following:
- Pressured speech;
- Flight of ideas;
- Inflated self-esteem;
- Decreased need for sleep;
- Involvement in activities that have a high probability of painful consequences that are not recognized; or
- Increase in goal-directed activity or psychomotor agitation
Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
- Understand, remember, or apply information (see 12.00E1).
- Interact with others (see 12.00E2).
- Concentrate, persist, or maintain pace (see 12.00E3).
- Adapt or manage oneself (see 12.00E4).
Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 12.00G2b); and
- Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 12.00G2c).
The first part of this listing discusses symptoms. The symptoms will be found in the records from your medical treatment. Communicating about your symptoms with your mental health provider is extremely important.
In addition to having medical documentation of your mental health symptoms, you need an extreme limitation in using information, dealing with others, or managing yourself (or two marked limitations) OR you have failed to improve despite seeking substantial treatment.
Listing 12.04, as with many listings, is difficult to meet. A person may be unable to work long before they meet this listing.
If you are going to a psychiatrist, in therapy and taking your medications but still have problems in your daily life dealing with other people or being able to focus from your Bipolar Disorder, you should file for Social Security Disability benefits as soon as possible.
The Bishop Law Firm represents Social Security Disability clients in Raleigh, Durham, Fayetteville, Cary, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids , Winston Salem, Garner, Greensboro, Greenville and surrounding areas in North Carolina.
Call us today for a free case review or start online now.
Also read NC Social Security Disability Lawyer