Psychiatrist for Social Security Disability

Do I have to go to a psychiatrist for Social Security Disability
By Kimberly BishopApril 27, 2013

If you allege being disabled when you apply for Social Security Disability from a mental health condition, you should be seeing a psychiatrist, therapist or both. Many clients describe devastating mental symptoms that stop them from working, but still do not want to go to a psychiatrist (a.k.a. “shrink”) because they are worried about what others will think of them (stigma).

Types of Social Security Disability Benefits

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 Social Security Administration's Five Step Sequential Evaluation.

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.

SSI is also available for disabled children and is evaluated under a different standard than adults. Children must have a medically determinable physical or mental impairment or impairments (including emotional or learning problems) which result in marked and severe functional limitations, and the impairment(s) has lasted or can be expected to last for a continuous period of at least 12 months or be expected to result in death.

Child SSI terminates when the child turns 18. The claimant will then have to reapply and be evaluated under the above adult sequential evaluation.

In order to be found eligible for either benefit you must have a severe illness that prevents you from working (engaging in substantial gainful activity).


Five Step Sequential Evaluation

At every step of the below Disability Process, SSA uses the Five Step Sequential Evaluation to determine if you are disabled.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

Medical Evidence (Medical Records)

In order to prove that you are disabled due to your mental illness, you will need medical evidence documenting your mental health symptoms. You should be seeing a psychiatrist, psychologist and/or therapist if a mental illness is your main disability.

Many clients will obtain a psychiatric medication from their treating doctor (family doctor or general practitioner). SSA prefers treatment (medical evidence) from a mental health specialist.

If you allege being disabled from a mental illness on your disability application and are not seeing a mental health professional, SSA may send you to a psychiatrist (consultative examination ) to be examined. This doctor will only see you once and their opinion will only be a snapshot.

So, YES, you do need to be going to a psychiatrist, psychologist or therapist (preferably a treating physician and a therapist) for Social Security Disability if you are alleging that mental impairments are preventing you from working.

What to tell a psychiatrist to get disability?

There are many psychiatric disorders (intellectual disability, bipolar disorder, anxiety disorder, personality disorder or depression, etc.) that can prevent you from working (also read Social Security Disability Conditions for a discussion of specific impairments). 

What to tell a psychiatrist depends on what symptoms you are having. Social interaction difficulties, anger, violence, hallucinations, sadness, hyper-vigilance, binge-eating, irrational fears, nightmares, flashbacks, suicidal thoughts or homicidal thoughts are all possible symptoms you may be struggling to deal with in your daily life.

The best thing to tell a psychiatrist to get disability is the truth about what you are going through.

Don't exaggerate, try to impress or worry about what a mental health professional is thinking about you. You should use your psychological treatment as time to discuss your symptoms honestly so you can receive feedback that can help you on your road to recovery.

In my experience, mental health professionals take issue with patients who see them merely to obtain disability benefits.

The symptoms that you discuss during therapy or psychiatry appointments can lead to a preliminary diagnosis. Many psychiatric disorders have overlapping symptoms so you may be given multiple r/o (rule out) diagnoses.

Establishing long term care with a mental health specialist can allow them to assess your diagnoses and symptoms over time to determine the correct course of treatment for you.

Unfortunately for many, finding the correct course of treatment for a mental disorder can be difficult. But if you are in therapy and following all medical advice but your symptoms fail to improve that is persuasive evidence to the Social Security Administration that your psychiatric disability is preventing you from working despite your best effort.

Effort counts. I advise my clients' that the best way to get on Social Security Disability benefits is to do all that you can to get well.

While mental illness is unseen compared to physical disability, the effects can be as devastating, if not more so. If you are suffering from a mental health impairment please seek treatment as soon as possible.

The Bishop Law Firm represents Social Security Disability clients in Raleigh, NC and surrounding areas. We do not get paid unless we win and we offer free case evaluations. Call us today or start your free case review now!

Also read NC Social Security Disability Lawyer

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