SSA Update: Criteria for Evaluating Mental Disorders

Published on: October 18, 2016

For a long time, qualifying for disability based on a mental disorder has been difficult. Psychological issues don’t usually have physically verifiable symptoms that can be checked in a physical exam.

The Social Security Administration’s (SSA’s) criteria for evaluating mental disorders can be very strict, requiring:

  1. Thorough documentation of a medically-determinable impairment.
  2. Consideration of the degree of limitation the impairment imposes on your ability to work.
  3. Consideration of whether these limitations are expected to last for a continuous 12 months or more (which may include an evaluation of treatments for the disorder) or have already lasted for 12 continuous months.

Mental Disorders Puzzle Picture

Currently, the SSA arranges mental disorders into nine distinct diagnostic categories:

  • Organic mental disorders (12.02)
  • Schizophrenic, paranoid, and other psychotic disorders (12.03)
  • Affective disorders (12.04)
  • Intellectual disability (12.05)
  • Anxiety-related disorders (12.06)
  • Somatoform disorders (12.07)
  • Personality disorders (12.08)
  • Substance addiction disorders (12.09)
  • Autistic disorder and other pervasive developmental disorders (12.10)

Certain elements of the SSA’s evaluation criteria are set to change in 2017.

The Office of the Federal Register’s website has a document that you should know about if you’re applying for or considering applying for disability—because it addresses some changes to the section 12.00 and 112.00 listings for mental disorders.

What’s Happening in 2017?

Notice of Proposed Rulemaking (NPRM) documents are long and complicated forms detailing long lists of legal rules, but we’ll try to break down the major changes here. For the full text of the document, you can find it on the Office of the Federal Register website at the link above.

Some basic changes include:

  • Changes in the titles for most existing listings to reflect the terms used by the American Psychological Association (APA) and the addition of new listings:
    • Neurocognitive disorders (12.02)
    • Schizophrenia spectrum and other psychotic disorders (12.03)
    • Depressive, bipolar and related disorders (12.04)
    • Intellectual disorder (12.05)
    • Anxiety and obsessive-compulsive disorders (12.06)
    • Somatic symptom and related disorders (12.07)
    • Personality and impulse-control disorders (12.08)
    • Autism spectrum disorder (12.10)
    • Neurodevelopmental disorders (12.11)
    • Eating disorders (12.13)
    • Trauma- and stressor-related disorders (12.15)
  • Removal of references to using standardized test scores for rating degrees of functional limitation for adults (save for listing 12.05—intellectual disorders)
  • Reorganization of listing criteria for intellectual disorder to reflect the three diagnostic criteria for intellectual disability

What Does This Mean for You?

These changes are being made in response to a growing understanding of mental disorders, and may actually help people with previously-unrecognized trauma and stress-related disorders qualify for disability.

Previously, people with trauma or stress-related disorders were included under the anxiety-related disorders listing. By giving these disorders their own category under the new rule, the granularity and accuracy of assessments of these disorders is likely to improve.

For veterans suffering from PTSD and others who have lived through traumatic experiences, this could be incredibly important.

The inclusion of eating disorders as a category can help those with extreme cases of these disorders get the help they need.

However, you may have noticed that substance addiction disorders are now missing from the mental disorders list. This could make applying for benefits under Social Security Disability Insurance more complicated.

But, if you suffer from peripheral neuropathy, liver damage, gastritis, pancreatitis, seizures, or mental disorders caused by your addiction, you may still be able to qualify for benefits.

Need help preparing your disability benefits claim before the changes coming in 2017? Worried about how they might affect your existing benefits? Contact Disability Experts of Florida for assistance today!

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