Post Traumatic Stress Disorder (PTSD) is a serious mental disorder that is often misunderstood. The effects of PTSD are worse when sufferers find they can no longer do their jobs. It is particularly challenging to qualify for disability benefits when suffering from PTSD.
Is PTSD A Disability?
An experienced disability lawyer can help you get the benefits you deserve if you are struggling with PTSD and are unable to work. Anyone who has been exposed to extreme stress or trauma can develop the disorder, from combat veterans to individuals who have experienced or witnessed a horrific incident.
People with PTSD struggle with additional impairments, while others with PTSD have only PTSD. Research has consistently linked traumatic stress exposures and post-traumatic stress disorder to cardiovascular disease, diabetes, diabetes complications, gastrointestinal disorders, fibromyalgia, chronic fatigue syndrome, musculoskeletal disorders, eating disorders, and sleep disturbances.
Disability claims for PTSD are often reviewed skeptically or unfairly and are denied without proper reason. There are many reasons for this, but perhaps the main reason is that it can be challenging to determine the severity of any mental illness objectively.
The Many Causes of PTSD
You need to provide sufficient medical documentation that you experienced a stressful event to qualify for PTSD disability benefits. The traumatic events involved in some cases of PTSD include physical assaults or muggings, terrorist attacks like 9/11, natural disasters like tornados, civil conflict, or catastrophic events like car crashes or explosions.
The symptoms of complex PTSD may also include long-term abuse, including physical, psychological, or sexual abuse.
- Neglect
- Domestic abuse and family violence
- Mental abuse
- Sexual assault
- Human trafficking
- Living as a Prisoner of War
- Living and fighting in a war zone
- Surviving concentration/internment camps
Disabling Symptoms of PTSD
Chronic or acute PTSD can take a wide range of severity levels. A jumble of images, sounds, smells, and other vivid memories of the event accompany the intense, adverse emotions that follow the threat. Symptoms of PTSD may include:
- Flashbacks
When someone is reminded of a past event that triggers flashbacks, the person feels as if the event is happening again without control. Individuals can be reminded of their own painful experiences by certain people, smells, or sounds in their surroundings. - Dissociation
Being emotionally numb is being emotionally detached from yourself and others. A person can become unaware of everything happening around them, being sucked back into the traumatic event mentally. - Nightmares
Intrusive memories of the event often trigger dreams and night terrors. - Intense Fears
There may be periods of horror and helplessness and episodes of intense, debilitating fear memories. This is referred to as emotional paralysis.
Further common symptoms of PTSD include:
- Anxiety and depression
- Difficulty concentrating
- Confusion
- Angry outbursts, exaggerated startle response
- Avoidant behavior
Traumatic events usually trigger PTSD symptoms shortly after they occur; however, they can also strike years or decades after the traumatic event.
Winning SSD Benefits for PTSD
Post-traumatic stress disorder is characterized by intrusive and recurring memories of trauma that can be distressing. Several criteria specified in the SSA's medical listing of impairments may qualify you to receive Social Security Disability benefits for PTSD.
Under the SSA listing 12.15, PTSD is categorized as a Trauma and Stressor-Related Disorder. These requirements, A, B, and C, are laid out in three parts. Your symptoms must meet the criteria outlined in paragraphs A and B - OR - A and C to qualify.
Documentation and medical evidence are discussed in Part A. The five characteristics in Part A must be present to diagnose trauma or stress-related disorders.
- The threat of death, serious injury, or violence is real or imminent
- The further reliving of the traumatic event involuntarily
- Reminders external to the event should be avoided
- An imbalance of mood and behavior, and
- Arousal and reactivity are increased
Part B requires mental functioning to be severely restricted in one or greatly restricted in two of the following areas:
- Understanding, remembering, or applying information
- Engage in social interaction
- Concentrate, persist or maintain pace
- Self-adaptation or self-management
According to the medical listing for Trauma and Stressor-Related Disorders, post-traumatic stress disorder must be "serious and persistent," which means there must be a documented history of PTSD for at least two years and evidence that both factors exist.
- An ongoing medical treatment, mental health therapy, psychosocial support, or a highly structured setting that minimizes the symptoms and signs of your mental illness is what you need.
AND
- Having marginal adjustment means you have limited capacity to adapt to changes in your environment or demands that are not already a part of your daily routine.
Winning Social Security Disability benefits for PTSD can be a very technical and medically complex process. We can assist you throughout the process, whether you are preparing to file your claim or appealing a decision that denies your claim.
If you cannot meet the medical criteria, what can you do? You should not give up because you have another and often a more viable option, the medical-vocational allowance offered by the Social Security Administration.
An impaired person's Residual Functional Capacity (RFC) is determined through the Medical-Vocational Allowance.
According to these standards, a patient must have severe post-traumatic stress disorder to prevent them from performing their previous employment or any other substantial gainful work. When SSA evaluates your work history, they consider your physical and mental demands.
As long as you are still capable of doing this type of work, the SSA will not find you disabled. After SSA determines that you cannot perform your past work, SSA will investigate whether work is available for you in the national economy.
PTSD claims are usually won at the SSA's last two evaluation processes. Social Security needs to know if you have post-traumatic stress disorder or other mental disorders. Still, it is just as important (if not more so) to determine your level of functional impairment.
Your treating physician will complete and submit specific mental and physical RFC forms for a post-traumatic stress disorder claim. Disability lawyers make sure the doctors' documentation is accurate and complete and specify your PTSD-related limitations distinctly and in the SSA's disability vocabulary.
Winning Long Term Disability Benefits for PTSD from the Insurance Company
It can be difficult to convince insurance companies that PTSD is a disability. Can you prove that your disorder and complications prevent you from working with an insurance provider?
Reading your policy and understanding its limitations and exclusions should be your first step. Most long-term disability insurance policies include the following restrictive provisions:
- PTSD and other mental health disorders are generally limited to 24 months of coverage under "mental and nervous" conditions. The insurance company will say you do not qualify for long-term disability before the 24 months of benefits, and disability benefits will cease when short-term disability (STD) benefits expire.
- Insurers may attempt to deny disability benefits for PTSD by citing the "act of war" exclusion found in long-term disability (LTD) policies.
- In addition to applying for Social Security disability benefits, most insurance policies require you to apply for them. In other words, any disability benefits you receive from your insurance company will be offset by the amount of your Social Security benefits. In addition, if Social Security approves your claim for disability benefits for PTSD, this does not matter to your insurance company regarding long-term disability benefits for PTSD.
Your doctor's support is one of the most important components of a successful LTD insurance claim. A disability lawyer works closely with doctors and mental health professionals to ensure that your claim meets the threshold of evidence required by insurers to prove you are disabled due to post-traumatic stress disorder.
Disability Compensation for Veterans with PTSD
As long as you can prove that your PTSD symptoms are related to your military service, the VA will recognize PTSD as a service-related disability. A veteran's disability claim for PTSD benefits is affected by these traumatic events or "stressors":
- You sustained a serious bodily injury, sexual abuse, or a personal trauma
- A threat of physical injury, sexual assault, or death was made against you
VA statistics indicate that PTSD is the most prevalent mental health issue returning combat troops suffer. Veterans of recent combat operations are more likely to suffer from PTSD, according to the VA's National Center for PTSD:
- 11-20% of veterans from Operations Iraqi Freedom (OIF) or Enduring Freedom (OEF)
- 12% of the veterans who participated in the Gulf War (Operation Desert Storm)
- 30% of all Vietnam veterans
- Traumatic sexual events can lead to PTSD. Thousands of veterans have been sexually assaulted, abused, and harassed while serving in the armed forces, known as military sexual trauma (MST)
Veterans with PTSD are eligible to receive disability benefits from the VA if the following apply:
- There are symptoms associated with a traumatic event or stressor, or the stressor is associated with the symptoms of PTSD.
- Your military service caused the stressor.
- Your symptoms prevent you from functioning as well as you once did.
- The doctor has diagnosed you with PTSD.
Applying for Social Security benefits can be an overwhelming process. If you are interested in seeking SSDI benefits, check out our article on how Social Security Disability Insurance benefits are calculated. To learn more, visit DisabilityHelp.org today!
