How Much Does Mental Health Disability Pay
In general, long term disability insurance will pay benefits equaling 60 percent to 80 percent of your work-related income. If you earn $4,000 in after-tax income, an LTD policy would pay $2,400 to $3,200 a month if you suffer a qualifying disability.
How an insurance company covers mental health disability depends on whether it was a pre-existing condition when you applied or whether it developed after you purchased coverage.
Insurers have different underwriting guidelines. Compared with physical disabilities, benefits are often limited in cases of mental health disabilities because:
- They are more difficult to diagnose than physical disabilities.
- Itâs more challenging to prove their effect on job performance and ability.
- They are more likely to be treatable than some physical disabilities that are permanent.
Some insurers will cover certain mental conditions but not others. Others may stipulate that if you have attempted suicide in the past, you cannot collect benefits for at least 10 years after the policy has been issued.
Another common way that some insurers limit benefits for mental and nervous disabilities is to impose a cap on how long you can collect benefits. For example, some carriers place a 24-month limit on disabilities, regardless of the length of your policy benefit period.
On the other hand, a few disability insurance companies do not have limitations on mental/nervous disorder claims.
Qualifying For Disability Benefits Based On The Bipolar Disorder Listing
To qualify under the SSA’s official listing for bipolar disorder, you must have a diagnosis of bipolar disorder I or II and a history of specific, severe symptoms causing a decrease in your abilities. This listing was updated signficantly in January 2017. Now, you must have at least three of the following symptoms:
- unnaturally fast, frenzied speech
- quickly changing ideas and thought patterns
- inflated self-esteem
- decreased need for sleep
- involvement in risky activities with painful consequences that are not recognized, and/or
- increase in physical agitation or in in goal-directed activity .
You must also meet “functional” criteria to show that you have a loss of abilities due to these symptoms. Generally, you must have an extreme limitation in at least one of the following areas, or a “marked” limitation in at least two of the following areas:
- understanding, remembering, or using information
- interacting with others
- concentrating and maintaining pace in performing tasks , and/or
- adapting or managing oneself .
Note that “marked” is seriously limiting; it is worse than moderate. Extreme is less severe than a complete loss of an ability, but worse than marked. Marked and extreme are matters of professional judgment used by a SSA psychiatrist or psychologist when reviewing the medical evidence.
How Is Bipolar Disorder Diagnosed
The symptoms of bipolar disorder are difficult to prove and diagnose. Due to this difficulty of diagnosis, individuals with bipolar who apply for disability benefits are often denied initially. This is because the symptoms typically come and go in waves and there are times when people with bipolar disorder have no symptoms at all. The symptoms also need to be clearly out of the individuals normal range of mood and behavior. Doctors who diagnose individuals with bipolar disorder use one of the four basic types listed in the Diagnostic and Statistical Manual of Mental Disorders.
Bipolar I Disorder: Individual has manic or mixed episodes that last longer than 7 days as well as depressive episodes that last at least 2 weeks. Manic episodes can get severe enough for hospitalization.
Bipolar II Disorder: Individual has episodes of hypomania instead of mania along with full depressive episodes. Hypomanic episodes are similar to manic episodes except that they are not as intense and dont tend to last as long.
Bipolar Disorder Not Otherwise Specified : Individual shows symptoms of bipolar disorder but technically doesnt meet the qualifications for bipolar I or II.
Cyclothymic Disorder: Individual has episodes of hypomania and periods of depression. These periods of depression are not severe enough to be considered full depressive episodes.
What Is Bipolar Disorder
Bipolar disorder is a mental illness that is characterized by unusual shifts in mood, energy and activity levels. People who have been diagnosed with bipolar disorder often have varying abilities to carry out daily tasks. Bipolar disorder involves clear changes in mood, from manic, highly energized periods to more depressed, sad times.
There are four primary types of bipolar disorder. They include:
1. Bipolar I Disorder: the most severe type of bipolar disorder, this type includes manic episodes that last for at least seven days or that are so severe that they require hospitalization. Depressive episodes usually last for at least two weeks.
2. Bipolar II Disorder: this type has both depressive and manic episodes, but with less extreme manic periods.
3. Cyclothymic Disorder: also known as cyclothymia, this type involves numerous periods of hypomanic symptoms and depressive symptoms for at least two years.
4. Other Specified and Unspecified Bipolar and Related Disorders: this type involves bipolar symptoms that do not meet the criteria for one of the other diagnoses.
Signs and symptoms of a manic bipolar disorder episode include:
- Feel very up, high, or elated
- Have a lot of energy
- Have increased activity levels
- Eat too much or too little
- Feel tired or slowed down
- Think about death or suicide
Bipolar disorder affects people in different ways. While medication and psychotherapy can help to control the symptoms of bipolar disorder, it may not completely eliminate them.
Understanding Your Unique Symptoms
When filing your long term disability claim, the insurance company will want to know about your bipolar disorder symptoms. They must understand how your symptoms are disabling to you and your career. Remember, bipolar disorder presents differently in different people. Each person will have a different cycling pattern, and the pattern may change unexpectedly. It is not fair to broadly categorize people with bipolar disorder because it is a unique condition that affects different people differently. To fairly evaluate your bipolar disorder long term disability claim, the insurance company must understand how your condition personally affects your functioning.
Do You Have To Take Medication To Receive Ssdi Benefits For Bipolar Disorder
There is no requirement by the SSA that you take medication. However, if you have been treated by a psychiatrist who recommended medication and you are not taking it, it will count against you on your application. The SSA wants to know that youre doing everything possible to improve your mental health, and if you refuse treatment they will assume this is the reason you arent well enough to work.
Can You Receive Retroactive Payments
Once the SSA approves your SSDI application and calculates your monthly benefit, you may be entitled to a back pay award. How many months of payments you will receive will depend on the date you applied for benefits and your disability onset date.
If you are applying for SSDI benefits, you need the assistance of a skilled Social Security disability lawyer to get your application approved and receive the benefits you deserve. To schedule a free consultation with a member of our legal team, fill out the online form on this page or call our Roswell office today.
How Your Ssdi Payments Are Calculated
The severity of your disability will not affect the amount of SSDI benefits you receive. The Social Security Administration will determine your payment based on your lifetime average earnings before you became disabled. Your benefit amount will be calculated using your covered earnings. These are your earnings at jobs where your employer took money out of your wages for Social Security or FICA.
Your SSDI monthly benefit will be based on your average covered earnings over a period of time, which is referred to as your average indexed monthly earnings . The SSA uses these amounts in a formula to determine your primary insurance amount . This is the basic amount used to establish your benefit.
SSDI payments range on average between $800 and $1,800 per month. The maximum benefit you could receive in 2020 is $3,011 per month. The SSA has an online benefits calculator that you can use to obtain an estimate of your monthly benefits.
Ten Social Security Disability Tips
1. Expect to have to put some effort in. There is is still a lot of ignorance around bipolar disability and this makes it harder to get approval from the SSA, compared to someone with an an obvious physical disability. You can walk, talk and fill in forms so what is your problem? Yeah, right!
2. Persist. Most people succeed eventually, but not on their first attempt. Remember what Dr Susan says: APPEAL! APPEAL APPEAL!
3. Involve your psychiatrist or other members of your medical team. The SSA will not approve your claim for bipolar disability without medical support.
4. File as soon as possible. The process is slow 3 to 5 months and even slower if you need to appeal.
5. Keep lots of documentation such as all your medical records. It helps if you are seeing your doctor regularly. A big factor is being able to demonstrate how your bipolar disorder impacts on your moods and ability to work so other records such as your Bipolar Mood Charts may be very useful.
6.Ask your doctor to complete an RFC form for you. However, remember that you cannot get bipolar disability just because your doctor considers you eligible. It is the SSA who decide.
7. Stay calm and be polite. The process can be very frustrating but will only be worse if you lose your cool. The folks at the SSA are just doing their jobs and everything will go smoother if everyone can stay nice.
Bipolar Disorder And Social Security Disability Benefits
- This image courtesy of Unsplash
Bipolar disorder sometimes known as manic depression is a disorder of the brain. People with this disorder will often experience extreme shifts in levels of activity, mood and energy. Such extremes are referred to as manic and depressive episodes. Out of all bipolar disorder cases, 83% are classified as severe.
Most cases of Bipolar Disorder go undiagnosed throughout childhood and teen years, leaving most diagnoses to be delayed and without medical treatment until well into adulthood. If untreated, this can be a dangerous disorder, as many people who suffer from this condition can experience suicidal thoughts during depressive episodes, and can engage in risky behavior during manic episodes.
Contact Our Attorneys For Help With Your Ssdi Claim Today
When your bipolar disorder prevents you from working, SSDI benefits may be the only thing that helps you keep a roof over your head and provide for your family. Dont risk having your application rejected. We can help you identify the weak points in your application, get the medical records to fix them, and maximize your chances of getting benefits.
How The Ssa Evaluates Claims For Bipolar Disorder And Other Mental Health Issues
The good news is, the SSAs Blue Book does include a listing for depression-related mental illnesses. This includes bipolar disorder and what it calls personality and impulse-control disorders, which includes BPD. You can read the claim evaluation criteria listed there, but its quite difficult to understand unless youre a doctor. Regardless of your diagnosis, the part that matters when you apply for disability benefits is always the same. Heres what the SSA looks for when you file your application, no matter what health issues you have:
Service Connection For Bipolar Disorder
If you are a veteran suffering from bipolar disorder, you may be eligible for VA disability benefits. In order to receive monthly disability compensation, you must first establish service connection. The following three elements of service connection are required by VA:
- A current diagnosis of bipolar disorder
- An in-service event, injury, or illness
- A medical nexus linking the current diagnosis of bipolar disorder to the in-service incurrence
One of the first pieces of evidence VA looks for when determining a veterans eligibility for service connection are in-service treatment records. If symptoms of bipolar disorder emerged while a veteran was in the military and he or she sought treatment with a mental health counselor, it should be documented in-service records. In some cases, veterans do not have in-service records detailing the onset of their bipolar disorder. Here, veterans can provide lay statements from themselves, family, friends, or fellow service members describing how bipolar disorder has affected them.
Cost Of Living Increases
The federal rate amount regularly increases with cost-of-living adjustments . The COLA is usually between 1.3% and 2%, but some years it can be as high as 3% or as low as 0%. In 2021, the COLA was 1.3%, which increased the maximum federal SSI payment from $783 in 2020 to $794 in 2021. Read our article on Social Security’s annual COLA for more information.
Is Bipolar A Disability
The Americans with Disabilities Act is a law that helps people with disabilities get equal rights at work. Bipolar disorder is considered a disability under the ADA, just like blindness or multiple sclerosis.
- Social Security Disability Insurance is for people who have worked and paid Social Security taxes.
- Supplemental Security Income is for people with a limited income.
Read on to learn how the ADA and Social Security might benefit you.
Medical Evidence Required For Disability Based On Bipolar Disorder
At the SSA’s request, your treating doctor should submit to the SSA your psychiatric medical record showing the entire history of your bipolar disorder, including documentation of any severe or violent manic episodes. Your psychiatric record should include all treatments attempted, including any mood-stabilizing medications that you’ve tried, such as lithium, carbamazepine, or valproic acid, what your current prescribed therapy is, and whether you regularly comply with the prescribed therapy . Your medical record should also include the efficacy and side effects of each medication, and how their side effects, along with your symptoms, affect your daily activities, your functioning, and your ability to hold a job.
If there is evidence in your medical file that your doctor suspects your use of alcohol or drugs compounds your emotional problems, this can affect your claim. Learn more in our article on how alcoholism and drug dependence affect disability claims.
How Hard It Is To Get Benefits For Mood And Anxiety Disorders
As anyone who has suffered from serious depression or anxiety knows, it can be very difficult to convince otherswho’ve never experienced the crippling effects of these conditionsthat you aren’t able simply to “get over it.” Unfortunately, the same is often true when it comes to convincing skeptical disability claims examiners and judges that your condition truly prevents you from working and is long-lasting.
This skepticism is reflected in our survey results: Less than four in ten readers with mood or anxiety disorders were approved for benefits at some point in the process. At the initial application stage, the outlook was particularly dim: More than eight in ten readers were denied. It’s worth noting, however, that a sizeable portion of those were likely “technical denials,” generally because the applicants didn’t meet the work-history and/or financial requirements for SSDI or SSI. According to government statistics, 45% of SSDI applications filed in 2018 received technical denials; the proportion was lower for SSI applications .
For Social Security Disability Insurance Beneficiaries
If you receive SSD benefits, you have a trial work period of nine months that allows you to test your ability to work without risking your benefits. Be sure to check how many months you have left of your trial work period before you begin. A month only counts if you earn over $720. After the trial work period ends, you will not receive benefits in months where you earn over $1000. For three years after the end of your trial work period, you can begin receiving benefits again if you stop earning $1000/month and you?re still disabled this is called Expedited Reinstatement of Benefits, or EXR.
Approval Rates For Mood And Anxiety Disorders On Appeal
If you’ve received an initial denial letter because you didn’t meet Social Security’s medical criteria, that’s no reason to give up. If you request a hearing before an administrative law judge , the likelihood of receiving benefits goes up dramatically. Government statistics from 2007-2015 show that nearly six in ten applicants who listed mood or anxiety disorders as their primary impairment were approved after a hearing.
Several factors contribute to the better outlook at hearings. For one thing, it takes a long time to get to a hearing. While the wait can be frustrating, it can help you build stronger evidence. This is particularly critical with mood and anxiety disorders. If you can show that your mental condition has continued to be severe and to keep you from working, a judge is more likely to be convinced that you’re eligible for disability benefits, and that your condition isn’t short-term.
Our survey points to another important reason for the higher approval rate at hearings: More applicants enlist the help of a lawyer at this stage in the process. Nearly three-quarters of all readers who went to a hearing were represented by an attorney, compared to 30% at the initial application stage. And applicants with lawyers had a much greater chance of winning disability benefits .
Mental Health Disability Explained
Mental illness is not by itself a disability. However, there is a class of mental health disabilities called psychiatric disabilities. According to the Center for Psychiatric Rehabilitation at Boston University, these refer to mental illnesses that significantly interfere with major life activities, such as working.
On the centerâs website, it says:
âThe irregular nature of mental illness may create problems in establishing or maintaining consistent work or school patterns. Some individuals may need time off for medical appointments or to recuperate. The irregular nature of mental illness might also impair an individualâs performance.â
The Social Security Administration recognizes several mental disorders that can cause long term disability and qualify sufferers for Social Security Disability Insurance benefits. These include:
- Anxiety disorders
To qualify for SSDI, conditions must:
- Be diagnosed by a doctor.
- Prevent you from doing any work which you have done up until now.
- Render you unable to reasonably be trained for other work that is available at the time of your disability.
- Be expected to last at least a year.
According to the Integrated Benefits Institute, mental issues are the fourth most common reason for disability claims, accounting for about 9 percent of all claims.
Meeting A Disability Listing For Depression Or Bipolar Disorder
The Social Security Administration will automatically grant disability benefits for depression or bipolar disorder if you can show you have the symptoms and limitations listed in its official disability listing for depression or bipolar disorder. The SSA will consider treatment notes from your doctor or psychologist, mental status evaluations, psychological testing, and any reports of hospitalizations.
Symptoms. To qualify for either disability benefits on the basis of depression, you must show you have at least five of the following symptoms:
- depressed mood
- involvement in risky activities with painful consequences that are not recognized, and/or
- increase in physical agitation or in in goal-directed activity .
Limitations. For either disorder, you must show that you also have a loss of abilities, either an extreme limitation in one of the following areas or a “marked” limitation in two or more of the following areas:
- adapting to change or managing oneself
- concentrating on and finishing tasks
- interacting with others using use socially appropriate behaviors, and/or
- understanding, remembering, or using information .
Social Security Disability And Bipolar Disorder
Bipolar disorder is a serious mental illness that is characterized by extreme changes in mood periods of depression and periods of being extremely happy or being irritable. People diagnosed with bipolar disorder often experience both mania and depression. Common symptoms during the manic phase include: poor concentration, poor judgment, poor temper control, little need for sleep, and reckless behavior. Common symptoms during the depressive episode include: sadness, difficulty concentrating, remembering or making decisions, eating problems, fatigue or lack of energy, loss of pleasure, feeling worthless, thoughts of death or suicide. If you are unable to work as a result of your Bipolar Disorder, or any other condition, Social Security Disability can provide essential benefits. At Disability Advocates Group, we have successfully assisted many clients suffering from Bipolar Disorder to get the Social Security Disability benefits they need and deserve.
Five Things To Know About Getting Disability For Mental Illness
A severe mental illness can be incapacitating, making it impossible to work. Bouts of illness, concentration problems, difficulty communicating, medical appointments, and unplanned absences can make getting and keeping a job extremely difficult.
With no work and no steady source of income, thousands of people with mental health conditions apply each year for Social Security Disability benefits in hopes of receiving a monthly check.
If only it were that easy.
The reality is that getting Disability for mental illness can be challenging and requires more effort than filling out a few forms. Because mental illness is a hidden or invisible condition and is often subjective in nature, it can be among the most difficult Disability claims to prove. Still, it is not impossible and it is worth the effort.
A good starting point is to take some time to understand how the Social Security Administration handles these types of cases. Heres a crash-course on mental disorder Disability claims, complete with five things you should know:
If your condition does not meet the criteria of a Blue Book listing, but you can prove that your mental illness prevents you from working any job, you could still qualify for benefits. The Social Security Administration will determine whether or not you are able to work any job by evaluating your work history, age, and physical and mental capabilities.
Connect With Crest Ssd To Get Help From A Representative
Applying for disability benefits with a bipolar disorder diagnosis can be a complicated and intimidating process if youre applying alone. Every case is different, and an experienced disability advocacy service like Crest SSD is helpful to have in your corner to support your case.
Hiring a qualified SSDI representative may be in your best interest to help guide you through the application or appeals processes. We encourage you to reach out to us to determine the best method to increase your chances of getting disability for bipolar disorder.
Connect with us to discuss your situation and receive the benefits you or your loved one deserve. Complete this form or
Let Crest SSD Help You File Your Social Security Disability Claim.
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