Top 5 Reasons Why Mental Illness Disability Claims Are Denied

by May 8, 2017

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There are numerous mental disorders that can qualify someone for Social Security Disability (SSD) benefits, such as autism, schizophrenia, mood disorders, and anxiety disorders. In fact, of all the disability claims the Social Security Administration (SSA) receives each year, roughly a third of them involve diagnoses for mental disorders.

Unfortunately though, mental illness-related claims are often denied and are much harder to prove than claims for physical ailments. Below, we discuss the top five reasons why mental illness disability claims are denied and how you can improve the chances of winning your case. For help with your disability claim, call the Disability Advantage Group at 865-566-0800 and request a free consultation.

Why are mental illness disability claims susceptible to denial?

Getting approved for disability is more difficult when your impairment is mental rather than physical in nature. Why?

  1. Evidence is primarily subjective. Physical impairments are relatively easy to prove with blood work, x-rays, and other objective medical tests. In contrast, most mental disorder symptoms and signs are subjective in nature and there are few tests that evaluate the severity of a mental condition. Anxiety, for example, does not show up on a CT scan. Physicians must make diagnoses for mental disorders primarily using just observation and patients’ own reports of their symptoms. This makes it substantially harder to prove to the SSA that you are genuinely disabled.
  1. Failure to provide supportive evidence. Many claims are denied because of incomplete, weak, or scarce supportive evidence. Mental health records, applicable objective tests such as IQ and memory impairment testing, and reports from your psychiatrist or other mental health care provider are the primary types of evidence you will have to prove your disability claim. However, these are not the only types of items to submit. The SSA will review any viable evidence you provide them with, even from non-medical sources, such as:
  • Written testimonies from your therapist or group counselor
  • Case files from your social worker
  • Letters from your spouse, family, former co-workers, clergy, etc. that discuss how your mental illness is impairing your ability to function and work
  • Your own personal account of your condition and functional limitations

The more evidence you can collect and give the SSA, the better.

  1. Noncompliance with treatment regimen. A determination as disabled for a mental disorder is contingent on compliance to treatment. You must receive and stick to your treatment protocols (e.g., prescriptions and counseling) for the SSA to consider you disabled. Failure to seek out and comply with treatment from your regular doctor, psychiatrist, and/or other mental health provider for your mental disorder will result in a denial or cause the SSA to shut off disability benefits.
  1. Poor care from mental health providers. Not all mental health care professionals provide the same standard of care. If you are receiving suboptimal care, not only could it impede your healing and quality of life, but it could also hinder your claim. Your physician should regularly evaluate you, explain treatment options, keep a watchful eye on how you respond to treatments, and then adjust accordingly. She should also maintain thorough notes in your file about your condition and limitations to share with the SSA. If you think you are not receiving the quality of care you deserve, seek out a new provider and get a second opinion.
  1. Cultural bias. Millions of Americans live with chronic mental illnesses that make daily life a challenge. Unfortunately, society often discredits the validity of mental illnesses. Many SSD claims examiners share this bias, often holding a belief that people filing for disability based on mental conditions are merely malingering or indolent. This cultural prejudice towards mental illnesses is an obstacle many claimants run into.

How can I improve the chances of winning my mental illness claim?

When your mental illness is preventing you from working, getting approved for disability becomes top priority. Monthly disability benefits can help you and your family stay afloat. There are a few things you can do to increase the chances of winning your claim:

  • Stick to your treatments.
  • Keep a daily journal to log your symptoms and note how your condition is affecting your daily life. Share your journal with your psychologist/psychiatrist and lawyer.
  • Consult a disability lawyer that manages mental illness claims. A lawyer can help you gather the supportive evidence you need, obtain testimonies from mental health experts, help justify your disability to the SSA, and be on the ready to appeal your claim if it is denied.

For a free consultation with a disability lawyer, call the Disability Advantage Group today at 865-566-0800.