Social Security Disability for Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop after you've experienced a shocking, scary, or dangerous event. The specific causes of PTSD are varied, but some common traumatic events include exposure to war, violence, sexual assault, domestic violence, crime, a serious accident, or a natural disaster.

You might have seen PTSD called different terms when referring to veterans (like "shell shock" or "combat fatigue"), but anybody can develop PTSD. The terms "PTSD" or "PTSI" (post-traumatic stress injury) are relatively recent, but people have known for a long time that trauma can affect your brain even after the traumatic event has ended.

Is PTSD a Disability?

The Social Security Administration (SSA) recognizes that symptoms from PTSD can prevent you from working. For example, you might have recurring flashbacks and nightmares that can disrupt your daily routine. Other symptoms of PTSD can include:

• angry outbursts
• extreme fear that the traumatic event will happen again
• being overly alert and aware of your surroundings ("hypervigilance"), and
• a tendency to be easily startled.

If you're experiencing these symptoms, it's best to contact a psychologist or psychiatrist to determine whether you have a post-traumatic stress disability such as PTSD or PTSI. Your doctor will conduct a "mental status examination," where you'll answer questions about your history, your current mood, and your thought process. Your answers will help your doctor make the right diagnosis.

Doctors offer many ways to treat PTSD. Your doctor will likely recommend that you see a counselor or therapist. A therapist can help you develop stress management skills to better handle your PTSD symptoms. Your doctor can also recommend antidepressant or anti-anxiety medications to improve any problems you might have with sleep or concentration.

Can I Get Social Security Disability for PTSD?

Social Security can find you disabled "medically" or "vocationally." Medical disability means that your medical record documents symptoms or test results that the SSA has already determined are enough to find you disabled under its "listing" of disorders. (The listing of disorders contains impairments that the SSA thinks are serious enough to find you disabled without deciding that you can't do any jobs.) If you're approved through a vocational allowance, that means the SSA has found that your particular limitations make it impossible for you to do any job.

Qualifying Under the Medical Listing for PTSD

Social Security evaluates PTSD under the listing for "trauma- and stressor-related disorders," listing 12.15. For the SSA to find that you're medically disabled because of your post-traumatic stress disorder, you'll have to satisfy the requirements set out below.

First, your medical record must contain evidence of each of the following:

• exposure to actual or threatened death, serious injury, or violence
• involuntary re-experiencing of the traumatic event (for example, intrusive memories, dreams, or flashbacks)
• avoidance of external reminders of the event
• disturbance in mood and behavior, and
• increases in arousal and reactivity (for example, exaggerated startle response or sleep disturbance).

To find this evidence, the SSA will look at your doctor's treatment notes to see what medications you take, how you feel and act during doctor's appointments or counseling sessions, and the results of your mental status examinations. Make sure to let the SSA know if you are hospitalized or switch doctors so the agency can get the important evidence it needs.

Next, Social Security will look to see how much your symptoms limit your mental abilities. Simply having a diagnosis isn't enough—you'll need to show that your PTSD causes an "extreme" (debilitating) limitation in one, or a "marked" (intense, but not debilitating) limitation in two, of the following areas:

• understanding, remembering, or using information (learning new things, applying new knowledge to tasks, following instructions)
• interacting with others in socially appropriate ways
• being able to concentrate on tasks to complete them at a reasonable pace
• adapting or managing oneself (regulating emotions, handling changes, having practical personal skills like paying bills, shopping, hygiene).

Proving these limitations can be tricky because terms like "marked" and "extreme" are subjective and not very well-defined. To help the SSA understand how you meet these criteria, it's a good idea to ask your treating psychiatrist, psychologist, counselor, or therapist to write a medical source statement. Having multiple providers who can provide evidence that your limitations are medically disabling strengthens your claim.

Most claimants (applicants) whom Social Security finds medically disabled because of PTSD do have evidence of marked or extreme limitations. But Social Security can find that you're medically disabled without those limitations if you can show that you're only able to function as well as you do because you get a lot of help. The SSA will look for evidence of a support system that you can't function without, such as social workers, group homes, or family members who make sure that you're taking care of yourself.

Qualifying Vocationally for PTSD If You Don't Meet the Medical Listing

PTSD can affect every person differently. Your symptoms might not cause marked or extreme limitations, but they can still prevent you from working. If your medical record is supportive, Social Security can still find you disabled "vocationally" even when they don't think you're disabled under the medical listing for PTSD.

To figure out whether you can work any jobs, Social Security will want to know all the ways that PTSD interferes with your activities of daily living (ADLs). The agency asks you about your ADLs because it makes sense that something you're having trouble doing at home would be something you'd struggle with at work.

For example, if your mind is so preoccupied with revisiting a traumatic event that you're having difficulty paying attention to a TV show, you might have a hard time following simple instructions from an employer. Or, if you frequently yell at your friends and family when irritable, it's unlikely that you'll do well in a job where you'd have to deal with the other employees or the public.

The SSA will look at your medical records and your ADLs to determine what you can and can't do mentally. Because the SSA needs to see that your limitations prevent you from doing any work, the agency will then take these medical limitations and translate them into terms a vocational expert would understand. This process is called assessing your "residual functional capacity" (RFC). For example, any difficulty you have concentrating might be explained in your RFC as "off-task" behavior. Too much time spent off-task means that no employers would hire you for full-time work.

People with PTSD are often diagnosed with other mental impairments such as anxiety and depression. Be sure to document any treatment you're receiving for these conditions as well. Social Security will look at the combined effect of your impairments when assessing your RFC. So even if your PTSD is not disabling by itself, if you have other conditions, the combination of your limitations can add up to a disabling RFC.

How Do I Apply for Disability Benefits for PTSD?

An easy way to start your disability application is to file online with Social Security. You don't have to finish the application all at once; just make sure that you keep track of the application number given to you when you start the application so you can access it again if you need to come back to it.

You can also apply for disability benefits over the phone by calling 800-772-1213 from 8 a.m. to 7 p.m. Monday through Friday. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.

Finally, you can apply for disability benefits in person at your local Social Security field office. You can locate your field office here.

If you'd like help with your application, think about working with an experienced disability attorney. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time.