Bipolar Disability Benefits

Bipolar disorder is an often misunderstood and complex mental illness that affects millions of people throughout the United States and beyond. According to the Archives of General Psychiatry 2005, 14.8 million U.S. adults suffer with manic depression or bipolar disorder. The World Health Organization (WHO) estimates that bipolar disorder is the sixth biggest cause of disability in the world, affecting 222 million adults worldwide. In some cases, despite medication management and therapy, this disease can become debilitating enough to make holding employment nearly impossible. If a person with bipolar-disorder believes that he is too disabled to work, a claim for Social Security benefits is a feasible option.

Determining Bipolar Disability

• In order to qualify for bipolar disability benefits, the severity and scope of the illness must inhibit the ability to engage in gainful employment. The two types of benefits most people file for are Supplemental Security Income (SSI), which is based on income need and funded through federal tax revenue, and Social Security Disability Insurance (SSDI), which a person pays into through employment. The Social Security Administration evaluates disability for bipolar using specific symptom criteria for the affective-disorder category. A person experiencing a disturbance of mood followed by a full or partial manic-depressive syndrome may meet the disability evaluation requirement. However, this does not guarantee that a claim will be approved. Examples of impairments meeting requirements for disability include a depressive syndrome followed by four symptoms, such as anhedonia or a pervasive loss of interest in life; and a manic syndrome followed by three symptoms (i.e., high-risk behavior, pressure of speech, hallucinations or delusions). These symptoms together must result in a serious restriction of daily activities and episodes of decompensation (an increase in the severity and frequency of symptoms) that have persisted for a year or expected to last for a year in order to qualify for disability benefits.

Filing with Social Security

• Social Security disability claims can be filed at local Social Security field offices or a claim can be made for bipolar benefits by phone. If initiated by phone, a claims lead is then generated that includes basic demographics and information about the claimant's symptoms and disability. The case is forwarded to the the local SSA field office that checks non-medical eligibility factors such as age, employment and marital status. Subsequently, the representative sends the claim to Disability Determination Services (DDS) for a determination of disability. When filing, it is imperative to present a thorough picture of your bipolar illness. This includes medical evidence from hospitalizations, psychiatrists, therapists and other clinicians that can clearly document a history of impairment and unstable work history. Medical records should include progress notes, clinical findings, a diagnosis of bipolar, treatment plans and prognosis. A good rule of thumb is to include a written statement from a treating medical professional who can describe the impact and scope of your bipolar disease. If the medical documentation is not sufficient to present an accurate picture of the impact of your illness, DDS may request a consultative examination.

Appeal Procedures

• The denial rate is quite high for disability claims. On average, two out of three people are denied on their initial claim, but don't be discouraged. If your claim for disability has been denied, go through the appeal process that can begin upon receiving notice of a denial. An appeal can be completed online, by calling the toll-free number or by contacting the local SSA office. If calling by phone, please note that SSA representatives are available Monday through Friday from 7 a.m. to 7 p.m. Sometimes, opting for the administrative-appeal process can raise a person's chances of a positive decision. According to the National Alliance on Mental Illness (NAMI), the statistics for administrative-based appeals results in 60 percent positive judgments overall.

Representation

• In some cases, bipolar patients enlist the help of a friend, family member or lawyer to assist with obtaining a positive judgment for disability. If you find that it is too difficult to complete paperwork and manage your own claim due to the severity of your bipolar symptoms, appoint a trusted person to help with the claim process. Legal representation can be costly, but generally results in a favorable judgment. If unable to obtain legal representation, SSA can help appoint a representative. Also, contacting a company that specializes in helping people with disability claims is another option. When appointing a representative, make sure to get the appointment in writing and file the necessary paperwork with SSA.

Important Considerations

• A claim for disability can take three to six months for a decision to be made. It is unclear to the general public why it takes so long to receive a decision and can be quite frustrating. This occurs for several reasons: the scope and severity of the person's illness (physical or mental), the length of time it takes to request medical records and whether a medical examination is required by SSA. Another reason for the long waiting period for disability benefits is that the Social Security Administration wants to make sure that the disability is a long-term illness with poor outcomes that have persisted over a six-month period. Stay persistent and check on the status of your case periodically.