Can you get Social Security disability for PTSD?

Indiana claimants may qualify for Social Security disability benefits if they have post-traumatic stress disorder. PTSD may follow a traumatic event experienced once or over a sustained period, and it can be severe enough to cause long-term psychological problems.

Many people with severe mental disorders are unable to work, and PTSD is one of those disorders. I have represented numerous clients whose PTSD symptoms are severe enough to prevent employment, even though they are physically healthy enough to meet the demands of many kinds of jobs.

Symptoms typically arise after a person has experienced or witnessed a terrifying event. Many factors contribute, and everyone experiences PTSD differently.

Symptoms of PTSD

While symptoms vary in type and intensity, those I see most often in my practice include:

• Recurrent, intrusive memories of a traumatic event
• Reliving the event through flashbacks
• Nightmares about the event
• Avoiding situations, places, or people that are reminders of it
• Emotional numbness or detachment
• Hypervigilance and an exaggerated startle response
• Concentration difficulties
• Anger outbursts and irritability
• Sleep disturbance
• Self-destructive behavior

These are only examples, and a person may have other symptoms that together amount to a disabling condition.

PTSD has its own listing now

This is worth stating clearly, because most published guidance on this topic has not caught up.

For many years Social Security evaluated PTSD as an anxiety disorder under listing 12.06. That changed when the mental disorder listings were rewritten in 2017. PTSD is now evaluated under listing 12.15, Trauma and stressor-related disorders, which was created specifically for these conditions.

If you have been reading about arguing a PTSD claim under the anxiety criteria, that information is out of date. The framework is similar, but the diagnostic requirements are quite different, and they are stricter in one important respect.

The listing is satisfied by paragraph A together with either paragraph B or paragraph C. As with any claim, your condition also has to have lasted, or be expected to last, at least twelve months.

Paragraph A: all five criteria are required

Most mental disorder listings ask for a subset of symptoms. Depression needs five symptoms from a list of nine. Anxiety needs three from a list of six. Listing 12.15 does not work that way.

Paragraph A requires medical documentation of all five of the following:

• Exposure to actual or threatened death, serious injury, or violence. The qualifying trauma needs to be identified in your treating records, not simply assumed from the diagnosis.
• Subsequent 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.
• Increases in arousal and reactivity, for example an exaggerated startle response or sleep disturbance.

There is no partial credit here. A file that documents flashbacks and hypervigilance thoroughly but never records the avoidance behavior, or never identifies the trauma itself, has a gap where the listing needs an entry.

This is worth acting on, because these are all things you experience and your provider may not have thought to write down. It is worth going through the five with your psychiatrist or therapist and making sure each one appears somewhere in your notes.

Paragraph B: how much it limits you

Paragraph B measures four areas of mental functioning:

• Understand, remember, or apply information
• Interact with others
• Concentrate, persist, or maintain pace
• Adapt or manage oneself

You need an extreme limitation in one, or a marked limitation in two.

Paragraph C: serious and persistent

There is an alternative route where the disorder has been serious and persistent: a documented history over at least two years, with ongoing treatment, therapy, or a highly structured setting that reduces your symptoms, together with marginal adjustment, meaning minimal capacity to adapt to changes or demands that are not already part of your daily life.

This route often fits PTSD well, because avoidance is itself a way of managing the condition. Someone who functions within a narrow, controlled routine, and who deteriorates when that routine is disturbed, is describing marginal adjustment.

PTSD and veterans

Many veterans have returned from active duty with a PTSD diagnosis, and there are two things worth understanding about how that interacts with a Social Security claim.

A VA rating does not decide your Social Security claim

The Department of Veterans Affairs and Social Security use different definitions of disability and different rating systems. A VA finding that you are disabled because of PTSD, even at 100 percent, does not mean Social Security will reach the same conclusion.

For claims filed on or after March 27, 2017, Social Security does not analyze another agency’s disability decision at all. What it does do is consider the medical evidence underlying that decision, and this is where the real value lies. Your VA treatment records, Compensation and Pension examination reports, and Disability Benefits Questionnaires are all evidence Social Security will consider.

The practical point is this: submit the records, not just the rating letter. The rating on its own does very little. The clinical documentation behind it can carry the claim.

Some veterans qualify for expedited processing

Social Security prioritizes claims in two situations relevant to veterans:

• A VA disability compensation rating of 100 percent Permanent and Total.
• Wounded Warriors, meaning service members who became disabled while on active military service on or after October 1, 2001. This applies regardless of where the injury occurred and is not limited to combat.

Social Security usually identifies qualifying veterans automatically. In some cases a veteran needs to self-identify and provide the VA notification letter as proof, so it is worth mentioning your status when you apply rather than assuming the system has caught it.

Expedited processing moves your claim up the queue. It does not lower the standard, and you still have to meet Social Security’s definition of disability.

What actually limits work

Many of my clients with PTSD tell me that their biggest obstacle to finding and keeping a job is an inability to interact appropriately with other people.

They describe difficulty leaving their homes and interacting even with family and friends, and they say that being around coworkers and supervisors all day would provoke severe symptoms. That degree of impairment in social functioning sharply limits the kinds of work available, and it maps directly onto the “interact with others” area in paragraph B.

Combined with the difficulty concentrating and staying on task that frequently accompanies PTSD, these limitations often rule out full-time performance of any occupation in a competitive workplace.

Two further points worth documenting:

• Triggers in the workplace. Noise, crowds, being approached from behind, particular environments. These are concrete and specific, and they explain why a job that looks suitable on paper is not.
• Sleep. Nightmares and disturbed sleep produce daytime exhaustion that affects concentration and attendance, and this is often left out of a file entirely.

Evidence

Unlike many physical conditions, where objective testing helps establish the cause of symptoms, mental health conditions have to be proven through treatment records. Social Security reviews those records for the types of symptoms you have, their severity, and their effect on your daily life.

It is important to have progress notes from a qualified psychiatrist or therapist showing regular, ongoing treatment. A statement from a treating provider addressing your diagnosis, symptoms, and specific limitations is often the most valuable document in the file, particularly if it addresses how often you would be absent and how much of a workday you would be off task.

Where a VA provider is your main treating source, be aware that they may be unfamiliar with Social Security’s forms and criteria, which are different from the VA’s. It is worth asking early rather than close to a hearing.

Tell Social Security about everything

Many of my clients have a combination of physical and mental impairments. Your PTSD alongside symptoms from a back problem, diabetes, fibromyalgia, or any other qualifying condition may leave you without the functional capacity for any kind of work.

Social Security must consider all of your impairments in combination. It cannot focus on one condition and ignore the others. Your conditions together with your age, education, and prior work experience all affect the outcome of your disability appeal.

Talk with an Indiana disability attorney

I have experience representing claimants with mental disorders, including bipolar disorder, depression, and anxiety and panic attacks, which frequently accompany PTSD.

For a free consultation, call (866) 950-5116.