Post-traumatic stress disorder, or PTSD, is an all-too-common mental health disorder which impact those who have experienced stressful, frightening, or shocking events in their lives, and is especially common among those who have suffered a life-altering injury or illness. Attorneys at our firm frequently see individuals who have experienced a lift altering event, even one which was not sudden or accident-related, who suffer from mental health disorders including PTSD as a result. While often difficult to discuss, PTSD can be a vital component of a disability case, and it is critical to understand what PTSD is, how it is proven in a case, and how Social Security considers its impact on the person.
PTSD is a strong emotional and/or physical reaction following exposure to a traumatic experience. A traumatic experience is any event in life that causes a threat to our safety and potentially places our own life or the lives of others at risk. As a result, a person experiences high levels of emotional, psychological, and physical distress that temporarily disrupts their ability to function normally in day-to-day life. Trauma – reaction and recovery, Better Health Channel, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/trauma-reaction-and-recovery. PTSD is therefore the body reacting after an overload of stressful stimuli, which can lead to a heightened or altered emotional state, and causing physical symptoms interfering with an individual’s ability to function the way he or she did prior to the event. PTSD does not always result from an immediate and temporary shock. Long-term treats to our well-being, such as long-term illnesses which threaten careers, incomes, and stability in our lives can also cause trauma responses.
PTSD is more than a mental condition. It causes physical symptoms as well and can impact a person in a number of ways. The symptoms of PTSD include intrusive memories, reactions triggered by reminders of the trauma and avoidance of such reminders, nightmares, irritability, trouble sleeping, increased tension and increased startle response, as well as difficulty with concentration, memory, and cognitive functioning. Post-traumatic stress disorder (PTSD), Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967. The loss of sleep, fatigue, and cognitive symptoms caused by PTSD, as well as the interference with functioning due to intrusive memories, avoidance, and other symptoms, cause the person to be unable to complete normal work activities, particularly working with other people including co-workers and the public, work which may involve reminders of the trauma, and work involving travel or unfamiliar environments.
In determining whether a person can work, Social Security considers whether he or she has documented medical conditions which interfere with their ability to work. Some conditions are automatically disabling if certain symptoms exist, or certain test results have been found. Other conditions may not meet these exact criteria, but are still considered in making a disability determination. In these cases, the impact of the condition and its symptoms are assessed, and how it will interfere with the individual’s ability to work is considered. All conditions an individual experiences are considered together, to form a complete picture of all impairments he or she experiences, and all impacts these impairments have on their ability to function. Social Security then considers whether the individual, with all these impairments, can perform any work activities full-time. It is important to note, however, that Social Security requires evidence from a medical provider documenting the condition and its symptoms in order to fully consider it at all steps of this evaluation, and untreated conditions will be given less weight in the determination than those with an extensive treatment history.
As with any medical diagnosis considered by Social Security, you must have documentation of a medical diagnosis of the condition and supporting medical records for Social Security to fully consider the condition in ways during the evaluation process. This means that for conditions such as PTSD to be fully considered, you must be receiving treatment or, at the very least, talking to your doctor about the symptoms you are experiencing and how they have impacted your life. Treatment available for PTSD includes treatment with a psychologist or psychiatrist to determine the source, extent, severity, and possible treatments for the trauma response; therapy and counseling to prevent ongoing stress reactions and develop better responses when they do occur, medication to help manage symptoms, and other treatments depending on the individual situation. This is not a comprehensive list, and any treatment for your mental health conditions should be managed by a licensed professional.
Social Security considers PTSD in various ways during the disability determination process. Social Security considers the impact of PTSD in all cases for both children and adults, so long as there is supporting documentation to show the diagnosis and its impacts. To be automatically considered disabled, an individual must have documentation of a stressful/traumatic event, re-experiencing of the event, avoidance of reminders, altered mood or behaviors, and increased reactivity, as well as an impact on their ability to function. Appendix 1 to Subpart P of Part 404—Listing of Impairments, Part A, listing 12.15. If a person does not have adequate documentation of all of these symptoms of PTSD, Social Security will still consider the impact of their condition, but will consider specifically how those symptoms interfere with their ability to work, and whether they prevent them from working altogether. This can include the need to avoid startling stimuli, the need to avoid working with the public, a need for work with low concentration or memory requirements, and the need to avoid a stressful work environment.
If you believe you may have PTSD or another mental health condition as a result of exposure to a traumatic event, consult with your doctor and find out what treatments may be available to you. If you are applying for or considering applying for Social Security disability benefits, it is important that you begin seeking treatment as soon as possible and follow your doctors’ recommendations. While affording treatment, particularly after an injury or illness, can be challenging, there are often low- or no-cost services available for those with low incomes. Look for free or low-cost mental health care available in your area. Social Security reviews medical documentation of an individual’s treatment for conditions such as PTSD, and determines what impact the noted symptoms have on his or her ability to work. Social Security has published a short fact sheet on PTSD covering these details available here.
Finally, while mental health is often a sensitive subject, know that your doctors and attorneys are comfortable discussing it, and are familiar with the symptoms and impairments caused by this condition and are more than happy to help guide you through the process of finding treatment and including it in your disability claim.
By Erika N. Dowd, Esq.
Have more specific questions about how you PTSD or mental health condition may work with a Social Security Disability claim? Reach out to Quatrini Law Group any time for a free consultation at 888-534-6016.