Disability Benefits for Bipolar Disorder

 
Bipolar Disorder is a condition that causes extreme changes in an individual’s mood. Thousands of Americans who are diagnosed with this condition every year are unable to work and hold employment due to their symptoms. If an individual is unable to work because of bipolar disorder, he or she may qualify for either Supplement Security Income (SSI) or Social Security Disability Insurance (SSDI).
 

About Bipolar Disorder and Disability

Bipolar disorder is a mental illness associated with episodes of mood swings ranging from serious mania to depression. Episodes of bipolar disorder can last a few hours to several months and consist of highs (periods of mania) and/or lows (periods of depression). Others experience what is known as “mixed mania” or the combination of feeling manic and depressive at the same time. The individual feels all of the feelings of a manic high (agitation, restlessness, etc.) while also experiencing the negative feelings of depression (fatigue, slowness in activity or thought). Many people consider mixed mania as the worst part of bipolar disorder.

Here are the symptoms related to episodes of mania and depression:

Symptoms of Mania (highs)

  • Aggressive or reckless behavior
  • Feelings of irritability
  • Easily distracted
  • Decreased need for sleep without feeling tired
  • Poor judgment
  • Racing thoughts and speech
  • Impulsiveness
  • Increased levels of optimism and self-confidence

Symptoms of Depression (lows)

  • Feelings of sadness and hopelessness
  • Changes in appetite
  • Changes in sleep patterns
  • Loss of energy (mental and physical)
  • Random crying spells
  • Feelings of worthlessness and pessimism
  • Inability to focus and concentrate
  • Thoughts of suicide or death
  • Repeatedly going over thoughts

According to the National Institute of Mental Health, approximately 5.7 million people (18 or older) are affected by bipolar disorder in a given year. There is no cure to the disorder but it can be controllable for some individuals with medication or psychotherapy. If the disorder can’t be controlled through varies treatments, its symptoms can cause distress and disruption to an individual’s everyday life.

How is Bipolar Disorder diagnosed?

The symptoms of bipolar disorder are difficult to prove and diagnose. Due to this difficulty of diagnosis, individuals with bipolar who apply for disability benefits are often denied initially. This is because the symptoms (episodes) typically come and go in waves and there are times when people with bipolar disorder have no symptoms at all. The symptoms also need to be clearly out of the individual’s normal range of mood and behavior. Doctors who diagnose individuals with bipolar disorder use one of the four basic types listed in the Diagnostic and Statistical Manual of Mental Disorders.

Bipolar I Disorder: Individual has manic or mixed episodes that last longer than 7 days as well as depressive episodes that last at least 2 weeks. Manic episodes can get severe enough for hospitalization.

Bipolar II Disorder: Individual has episodes of hypomania instead of mania along with full depressive episodes. Hypomanic episodes are similar to manic episodes except that they are not as intense and don’t tend to last as long.

Bipolar Disorder Not Otherwise Specified (BP-NOS): Individual shows symptoms of bipolar disorder but technically doesn’t meet the qualifications for bipolar I or II.

Cyclothymic Disorder: Individual has episodes of hypomania and periods of depression. These periods of depression are not severe enough to be considered full depressive episodes.

Another form doctors diagnose is called rapid-cycling bipolar disorder. This is a more intense version of bipolar I disorder where the individual experiences four or more episodes of major depression, mania, or mixed mania within a year period. The rapid-cycling bipolar disorder tends to surface at younger ages in comparison to bipolar I or II.
 

Qualifying for Disability with Bipolar Disorder

Becoming approved for Social Security Disability benefits with bipolar disorder alone is rather quite difficult. This is due to the fact that many mental illnesses such as bipolar disorder are hard to validate and can be controllable through medication and/or psychotherapy. Generally people who are approved for benefits with bipolar disorder also have other disabling conditions such as schizophrenia, clinical depression, PTSD, etc.

The Social Security Administration’s Blue Book lists the requirements for specific disabilities to qualify for disability benefits. Listing 12.00 deals with mental disorders and section 12.04 of the Blue Book lists the requirements necessary for an individual with an affective disorder to qualify for Social Security Disability. An applicant’s bipolar disorder must satisfy requirements A and B or must satisfy requirement C.

Requirement A

1.) Symptoms of depression – at least 4 of the following:

  • Appetite disturbance in addition to weight change
  • Difficulty thinking, focusing or concentrating
  • Loss of interest in the majority of activities
  • Psychomotor retardation or agitation
  • Lower energy levels
  • Feelings of worthlessness or guilt
  • Sleep disturbance and inconsistency
  • Suicidal thoughts

2.) Symptoms of mania – at least 3 of the following:

  • Hyperactivity
  • Pressured speech
  • Rapid thought pattern
  • Inflated self-esteem
  • Insomnia or decreased need for sleep
  • Easily distractible
  • Performs activities with a high probability of painful results
  • Delusions, hallucinations, or paranoid thinking

Requirement B

Applicant has at least two of the following:

1.) Restriction of activities of daily living
2.) Difficulties in maintaining social functioning
3.) Difficulties in maintaining concentration, persistence or pace
4.) Repeated episodes of decompensation of extended length

If an applicant’s disorder doesn’t meet requirements A and B, he or she may still qualify under requirement C.

Requirement C

If their bipolar disorder has lasted at least two years and the disorder’s symptoms have weakened with medication and support, and one of the following:

  • Repeated episodes of decompensation of extended length
  • Another condition or change in environment would likely cause the individual to decompensate
  • One or more years of inability to function outside a highly supportive living arrangement

 

Medication Compliance & Bipolar Disorder

The Social Security Administration requires that all applicants are medication compliant. This means that the applicant is using or has attempted to use all treatments (medication, therapy, etc) offer by his or her treating doctor. If an applicant is not using prescribed medications, the SSA will deny the case because they assume the medication could potentially control and improve their condition's symptoms. Although there is an exception, if an applicant attempts to use the medication(s) but stopped taking them because of bad side effects, he or she will be considered medication compliant since they attempted to treat their condition.
 

Unable to Work with Bipolar Disorder & Mental RFC

As mentioned before, proving that a mental disorder is truly disabling and prevents an applicant from working is very difficult. One of the best ways to prove to the SSA that an applicant’s bipolar disorder prevents them from performing unskilled work is to have their treating doctor fill out a mental residual functional capacity.

This form describes what tasks an applicant is capable of in a work environment despite his or her mental disability. Tasks include the ability to concentrate, focus, properly communicate, perform tasks in a timely manner, etc. If your doctor fills out the form and finds the applicant is actually capable of unskilled work, he or she will be denied and vise versa.