Mental Health Disability Benefits: New Criteria for Evaluating Claims

Mental Health Disability Benefits: New Criteria for Evaluating Claims

Individuals frequently apply for mental health disability benefits. Oftentimes, however, these benefits are difficult to receive. Claimants may be unable to pinpoint specific impairments resulting from their mental disorder in the same way a claimant seeking benefits for a physical disorder would be able to allege.

When evaluating a benefits claim, the Social Security Administration (SSA) uses their issued regulations to determine whether the claimant should be entitled to receive mental health disability benefits. On September 26, 2016, the SSA published a new rule, “Revised Medical Criteria for Evaluating Mental Disorders” to provide further detail as to how mental health disability benefits claims should be evaluated. This revised rule will become effective on January 17, 2017, and will update the previous rule to employ current standards used by the mental health community. 

Background for the New Rule

The SSA drafted this new rule to contain updated information from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which is the most up-to-date standard mental health professionals use when classifying mental disorders for patients. In addition, the SSA took into consideration 2,245 comments from general members of the public, mental health professionals, vocational experts, legal services organizations, and disability policy experts.

Revisions to the Mental Health Disability Benefits Criteria

There are several key updates addressed in the revised criteria that individuals seeking mental health disability benefits should keep in mind when filing a claim:

  • Updated Diagnostic Criteria for Intellectual Disability: Section 12.05 of the revised rule now addresses individuals with intellectual disability, defined by three elements: (1) significant limitations in intellectual functioning, (2) significant deficits in adaptive functioning, and (3) evidence that the disorder began during the developmental period. In evaluating a claim for mental health disability benefits, the SSA will now categorize claimants by whether or not they are able to take a standardized intelligence test.
  • Updated Symptoms and Examples for Trauma- and Stressor-Related Disorders: The DSM-5 was updated to include trauma- and stressor-related disorders in order to address the expanded list of disorders now recognized by mental health professionals. Accordingly, the SSA criteria also now have a separate section for trauma- and stressor-related disorders, defined as disorders characterized by experiencing or witnessing a traumatic or stressful event or after learning of a traumatic event. These include post-traumatic stress disorder and adjustment-like disorders. The SSA criteria further list specific symptoms evaluators should look for when determining a claim for mental health disability benefits.

Overall, the revised rule clarifies the different symptoms the SSA will look for in a claimant’s mental health disability benefits application and specific types of disorders that fall under mental disorders. It is important to understand these revised criteria before you file a benefits claim to help maximize your potential for success.

Get Help From a Charleston, SC Disability Benefits Attorney

When applying for mental health disability benefits, the SSA will look to the recently revised regulations to determine whether the claimant should be entitled to receive benefits. You should hire lawyers who understand the new rule and disability benefits applications and can help you understand what your likelihood of receiving disability benefits is. The experienced Charleston, SC disability attorneys at Klok Law Firm LLC can help you complete your application to receive the disability benefits you are entitled to receive.

Contact us today for a free case consultation.