If you are applying for Social Security disability benefits based on post traumatic stress disorder (PTSD) you need to know what Social Security judges are demanding for approved cases. PTSD is a very common ailment and judges hear these cases weekly, if not daily. You will need extremely compelling evidence to win.
Several years ago, a PTSD claimant could come to a hearing and expect to win with evidence documenting a traumatic event (physical trauma, sexual abuse, military combat trauma) and treatment records from the VA or perhaps from a family doctor who prescribed anti-anxiety meds, and perhaps some counseling notes. This level of evidence most likely won’t be enough to win.
When I speak with a potential client about PTSD, I will ask the following questions:
- What was the traumatic event that gave rise to your PTSD?
- Over what period of time were you subject to the trauma?
- Have you been evaluated by a licensed psychologist?
- Are you receiving regular treatment from a psychologist?
- Have you been evaluated by a psychiatrist?
- Gas the psychiatrist prescribed anti-anxiety and other psychotropic medications?
- Has your doctor changed your medications or upped the dosage because you were not showing improvement?
- Have you been hospitalized one or more times at an inpatient psychiatric hospital?
- Have you attempted suicide or self harm one or more times?
- Is there any evidence of self-medication with street drugs or alcohol, and is evidence of self-medication in your medical record?
- Are there any gaps in your treatment? If so, why?
- If you treat at the VA, have you or would you be prepared to pay for an evaluation and possible treatment from a private psychologist?
Non-Medical Factors
In addition to the need for compelling medical and counseling evidence, disability judges consider a variety of non-medical factors:
- Age – your chances greatly improve if you are age 50 or older. Because PTSD is an “invisible” disorder that usually lasts a lifetime, Social Security administrative law judges are under a lot of pressure not approve 30 year olds and thus obligate the disability trust fund for 25 or 30 years.
- Work History – your chances greatly improve if you have a long work history. This demonstrates that you have tried to work through your trauma but perhaps the passage of time made it more difficult to get past the intrusive thoughts, anxiety triggers and sleep issues.
- Work Attempts – if you lost one or more jobs because of anger control issues, or your inability to control symptoms, evidence in the form of statements from former co-workers or supervisors can be very helpful.
- Written Statements or Testimony from Friends or Relatives – I rarely call witnesses in Social Security disability hearings (because the hearings only last 45 minutes) but often I will ask a witness to testify in a PTSD case. Testimony from a spouse, adult child or close friend describing your anger control problems, crying spells, and other odd behaviors can help paint an accurate picture for the judge.
Remember the Big Picture: What Matters to Social Security
You will win Social Security disability benefits for your PTSD claim if we can prove that because of your symptoms:
–inappropriate behavior at work
–unstable emotional condition
–extreme difficulty with concentration and focus
–poor reliability
you would not be a reliable employee at even a simple, one or two step job where you worked by yourself
All that matters is what the medical record and non-medical evidence say about the limitations you have had and would likely have trying to perform a simple job 8 hours a day, 5 days a week.
The best evidence we can present to win your case includes:
- a compelling medical record showing regular visits with your psychologist and/or psychiatrist but no real improvement in your condition;
- evidence of one or more in-patient psychiatric hospitalizations due to suicidal tendencies or other severely abnormal behavior
- a statement from your doctor(s) identifying work limitations you would likely experience if you try to work. This can be in the form of a narrative report from the doctor, or it can be in the form of a functional capacity evaluation. Personally I like to use functional capacity evaluations because I can include questions that address limitations I know judges will find compelling – for example if I ask the doctor and he states that you are likely to need to take unscheduled breaks due to crying spells 3 or more times a day, 3 or 4 days a week, I know that any vocational expert your judge uses will testify that this level of absenteeism is unacceptable for any type of competitive work.
What Does Not Matter to Social Security
- it does not matter that you have no transportation to a job
- it does not matter that you could not survive financially with an entry level job
- it does not matter that you believe no one would hire you
- I am finding that judges are less inclined to approve claims when the only treatment is at the VA. Further, Social Security will not honor a 100% service connected disability rating from the VA – it is a factor but not a determinative one.
- I am also finding that judges expect to see on-going and extensive counseling with one or more psychologists. Treatment by your family doctor – including medication management – is not sufficient.
