Getting Disability Benefits for Bipolar Disorder

If you have symptoms of mania such as hyperactivity and distractability that affect your functional abilities, you may be able to get disability benefits.

Bipolar disorder, also known by the name of manic depression, is a psychotic mental disorder involving both depression and mania (a mood characterized by euphoria, hyperactivity, fast talking, rapid thoughts, and sometimes poor judgment). In bipolar disorder, there is an expansive and elated mood (mania) that may cycle with depression; a less severe form is known as cyclothymia. Some people have “rapid cycling” of manic and depressive episodes, but for others a manic or depressive episode can last for weeks or months.

To qualify for disability benefits for bipolar disorder, your condition must be severe enough that either of the following are true, even with proper medication:

  • You meet the specific requirements for bipolar disorder that the Social Security Administration (SSA) has set out in its impairment listing on mood disorders (listing 12.04).
  • You can’t function at a high enough and consistent enough level to hold a basic, unskilled job.

Qualifying for Disability Benefits Based on the Bipolar Disorder Listing

To qualify under the SSA’s official listing for bipolar disorder, you must have a diagnosis of bipolar disorder I or II and a history of specific, severe symptoms causing a decrease in your abilities. This listing was updated signficantly in January 2017. Now, you must have at least three of the following symptoms:

  • unnaturally fast, frenzied speech (“pressured speech”)
  • quickly changing ideas and thought patterns (“flight of ideas”)
  • inflated self-esteem  (usually with false beliefs)
  • decreased need for sleep
  • distractibility
  • involvement in risky activities with painful consequences that are not recognized, and/or
  • increase in physical agitation (such as pacing or restless busyness) or in in goal-directed activity (such as taking on new projects).  

You must also meet "functional" criteria to show that you have a loss of abilities due to these symptoms. Generally, you must have an extreme limitation in at least one of the following areas, or a "marked” limitation in at least two of the following areas:

  • understanding, remembering, or using information (ability to understand instructions, learn new things, and apply new knowledge to tasks)
  • interacting with others (ability to use socially appropriate behaviors)
  • concentrating and maintaining pace in performing tasks (ability to complete tasks), and/or
  • adapting or managing oneself (ability to control behavior, adapt to new situations, and have practical personal skills like paying bills, cooking, dressing).

Note that "marked" is seriously limiting; it is worse than moderate. Extreme is less severe than a complete loss of an ability, but worse than marked. Marked and extreme are matters of professional judgment used by a SSA psychiatrist or psychologist when reviewing the  medical evidence.

Alternately, if you can't show that you currently have the functional limitations above because you have been living in a highly structured or protected situation or undergoing intense treatment, you may be able to meet a second set of functional criteria. You can qualify under this second set of criteria if:

  • your disorder has been medically documented as serious and persistent over a period of at least two years
  • you have been living in a highly structured setting or receiving ongoing medical treatment or mental health therapy that diminishes your symptoms, and
  • you have minimal capacity to adapt to demands that are not already part of your daily life or to changes in your environment.

This second set of functional criteria recognizes that there are some people who may not be showing symptoms such as not interacting well with others or being able to take care of themselves because they live in highly protected and supervised situations that makes their functional abilities appear better than would be the case in real-life situations where the demands on them would be greater.  

People with bipolar disorder II often exhibit depression and hypomania, a milder form of mania, and so may not have the above required symptoms. These bipolar patients may be able to  qualify for disability under the depression listing  if their depression is severe enough.

Qualifying for Disability Based on Reduced Functional Capacity

If you don’t qualify under the SSA’s requirements for bipolar disorder, above, the SSA must next consider to what extent your bipolar symptoms impair your ability to work (such as your ability to follow directions, remember details, and use judgment in making decisions). The SSA will give you a rating of the type of work it thinks you can do (skilled work, semi-skilled work, or unskilled work).  This is called your mental residual functional capacity (MRFC). (For more info, read Nolo's article on  how Social Security uses mental RFCs.)

If the SSA finds that you cannot perform even unskilled work (which might be true, for instance, if your concentration is markedly limited and you can't sustain an ordinary routine), the SSA might grant you benefits under a “medical-vocational allowance.” But if you didn't meet the official listing above, it’s likely the SSA will find that you can do at least unskilled work.  And since there are so many unskilled jobs in our economy, it’s unlikely that you’ll be granted disability benefits unless you are 55 or older and have no more than an elementary school education. For these reasons, most claimants applying for disability benefits for bipolar disorder either qualify under the official listing above (rather than with an RFC and medical-vocational allowance) or they don’t qualify at all. However, if you have a physical impairment in addition to bipolar disorder, your physical RFC combined with your mental RFC can rule out so many unskilled jobs that there aren't any left you can do.

Cyclothymia

Cyclothymia , or cyclothymic syndrome, is on the bipolar spectrum, but isn't as severe as true bipolar disorder. Cyclomythic syndrome is characterized by alternating moods of depression and hypomania (milder than mania) and depression. However, those with cyclothymia rarely qualify for disability benefits as they are usually highly functioning, and often in fact can be creative and super productive workers. However, if patients who have been diagnosed with cyclothymia have persistent, major depression (even though the episodes may be intermittent), they may be able to  qualify for Social Security disability benefits for depression  if their depression is severe enough.

Medical Evidence Required for Disability Based on Bipolar Disorder

At the SSA’s request, your treating doctor should submit to the SSA your psychiatric medical record showing the entire history of your bipolar disorder, including documentation of any severe or violent manic episodes. Your psychiatric record should include all treatments attempted, including any mood-stabilizing medications that you've tried, such as lithium, carbamazepine, or valproic acid, what your current prescribed therapy is, and whether you regularly comply with the prescribed therapy (bipolar patients often take a drug holiday leading to problematic episodes). Your medical record should also include the efficacy and side effects of each medication, and how their side effects, along with your symptoms, affect your daily activities, your functioning, and your ability to hold a job.

If there is evidence in your medical file that your doctor suspects your use of alcohol or drugs compounds your emotional problems, this can affect your claim. Learn more in our article on  how alcoholism and drug dependence affect disability claims.

Starting a Disability Claim

You can call the SSA at 800-772-1213 to set up an appointment to fill out an application for SSDI or SSI disability benefits, or you can apply online if you’re filing for SSDI benefits only or if you're applying for SSI and have never applied for SSI in the past and have never been married. When you fill out your disability application, include a detailed description of how your bipolar disorder affects your daily life, your social functioning, and your ability to make decisions, focus, remember information, and complete tasks quickly, and how often you have manic episodes and/or symptoms of depression. If you have both bipolar disorder and a physical impairment that makes it impossible for you to work, consider hiring a disability lawyer to help you file your Social Security claim, or if your initial claim gets denied, to file an appeal with the SSA.

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