Getting Disability Benefits for Bipolar Disorder
If you have symptoms of mania, such as hyperactivity, distractability, pressured speech, or paranoia, as well as symptoms of depression, 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). 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 affective (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 and a history of specific, severe symptoms of both depression and mania, even if you currently are experiencing the symptoms of only one or the other.
First, you are required to have had any three of the following symptoms of mania, which are typically present in bipolar disorder I:
- excessive activity and energy (hyperactivity)
- 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 or insomnia
- easy distractibility
- takes risks by partaking in activities with likely painful consequences, or
- paranoid thinking, delusions, or hallucinations.
People with bipolar disorder II often exhibit hypomania, a milder form of mania, and so may not have the above required symptoms even though they have the required symptoms of depression, below. These bipolar patients may be able to qualify for disability under the depression listing if their depression is severe enough.
Second, you are also required to have had any four of the following symptoms of depression:
- decreased energy
- difficulty concentrating or thinking
- loss of interest in most activities (or anhedonia, the loss of ability to enjoy previously enjoyed activities)
- lack of physical movement, difficulty doing routine physical activities
- appetite disturbance with weight gain or loss
- disturbance of sleep
- feelings of worthlessness or guilt
- suicidal thoughts, or
- paranoid thinking, delusions, or hallucinations.
Third, the SSA requires that your bipolar disorder causes any two of the four of the following problems:
- repeated, extended episodes of decompensation (worsening symptoms)
- severe difficulties in maintaining social functioning
- severe difficulties in maintaining concentration, persistence, or pace, or
- severe restriction of activities of daily living (ADLs).
Alternatively, you might be able to qualify under bipolar disorder without fulfilling any of the above three requirements if your diagnosed bipolar disorder has lasted at least two years and has improved somewhat with medication and support, but you aren't expected to be able to work because your condition limits your ability to do even basic work activities and you have one of the following:
- repeated episodes of decompensation (episodes of worse symptoms, each of extended duration
- a condition such that even a minimal increase in mental demands or a change in your environment is predicted to cause you to decompensate, or
- a one- or two-year history of inability to function outside a highly supportive living arrangement, and signs that you’ll need to continue the arrangement.
Qualifying for Disability Based on Reduced Functional Capacity
If you don’t qualify under the SSA’s strict requirements for bipolar disorder, above, the SSA will next consider your bipolar symptoms and to what extent they impair your ability to work (such as your ability to concentrate, follow directions, remember details, and have appropriate social interactions). The SSA will give you a rating of the type of work it thinks you can do (skilled work, semi-skilled work, unskilled work, or unskilled work). This is called your residual functional capacity (RFC), and in the case of bipolar disorder, it’s called a mental RFC rather than a physical RFC. (For more info, read Nolo's article on how Social Security uses mental RFCs.)
Next the SSA will determine if there is any kind of work you can be expected to do at your RFC level. 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 jobs you can't do that there aren't any left you can do.
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 hypomania (milder than mania) and depression (though the depression isn't as severe as major 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 have 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, if you’re filing for SSDI benefits only (if you have paid enough taxes into the Social Security system), you can apply online. 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.