An anxiety disorder is a disorder in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. Anxiety disorders are the most common of emotional disorders.
Symptoms of anxiety disorders can include overwhelming feelings of panic and fear, uncontrollable obsessive thoughts, recurring nightmares, and painful, intrusive memories. Some also suffer from constant worry, irritability, insomnia, tiredness, difficulty focusing, and constantly being on alert for perceived threats. Physical symptoms of this condition can include increased heart rate, sweating, shaking, nausea, muscle tension, an easy startle reflex, and other uncomfortable physical reactions.
Anxiety disorder differs from normal feelings of nervousness, as the symptoms of anxiety disorder often occur for no apparent reason and do not go away. Rather than functioning as a call to action, these alarming reactions can make everyday experiences sources of potential terror. If left untreated, anxiety disorders can propel people to take extreme measures (such as refusing to leave the house) to avoid situations that may trigger or worsen their anxiety. Job performance and personal relationships inevitably suffer as a result.
There are several types of anxiety disorder. Generalized anxiety disorder (GAD) is characterized by at least six months of a more-or-less constant state of tension or worry, not related to any specific event. Panic disorder is characterized by repeated, unprovoked attacks of anxiety or terror lasting up to ten minutes. Social anxiety disorder (social phobia) involves fear of being negatively evaluated by others. Phobias are irrational, involuntary, and overwhelming fears that lead a person to avoid common objects, events, or situations, including social situations. In agoraphobia, there is fear of leaving the safety of one's home. Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent, and intrusive thoughts or impulses that the person may feel can be controlled by performing repetitive behaviors. Although OCD is no longer classified as an anxiety disorder, it is still evaluated under Social Security's listing as for anxiety disorders.
Note that PTSD is no longer evaluated as an anxiety disorder; it now has its own disability listing. (See our article on getting disability benefits for PTSD for more information.)
Not all cases of anxiety are severe enough to make an individual eligible for Social Security disability benefits. Disability benefits are available only to those who suffer a severe and marked impact on their lives as a result of their disability. For example, someone who just has mild anxiety and can still shower and get dressed every day and go grocery shopping and cook meals is not going to be eligible for benefits, but someone who experiences a significant interference with his ability to do normal daily activities may be able to qualify. In addition to the requirement that the disability be sufficiently severe, Social Security also requires that the disability be a long-term one. This means the inability to work due to anxiety must have lasted 12 months at the time of the application, or it must be expected to last for 12 months.
The Social Security Administration (SSA) provides guidance as to how severe anxieties, fears, or compulsions must be for them to make a person eligible for benefits. This guidance is found in the SSA's listing of impairments, which is a list of covered disabilities that provides details on what symptoms must be exhibited for those particular disabilities to be considered disabling.
Social Security published a new impairment listing for anxiety disorders, listing 12.06, in January 2017. The listing specifies that, for an individual to qualify for disability benefits on the basis of an anxiety disorder, he or she must have a diagnosis of anxiety disorder that is characterized by three or more of the following:
• difficulty concentrating
• muscle tension
• sleep disturbance, and/or
• getting fatigued easily.
In addition to having at least three of the above characteristics of anxiety disorder, you must also meet "functional" criteria to show that you have a loss of abilities due to the disorder. 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:
Note that "marked" is worse than moderate—you can think of it as seriously limiting. 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 therapy, you may be able to meet a second set of functional criteria. You can do this if your disorder has been medically documented as serious and persistent over a period of at least two years and you can show that you have been living in a highly structured setting or receiving ongoing medical treatment, mental health therapy, or psychosocial support that diminishes the symptoms of your mental disorder. You must also show that 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 stress and demands on them would be greater. In other words, their condition is “marginal” in that it is expected that they would not be able to perform the work if put in a work-like environment. In some cases, a person can fulfill this set of criteria by attempting to return to work and failing.
If the SSA finds that your symptoms don't fit into one of the above serious conditions, you may be able to get disability through a medical-vocational allowance (by showing you can't function enough to work). If an individual's generalized anxiety is so severe that it prevents them from performing any of their past jobs or any other type of work, they may be awarded disability benefits. Social Security disability examiners consider an individual's age, education, work history, and functional capacity when they make medical-vocational determinations.
Your claim will be assigned to a specialist for review, and you may be required to attend an interview or even undergo a consultative mental exam with an SSA-approved psychiatrist or psychologist to verify your condition. The process can take several months, but the more evidence and medical documentation you are able to provide, the better your chances of being able to get your claim approved. Qualifying for benefits on the basis of anxiety can be a challenge because this condition can be subjective to diagnose. You might find it helpful to consult with a qualified and experienced disability lawyer who can help you to get the evidence you need to convince the SSA that you are disabled enough to be entitled to benefits.
Note that the rules regarding disability for children are different; for more information, see our article on disability benefits for anxiety in children.