Can I Get Disability Benefits if Agoraphobia Keeps Me From Leaving My House?

Many people have an aversion to public places or feel anxious around large groups, but are able to handle basic activities such as grocery shopping with minimal assistance. But others have such an intense negative reaction to outside environments that it can confine them to their home and prevent them from engaging in simple interactions, a condition known as agoraphobia (uh-gor-uh-FO-bee-uh).

Social Security can find that severe agoraphobia is disabling when it keeps you from performing substantial gainful activity, or “SGA”, for at least one year. (You may be surprised to learn that the agency could award you benefits even if you’re able to work from home, as long as it doesn’t rise to the level of SGA.) Before you submit your application, it’s a good idea to familiarize yourself with the definitions and evidentiary requirements used by Social Security to determine whether you should be considered disabled.

When Is Agoraphobia a Disability?

The Social Security Administration (SSA) awards disability benefits to people who have a medically determinable impairment that keeps them from working full-time for 12 months or longer. This can include agoraphobia, a mental impairment that fits within the category of anxiety disorders. People with agoraphobia might have panic attacks just thinking about being in an environment that’s outside of their comfort zone, or experience some type of physical distress when they need to leave their house, like profuse sweating, increased heart rate, or trouble breathing.

Very extreme symptoms of agoraphobia may meet the requirements of Social Security’s Blue Book listing for anxiety disorders. “Listings” are medical conditions that the SSA considers severe enough to potentially qualify as automatically disabling, as long as your records contain specific findings. Even moderate symptoms can still make you eligible for benefits if they cause functional limitations keeping you from performing any full-time job on a regular basis.

Getting Disability Benefits for Agoraphobia by Meeting a Listing

Social Security evaluates agoraphobia under listing 12.06 for anxiety and obsessive-compulsive disorders. To get disability benefits by meeting this listing, your medical records will need to contain evidence of one or both of the following agoraphobia symptoms:

• panic attacks followed by an ongoing concern or worry about more panic attacks, and
• disproportionate (stronger than is necessary) fear or anxiety about at least two different situations, such as using public transportation, being in a crowd or line, or leaving your home.

You’ll also need to document how your agoraphobia interferes with your activities of daily living, and to what extent it causes you difficulty in the following areas:

• understanding, remembering, and applying information (like following directions)
• interacting with others using socially appropriate behavior
• concentrating on tasks long enough to finish them on time, and
• adapting or managing yourself (such as maintaining hygiene).

Your limitations must be “marked” in two of the above categories, or “extreme” in one, in order to meet the requirements of listing 12.06. Limitations are designated as marked when you can complete them independently, but with significant effort. If you have an extreme limitation, you can rarely (if ever) function in that area on your own.

Few people have agoraphobia severe enough to meet the strict criteria of listing 12.06. But mild or moderate symptoms of agoraphobia can be enough to qualify you for disability benefits if they keep you from working, especially if you have other physical or mental disorders. Getting benefits this way is known as a “medical-vocational allowance.”

Getting Disability Benefits for Agoraphobia by Showing That You Can’t Work

In order to determine whether you can work, Social Security will first need to assess your residual functional capacity (RFC). Your RFC is a set of restrictions that describes the most you’re capable of doing in a work environment.

People with agoraphobia will likely have an RFC that restricts the types of tasks they’re able to do and who they can work with. Limitations on jobs that involve public contact, such as cashier or server, are common. The more severe your agoraphobia is, the more limitations you’ll have in your RFC. Certain restrictions can rule out full-time work entirely, such as missing too many days of work because you can’t leave the house.

Once Social Security has assessed your RFC, the agency will compare your current limitations to the duties of jobs you’ve held in the past to see if you could do them today. Depending on your age, education, and work history, being unable to perform your past work might be enough to qualify for disability benefits based on a special set of rules known as “the grid.”

If the grid rules don’t apply to you (or you’re under the age of 50), but your RFC eliminates even the least stressful jobs with minimal public contact—whether due to excessive absences, reduced productivity, or other factors that are “inconsistent with competitive employment”—the SSA will find that you’re disabled.

What’s the Disability Check Amount for Agoraphobia?

Social Security doesn't award benefits based on the type of medical condition you have, so it won’t matter if you qualify for disability due to agoraphobia or another disorder. Rather, the amount you'll receive if you're approved depends on whether you qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Eligibility for SSDI is based on your employment history and the amount of work credits you’ve accumulated, while SSI is a needs-based benefit subject to income and asset limits. You can learn more about these programs—and calculate your estimated benefit amount— in our article on SSDI and SSI monthly check amounts.

VA Service-Connected Disability Compensation for Agoraphobia

Disabled veterans may qualify for benefits from both the SSA and the VA if they can show that their agoraphobia is service-connected (meaning it was the result of, or worsened by, their time on active duty). Unlike the SSA, which can only find that you’re disabled or not disabled, the VA assigns a disability rating percentage representing the extent to which your medical condition decreases your health and functioning.

Under the VA Schedule for Rating Disabilities (38 C.F.R. Ch. 4), agoraphobia is given the diagnostic code 9412 and evaluated according to the General Rating Formula for Mental Disorders. Compensable ratings of 10%, 30%, 50%, 70%, and 100% are available using the formula. (The criteria for each percentage are explained in more detail in our article about VA disability ratings for PTSD.)

Applying for Disability Benefits

Filing for Social Security is a fairly uncomplicated process. You can choose from the following methods:

• Apply online at the SSA’s website.
• Call the SSA at 800-722-1212 from 7 a.m. to 7 p.m. Monday through Friday. If you’re deaf or hard of hearing, you can call the TTY number at 800-325-0778.
• Visit your nearest Social Security field office and apply in person.

For additional details, check out our step-by-step guide on applying for SSDI or SSI. If you’re also interested in applying for VA compensation, you can find more information in our article on filing for veterans disabiliity benefits.

What If My Condition Doesn’t Qualify for Benefits?

Agoraphobia can be a tough condition to get disability benefits for on its own. Without strong medical records, disability judges and examiners can dismiss the condition as just being introverted or antisocial. If you weren’t awarded benefits on your first try, you can appeal the denial, preferably with assistance from an attorney who can effectively place your agoraphobia symptoms in the context of having a disabling mental health impairment.

An experienced disability lawyer can also help you gather medical evidence, stay on top of deadlines, handle communications with Social Security, and represent you at a hearing. Disability attorneys work on contingency—meaning they get paid only if you win—and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.