Getting Disability Benefits for Dysthymia

Dysthymia (dis-THIGH-me-uh), also known as persistent depressive disorder, is one of the two main types of clinical depression, along with major depressive disorder. The symptoms of dysthymia aren't as intense as those of major depressive disorder, but they can last longer—at least two years according to diagnostic criteria. If you've been diagnosed with dysthymia, you might find it hard to enjoy even happy occasions and become withdrawn in social situations. Dysthymia can also result from illnesses that limit your physical activities or cause pain.

Social Security recognizes that symptoms from mental illness can prevent you from working. For example, if your concentration is poor as a result of your dysthymia, you might not be able to complete even the simplest tasks at work. If you've been struggling with dysthymia for a long time and find it difficult to hold down regular employment, you should be aware of what it takes to qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Is Dysthymia a Disability?

The Social Security Administration (SSA) defines disability as being unable to engage in substantial gainful activity for over a year due to a medically determinable impairment. Because dysthymia involves having ongoing depressive symptoms at least two years, claimants with a dysthymia diagnosis shouldn't have a problem meeting this "durational requirement." But that's only one step in the disability determination process—you'll still need to show that your symptoms cause significant functional limitations that keep you from working.

Symptoms of Dysthymia

The symptoms of dysthymia are similar to, and may overlap with, the symptoms of major depression. They can include:

• changes in appetite, such as overeating or not eating
• changes in your sleep cycle, such as insomnia or oversleeping
• low energy or fatigue
• poor concentration or difficulty making decisions
• feelings of hopelessness, and
• low self-esteem.

Typical treatments for dysthymia include antidepressants and talk therapy. Your doctor might also recommend that you make changes in your lifestyle, such as starting regular exercise if you lead a sedentary lifestyle.

Dysthymia On Its Own vs. Combined With Other Conditions

Getting disability benefits for dysthymia alone can be challenging. The SSA might find that, while your symptoms prevent you from doing many jobs, you're still able to do work that doesn't involve a lot of contact with other people. But if you can't manage even minimal social interactions, all types of jobs might be ruled out for you.

People with dysthymia are often diagnosed with other conditions, like anxiety or bipolar disorder. Dysthymia can also magnify physical conditions such as fibromyalgia. The SSA will look at the total effect of your symptoms when determining whether you can work, so even if your dysthymia isn't disabling by itself, it can add up to a finding of disability when combined with other impairments.

When Does Dysthymia Qualify for Disability?

You may be able to qualify for Social Security disability benefits due to dysthymia if your residual functional capacity (RFC) rules out your past jobs and any other work in the national economy. Your RFC is a set of restrictions that reflect what kinds of job tasks you can still perform despite your medical condition. An RFC for somebody with dysthymia will likely contain mental limitations, such as being unable to focus for a certain percentage of the day, a prohibition against performing skilled work, and not being able to work around the general public.

The more severe your symptoms are, the more restrictions you'll have in your RFC—and the more likely no jobs will be available that you can perform. Somebody with mild dysthymia, for example, may be precluded from work involving complex problem solving (but can perform simpler tasks) while somebody with severe dysthymia might not be able to follow basic instructions on a regular basis.

If you're unable to perform even the least mentally demanding job duties full-time, Social Security will award you disability benefits. And if you're at least 50 years old and physically limited to light or sedentary work in addition to your dysthymia symptoms, you may have an easier time getting disability under the medical-vocational grid rules.

What Evidence Do I Need to Get Disability for Dysthymia?

The SSA makes its disability determinations by looking at your medical records and self-reported activities of daily living in order to see whether you're still capable of full-time work. Therefore, it's very important that you provide the agency with all the information it needs to understand the ways in which your dysthymia affects your life.

Disability Function Report

Part of your disability application includes a questionnaire called the function report. In the function report, make sure to tell Social Security in detail how your dysthymia makes it harder for you to do activities like go grocery shopping, pay your bills, or cook a meal. Because a lack of energy or motivation is one of the most common symptoms of dysthymia, if you're struggling to complete even basic chores like taking a shower or getting dressed, the SSA needs to know.

Treatment Notes From Your Medical Providers

In addition to your function report, Social Security will want to see that you've been receiving consistent treatment for your dysthymia. The SSA will send you a release form, asking for permission to obtain your medical records. Once you've given the green light, the agency will review your doctors' treatment notes to see what they have to say about your mental state. Ideally, your medical record will contain most, if not all, of the following:

• progress notes showing that you're regularly going to a doctor or therapist
• your doctor's observations about how you're feeling and acting during a visit
• comments about the effectiveness of medications you're taking, and
• mental status examinations showing any abnormalities in your thinking.

If you have a doctor or counselor whom you've seen consistently for a long time—say, over a year—it can be very helpful to your disability claim to ask one or both of them to write a medical source statement about your dysthymia. The SSA values the opinions of mental health providers who've seen your ups and downs over time, and who can shed light on how your mental limitations might prevent you from working.

Will I Have to Attend a Medical Exam?

Unless you have extremely comprehensive medical records, it's likely that the SSA will schedule you for a consultative mental examination on the agency's dime. During the hour or so that you're expected to attend the exam, a doctor—who is paid by Social Security to conduct mental evaluations but isn't an employee of the agency—asks you questions designed to assess your memory and abstract reasoning. The doctor then submits a report to Social Security containing their assessment of your mental RFC, which will then become a part of your medical records.

Dysthymia VA Disability Rating

Veterans who have service-connected dysthymia may qualify for disability compensation from the VA. The amount of compensation you can receive from the VA depends in large part on your disability rating, which is in turn based on how severe your mental health symptoms are. The VA uses the Schedule for Rating Disabilities to assign a percentage rating to veterans according to how significantly their disorder limits their functioning.

The diagnostic code for persistent depressive disorder (dysthymia) in the Schedule for Rating Disabilities is 9433 and is evaluated under the General Rating Formula for Mental Disorders. Under the formula, you may be assigned a rating of 0%, 10%, 30%, 50%, 70%, or 100%, depending on the extent of your symptoms.

Applying for SSDI, SSI, or VA Benefits

An easy way to apply for Social Security disability benefits is through the agency's online web portal. You can also file a claim over the phone by calling the national disability hotline at 800-772-1213 (TTY 800-325-0078) between 8 a.m. and 7 p.m., Monday through Friday. If you'd prefer to apply in person, you can make an appointment at your nearest Social Security field office.

Veterans can apply for benefits by submitting VA Form 21-526, Application for Disability Compensation and Related Compensation Benefits. The VA encourages veterans to submit this form electronically, but you can also print it out and bring it with you to your regional VA field office.

You can find more detailed information about how to begin your application in our articles on filing for Social Security benefits and filing for VA disability compensation. Veterans who are interested in submitting an application to both the SSA and the VA should read our article on what veterans should know about filing for Social Security disability.

How Hard Is It to Get Disability for Dysthymia?

It can be challenging to qualify for disability benefits based on dysthymia because the nature of the disorder involves "milder" symptoms of depression over a longer period of time. Many medical professionals, including psychologists and psychiatrists, might not recognize the symptoms of the disorder or brush off your concerns as being "not that bad" or "just part of life." Convincing a VA or SSA claims examiner that these symptoms not only exist, but cause significant difficulty in your daily functioning, can seem like an uphill battle.

Before you file your application, you may want to consider speaking with a disability attorney about your case, particularly one with experience handling dysthymia claims. Having a lawyer by your side as you navigate the disability determination system—including the likely appeals process—can greatly increase your chances of getting benefits. Disability lawyers don't get paid unless you win your claim (and many offer free consultations), so there's little risk involved for a potentially large reward.