Does Social Security Grant Disability Benefits for Borderline Personality Disorder?

Social Security recognizes that mental health conditions can significantly interfere with your daily life. If you have symptoms of borderline personality disorder that keep you from working full-time for at least a year, you may be able to receive disability benefits such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a mental health disorder that's characterized by significant mood instability and highly impulsive behaviors. People with BPD have difficulty controlling their emotions and often experience intense changes in their personality over short periods of time.

Symptoms of Borderline Personality Disorder

BPD is usually diagnosed by a mental health professional, such as a psychiatrist, after discussion of signs and symptoms. Common symptoms that could result in a diagnosis of borderline personality disorder include:

• looking at things in extremes, such as everything being bad or good
• frequent, wide mood swings
• rapid changes in interests and values
• patterns of unstable, intense relationships
• frequent displays of inappropriate, intense anger
• antagonistic behavior that leads to fights and other disputes
• impulsiveness, which often includes risky behaviors
• short, intense episodes of depression or anxiety (lasting no more than a few days), and
• fear of being abandoned that can lead to frantic efforts to prevent real or perceived abandonment.

Treatment for Borderline Personality Disorder

Like many related mood disorders, treatment for BPD mostly involves talk therapy and, in some cases, medication. Effective treatment for BPD (such as dialectical behavioral therapy) involves helping you learn skills to successfully manage your emotions, handle stress, and improve relationships.

Getting Disability Benefits for Borderline Personality Disorder

The Social Security Administration (SSA) has two ways that disability applicants with borderline personality disorder can qualify for benefits:

• Meet or equal a listed impairment. To "meet a listing," you must provide medical evidence of the criteria set out by a listing in the SSA's "Blue Book," which describes impairments that will automatically qualify an individual for Social Security disability. A medical expert may be able to testify that you equal the listing if you don't meet it exactly.
• Be unable to work. To show an inability to work, you must provide evidence that you can't do any job. Social Security will see if your mental and physical limitations rule out all jobs. The agency also looks at your age, education, and work history when determining whether any jobs exist that you can do.

Getting Disability for Borderline Personality Disorder by Meeting Listing 12.08

Social Security evaluates BPD under listing 12.08 for personality and impulse-control disorders. The SSA defines personality disorders as disorders characterized by inflexibility and an inability to adapt to different situations, which causes significant impairment in social relationships or the ability to get or maintain a job.

Meeting the requirements of the listing is a two-step process.

Pervasive pattern of symptoms. First, you'll need to show that you've been diagnosed with BPD and have medical documentation of a "pervasive pattern" (ongoing, not just a one-time event) of one or more of the following symptoms:

• inappropriate suspiciousness or distrust of others
• detachment from social relationships
• unstable personal relationships with impulsive and damaging behaviors
• disregard for and violation of the rights of others
• excessive emotionality and attention-seeking behavior
• feelings of inadequacy
• excessive need to be taken care of
• preoccupation with perfectionism and orderliness, and
• recurrent, impulsive, and aggressive behavioral outbursts.

Marked or extreme limitations. Then, you'll need to show that your symptoms result in an "extreme" limitation in one, or "marked" limitations in two, of the following areas of mental functioning:

• concentrating on tasks (completing tasks in a timely manner, ignoring or avoiding distractions while working, changing activities or work settings without being disruptive, working close to or with others without interrupting or distracting them)
• adapting or managing oneself (adapting to changes, controlling one's behavior, being aware of normal hazards and taking appropriate precautions)
• interacting with others (responding to suggestions, criticism, correction, and challenges appropriately), and
• learning, understanding, and remembering information (following oral instructions, using reason and judgment to make work-related decisions).

Extreme limitations are more serious than marked limitations. For example, somebody whose BPD causes them to need additional supervision and reassurance in order to complete chores—but who does eventually get them done—might have "marked" limitations in the area of concentrating on tasks.

But somebody who frequently loses their temper and refuses to do a simple chore, such as washing dishes, is likely to have an "extreme" limitation in that area.

Getting Disability for BPD by Showing an Inability to Work

If the SSA decides your symptoms don't meet the requirements of the personality disorders listing, the agency will consider whether your limitations should really be keeping you from working. To do this, Social Security will create a mental residual functional capacity (RFC) assessment for you.

A typical RFC for someone with BPD would list the mental limitations that make it difficult to hold down a full-time job. For example, an inability to control emotions and being easily angered are some obstacles that can prevent people with BPD from working full-time.

Additionally, BPD symptoms could make interactions with coworkers difficult or prevent proper responses to reasonable suggestions from supervisors. Anger problems can cause issues in customer service positions.

While some jobs are more solitary in nature, even in those positions an inability to control your emotions (such as becoming so frustrated at a task that you don't finish it) can result in a loss of workplace productivity.

Impulsive behavior can also have a significant impact on your decision-making process. Employers are unlikely to hire and retain employees who leave the work station too frequently or call out too many times.

Getting Medical Evidence to Support Your Disability Application for BPD

Social Security wants to see your specific symptoms and any laboratory findings from your psychiatrist or psychologist, as well as the effect of your impairments on your functional abilities and how long your impairments are expected to last. You should submit the following to the SSA with your disability application:

• medical records, including mental status examinations and psychological testing
• letters from doctors and therapists who you've seen regularly for treatment
• a statement in your own words describing how your BPD makes it difficult to work, and
• statements from others who have close contact with you, including other health care providers or family or friends.

Your medical records are the foundation of your disability application, so make sure you keep the SSA in the loop if you start a new treatment or begin seeing a new provider. If you haven't been able to access regular medical treatment for your borderline personality disorder, learn more in our article on getting approved for disability benefits without having seen a doctor.

Disability Benefits for Related Mental Health Conditions

About 85% of people with borderline personality disorder have other mental illnesses that are "comorbid" (meaning occurring at the same time) with a condition like:

• depression
• anxiety
• schizotypal disorders
• eating disorders, and
• bipolar disorder.

Additional conditions that often overlap with BPD include antisocial personality disorder, avoidant personality disorder, and intermittent explosive disorder. In children, oppositional defiant disorder can sometimes be a precursor to BPD.

For more information, see our article on mental illness and Social Security disability.