Social Security Disability and SSI Benefits for OCD

If obsessive compulsive disorder disrupts your ability to work, you may be able to get disability benefits from Social Security.

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If obsessive-compulsive disorder, or OCD, significantly interferes with your ability to hold a job and maintain social and personal relationships, you should be able to get disability benefits.

How Does OCD Affect Your Functioning?

Obsessive-compulsive disorder is a psychiatric condition characterized by obsessions (constant unwelcome ideas and feelings) and compulsions (repetitive tasks a person is compelled to do to alleviate the obsessions). Obsessive thoughts can include the fear of contamination by germs, followed by cleansing, and the fear of pending danger or disaster, relieved by checking door locks, faucets, stoves, etc., as well as hoarding and ordering. OCD compulsions can be time-consuming, taking an hour or more a day.

Those with OCD remain locked in an uncontrollable cycle of obsession followed by compulsion, because any attempt to resist a compulsion causes their anxiety to rise to a level that is unbearable, and their tension can be relieved only by performing the required compulsive action. This can make it difficult to focus on a task, work, and hold down a job, and thus can lead to disability if untreated.

Obsessive compulsive disorder may, in some cases, be related to a brain injury or infections. Obsessive-compulsive disorder is often a chronic condition that evolves into clinical depression. In fact, many individuals with OCD are treated with anti-depressant medications.

Disability Benefits for Severe OCD

OCD is evaluated by the Social Security Administration (SSA) as an anxiety-related disorder. For you to get benefits for OCD, your symptoms must be so severe that, even with treatment, you experience severe anxiety or disturbing behavior that interferes with your ability to work. You prove this by meeting the requirements of the OCD part of the anxiety disorder listing.

To meet the listing, you must first have a diagnosis of OCD characterized by either an involuntary, time-consuming preoccupation with intrusive, unwanted thoughts or by repetitive behaviors aimed at reducing anxiety. In addition, you must show that you have a loss of abilities: either an extreme limitation in at least one of the following areas or a "marked" limitation in two of the following areas:

  • learning, understanding, and remembering information and instructions
  • interacting with others using socially appropriate behaviors
  • concentrating on and finishing tasks, and/or
  • managing your behavior, regulating your emotions, caring for yourself, and adapting to change.

Note that "marked" is worse than moderate—you can think of it as seriously limiting.

Alternately, if you can't show that your functional limitations are not currently as severe as the above requirements because you have been living in a highly structured or protected situation or undergoing intense therapy, you may be able to get benefits if you can show that you've had OCD for at least two years that is being managed by treatment and that you have minimal capacity to adapt to demands that are not already part of your daily life or to changes in your environment.

Medical-Vocational Allowance for Less Severe OCD

The SSA may not believe that your symptoms are severe enough to qualify under its official listing for OCD; for instance, say your OCD severely interferes with your ability to concentrate at times, but it doesn't interfere with your social functioning or comprehension, or ability to manage yourself. In this case, you might be able to get benefits through a "medical-vocational allowance."

Your first step will be to prove that you can't work at your old job (say you were an accountant) because your symptoms prevent you from focusing for long periods of time or your perfectionism prevents you from working at a reasonable pace. Perfectionism compels people to repeatedly check for potential mistakes or errors that might reveal their own faults, because the thought of appearing imperfect causes them intense anxiety. People suffering from perfectionism often need constant reassurance that they have performed a task properly.

If the SSA is convinced you can't do your old job, it will see whether there are any other jobs you can be expected to learn and do. You would then have to show the SSA that you don't have the skills or education to do even a simple unskilled job, which will be hard to do. Unless you have a physical limitation as well, the SSA will likely say that you can do a job involving simple, routine tasks, such as bagging groceries. You would have to show that your compulsions or ability to focus interfere with your ability to do even simple, routine tasks like this.

Proving your limitations are severe will require that you have a strong medical record that shows you have ongoing and regular treatment with a qualified mental health professional, preferably a psychiatrist, because you will need a doctor's help in showing the SSA the severity of your condition. For more information on proving that you can't do simple unskilled work, see our article on mental medical-vocational allowances.

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