Updated March 31, 2017
Panic attacks are frequently cited on applications for disability, generally along with other psychiatric conditions, such as depression and one or more phobias, such as agoraphobia. It has been estimated that about 10% of the general public may experience one panic attack per year, and about one in sixty individuals in the US suffers from panic disorder at one time in their lives.
Generally, panic attacks are short, intense episodes of extreme fear or psychological distress. Some people describe them as a short period of apprehension or terror with a sense of doom. Symptoms may include heart palpitations, shortness of breath, sweating, hyperventilation, choking, paresthesias (a tingling sensation), and a multitude of other symptoms that may lead an individual to think they are dying or going insane.
A panic attack is different from normal feelings of being extremely worried or "stressed out," in that it occurs suddenly, without any warning, and without any way to stop it, and that the level of fear is way out of proportion to the actual situation.
A panic attack is not dangerous, but it can be terrifying, largely because sufferers feel they are not fully in control of their actions or emotions. Panic disorder often leads to other complications, such as depression, substance abuse, medical complications, and even suicide. Ironically, people with panic disorder often develop additional phobias that come from fear of the panic attack itself. In these cases, people will avoid certain objects or situations because they fear that these things will trigger another attack.
Many individuals learn to overcome panic attacks with the help of counseling and medication. However, an individual who has a severe panic disorder (recurrent, uncontrollable panic attacks) may experience nervous exhaustion or agoraphobia (the inability to leave the security of one's home). For those who continue to have panic attacks and these associated psychiatric conditions, it can be difficult to hold down a job. (For more information on related conditions, see our general article on anxiety disorders and disability.)
In its impairment listings, the Social Security Administration (SSA) lays out certain criteria that you must meet to get approved for disaiblity benefits. The SSA released a new listing for anxiety and panic disorders in January 2017, listing 12.06. To rise to the level of a disability for which Social Security will pay monthly benefits, this listing requires that you have been diagnosed with panic disorder or agoraphobia, with one or both of the following:
• Panic attacks followed by a persistent concern or worry about having additional panic attacks in the future, or worry about the consequences of future panic attacks, and/or
• Increased fear or anxiety about being in at least two different situations (for example, taking the bus, being in a public place, being in a crowded area, waiting in line, or being outside of your home).
You must also meet "functional" criteria to show that you have a loss of abilities due to your panic disorder. Generally, your panic disorder must cause you to 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 panic 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 active symptoms of their panic disorder or currently having panic attacks 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 stress would be greater. In other words, their condition is “marginal” in that it is expected that they would not be able to go to work without experiencing panic attacks if put in a work-like environment.
Medical documentation of your anxiety condition and the restrictions brought about by the condition is of the utmost importance. Disability claimants who suffer from panic attacks should maintain a consistent relationship with a qualified mental health professional, preferably a psychiatrist (more weight is generally given to the treatment notes provided by an MD). At the very least, a panic attack claimant who has no other treatment options should try to seek regular ongoing treatment from their local department of mental health.
Your doctor should include in his or treatment notes what your panic attacks are like, how long they last, how frequently they occur, and what brings them on, if anything. Most importantly, your doctor should describe how they limit you from doing things at home, at work, or socially. Also in your medical record should be a list of any medications you have tried or are taking, and how they affect your panic disorder.
If you don't meet the SSA's formal requirements (above) for an anxiety disorder to qualify for disability benefits, you might still be able to get disability benefits if your panic disorder severely limits the types of jobs you can do. For more information on this alternative way to get benefits, called a "medical-vocational allowance," see our article on medical-vocational allowances for mental disorders.