The Process

Social Security goes through a step-by step process to determine if you are medically eligible for benefits.  The first step is to collect your medical records.  If you have been treated for your condition, you need to turn that information in.  List all doctors, counselors, hospitals, mental health centers, and other treatment facilities you have been in. Social Security pays those entities to send your records in to them.  If you haven’t been able to afford regular treatment, Social Security can send you to a medical professional for a complete evaluation that they pay for. This doctor cannot treat you; they simply do an evaluation that they then send to Social Security.

With bipolar disorder, a key factor in being allowed for benefits is the frequency of your episodes.  I was found eligible because I had experienced both manic and depressive episodes at a certain frequency.  You can also be found eligible depending on the type of difficulty you are having working.  You can be allowed on what is called your “mental residual functional capacity” which is Social Security’s term for what kinds of work functions you are still able to perform.  If you are found unable to do skilled or unskilled work, you can be allowed for benefits.  If you have restrictions in being able to interact with people, you can be found eligible as well.

When reporting your symptoms, particularly if you do not have regular treatment, be as specific and honest as possible.  If you are taking medication and have side effects, make sure you report those as well, particularly if you have had to discontinue certain medications because of the severity of the side effects.  If you are noncompliant with treatment, that can affect whether or not Social Security will allow you for benefits, depending on the situation.  If you have co-existing diagnoses, be sure to include those in your information as well.

I was sent on an exam by Social Security, but since I had regular treatment, I was able to schedule the appointment with my treating psychiatrist.  The exam consisted of my doctor asking me about my current functioning day to day and about my difficulties working.  Depending on your diagnosis, you may also do psychological testing, such as IQ testing and memory testing.

If you are allowed for benefits, you will get a notification from Social Security telling you your onset date (when you became eligible) and how much you will receive in benefits.  Keep this letter for your records.  If you are denied, you have avenues to appeal this decision.  Do not get discouraged if you are denied the first time.  Tell the Social Security office that you want to appeal this decision.  Your case will be reviewed again by the agency that issued the denial, depending on if you were denied because of medical or financial considerations. IF you are denied again, you can appeal that decision as well, going before a judge versed in Social Security law.  Contrary to what some may tell you, you do not need a lawyer to appeal to the judge—you can handle your own appeals.  Avenues for appeal exist even after this level—Social Security can inform you about your options at that point.


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