Over 40 million Americans over the age of 18 suffer from an anxiety-related
disorder in a given year. That represents approximately 18% of the adult
American population in the United States. While most of these people can manage their condition with
medications and therapy, others cannot. For some, an anxiety-related disorder
can prove debilitating to the point that it prevents normal functioning on a
day-to-day basis. For such people, anxiety can make gainful employment
impossible and creates a financial catastrophe.
Fortunately, Social Security
Disability (SSD) or SSI can serve as a critical financial lifeline for those
people disabled by anxiety-related disorders. In this post, I will review the
criteria necessary to meet Social Security's medical listing for anxiety and, thus, qualify for
SSD or SSI benefits. It is important to note that you can still qualify for benefits even if your anxiety does not meet the level of the medical
listing. In that case, you will have to demonstrate that your anxiety (and
any other medical conditions) would prevent you from sustaining full time work
– 8 hours a day, 5 days a week.
Defining Anxiety-Related Disorders
The Social Security Administration (SSA) defines an anxiety-related
disorders as a condtiion in which either:
- anxiety is experienced consistently, or
- anxiety is felt when the individual tries to
overcome symptoms of another condition. Examples of this definition would be
anxiety experienced during attempts to confront a dreaded object or situation
for people suffering from phobias or during attempts to resist obsessions or
compulsions by those suffering from obsessive-compulsive disorder (OCD).
Medical Listing for Anxiety
A medical listing is a collection of medical criteria created by the Social Security Administration (SSA) for a particular condition to qualify for disaiblity benefits. If
your condition meets the criteria in the medical listing, you will meet the
medical requirements necessary for receiving Social Security Disability
benefits and be approved.
According to the SSA, an anxiety-related
disorder is a medically documented condition with at least one of the following
- Generalized persistent anxiety accompanied by
three of the four following groups of signs or symptoms:
- Motor Tension: trembling, restlessness, easy
fatigability, tension of muscles
- Autonomic hyperactivity: shortness of breath,
rapid heartbeat, dizziness, cold hands
- Apprehensive expectation: sense of impending
- Vigilance and scanning: increased startling,
trouble with concentration, feeling nervous/anxious/wound up.
- Phobic disorder: A persistent irrational fear
(phobia) of a specific object, activity, or situation that results in an
overwhelming desire to avoid such objects, activities, or situations.
- Panic attacks: Audden unpredictable onset of
intense apprehension, fear, terror and sense of impending doom that occur at
least once a week on average.
- OCD: Obsessions and compulsions that cause
significant anxiety or distress.
- Post-Traumatic Stress Disorder: Recurrent
intrusive recollections of a traumatic experience that cause marked distress
Does your condition cause severe functional limitations? The second consideration is whether your condition is severe enough to limit
you from working. You can satisfy this guideline in one of two ways.
- Demonstrate that the condition is significantly
limiting your ability to function by meeting two of the following criteria:
- Marked restriction of activities of daily
living. These are the activities that people do on a daily basis that allow them
to independently live their lives. These activities include grooming and
hygiene, using a telephone, cleaning your home, paying bills, and using public
transportation. In evaluating your ability to perform activities of daily
living, the SSA will also determine the extent to which you can perform them.
In other words, the SSA will determine if you can perform these activities
independently, appropriately, effectively, and for extended periods of time.
Through this evaluation, the SSA will determine the extent to which your
condition limits your ability to function on a daily basis.
- Marked difficulties in maintaining social
functioning. This describes your ability to interact effectively with other
people. To determine this, the SSA will look for any history of altercations,
evictions, termination of employment, avoidance of relationships and other
signs that your condition prevents you from establishing and maintaining social
interactions and relationships necessary for a functional role in both the workplace
- Marked difficulties in maintaining
concentration, persistence, or pace. This describes the ability to maintain
enough concentration to successfully complete tasks commonly performed in the
workplace. Such limitations are usually demonstrated through psychological
testing (mental status examination), prior work evaluations, or both.
- Repeated episodes of decompensation, each of
extended duration. This describes periods of exacerbation in which your anxiety
becomes so severe that you experience the marked functional limitations
described above. These periods of decompensation are usually identified in the
medical record as times when medications or treatments need to be significantly
altered and/or documentation is present expressing the need for a more
structured psychological support system (hospitalization, for example). The SSA
defines “repeated episodes" of "extended duration" as
three periods within one year (or an average of once every four months), each lasting
for at least two weeks.
- Demonstrate through medical records that you
have had an anxiety-related condition of at least two years and one of
- Repeated episodes of decompensation (worsening of symptoms) that last
for an extended period of time
- Demonstration that your disease is so severe that
even a minimal increase in mental demands or change in the environment would be
predicted to cause decompensation, or
- Documented history of one or more years of
inability to function outside of a highly supportive living arrangement with a
continued need for this highly supportive living arrangement.
Even if you do not meet the medical listing for anxiety conditions, you can
still obtain SSD or SSI benefits if you can demonstrate that you can't do your prior work and that, given your age,
education and work experience, you would be unable to perform any other work with the restrictions and functional
limitations caused by your anxiety disorder.