This is a very broad category that includes organic mental disorders; psychotic disorders; mood disorders such as depression, mania and bipolar syndrome; mental retardation; anxiety disorders, including post-traumatic stress syndrome; somatoform disorders (persisting physical symptoms for which there is no demonstrable organic cause); personality disorders; substance addiction disorders; and autism and other developmental disorders.

The diagnosis of most mental disorders is based on the presence of characteristic signs and symptoms as documented on mental status examinations, psychological testing and psychiatric treatment records. The severity of these disorders is determined by the extent to which they impair an individual's daily living activities, social functioning and concentration, or by the number and frequency of what Social Security calls "episodes of decompensation" (temporary attacks of acute symptoms accompanied by the loss of adaptive functioning).

It has been our experience that Social Security does an unusually poor job evaluating disability claims based on mental disorders.   These disorders are among the most frequently encountered in our practice. They are all capable of producing symptoms that can significantly limit an individual's ability to work, yet many people suffering from mental illness are initially denied when they apply for disability benefits.  

There are two things to bear in mind concerning claims based on mental disorders. First, it is difficult to prove the existence and severity of any mental disorder if a person is not receiving professional psychiatric treatment. The records of such treatment and the opinions of the treating psychiatrist usually provide the best evidence of disability. Individuals suffering from mental illness who are not receiving psychiatric treatment have a hard time qualifying for disability benefits.

The second point to bear in mind is that many of the symptoms of mental disorders can be effectively controlled with medication. To establish a disability claim based on mental illness, it is generally necessary to prove that an individual's symptoms have persisted despite treatment with medication. Mentally ill individuals who don't take their medication can expect to have trouble with the Social Security Administration.

A word about substance abuse: Social Security will not award disability benefits to individuals whose alcoholism or drug abuse is a contributing factor material to their disability. However, benefits may be awarded in cases where substance abuse is a symptom of an underlying mental disorder that is disabling in and of itself.   Benefits may also be awarded based on physical problems, such as liver damage and pancreatitis, that are the product of prolonged substance abuse. In such cases, benefits are awarded only if the limitations imposed by these mental or physical disorders are disabling in and of themselves.