Social Security Disability and Post-Traumatic Stress Disorder

The Social Security Administration awards disability benefits to persons suffering from post-traumatic stress disorder.  The years of job harassment I experienced as an employee at the law firm of Akin, Gump, Strauss, Hauer & Feld were stressful and likely resulted in trauma.  I experience typical symptoms of PTSD in the form of avoidance (fear of re-entering the job market); traumatic memories and hypermnesia (as evidenced by my obsessive rumination about my experiences on this blog); and intense anger (the U.S. Marshal Service affirmed that I exhibited a disturbing level of anger in my writings about my employment experience and imposed continuing and indefinite protective measures against me to insure that I do not endanger the lives of protectees in their jurisdiction).  I also suffer from insomnia, for which I have been continuously medicated since the year 1999; insomnia is a typical symptom of PTSD.

Victims of workplace mobbing frequently suffer from: adjustment disorders, somatic symptoms (e.g., headaches or irritable bowel syndrome), Post Traumatic Stress Disorder, major depression.

In mobbing targets with PTSD, Leymann notes that the “mental effects were fully comparable with PTSD from war or prison camp experiences. Some patients may develop alcoholism or other substance abuse disorders. Family relationships routinely suffer. Some targets may even develop brief psychotic episodes, generally with paranoid symptoms. Leymann estimated that 15% of suicides in Sweden could be directly attributed to workplace mobbing.

Degrees of mobbing:

First degree: Victim manages to resist, escapes at an early stage, or is fully rehabilitated in the original workplace or elsewhere. Second degree: Victim cannot resist or escape immediately and suffers temporary or prolonged mental and/or physical disability and has difficulty reentering the workforce. Third degree: Victim is unable to reenter the workforce and suffers serious, long-lasting mental or physical disability.

PTSD, or post traumatic stress disorder, cases are approved by disability examiners and administrative law judges in two separate ways. The first route for approval is for indivduals whose medical record documentation satisfies the requirements of the relevant listing, which, in this case, is listing 12.06 (from the social security list of impairments titled "Disability Evaluation under Social Security", a.k.a. the blue book). The second means of approval is the manner in which the great majority of SSD and SSI disability claims are approved, the medical vocational allowance.

In a medical vocational allowance, the disability adjudicator, or decision-maker, has already determined that it will not be possible to award benefits on the basis of meeting, or equaling, the requirements of a listing in the blue book. However, the claimant's condition will still present itself as severe enough to:

A) Rule out the possibility of the claimant returning to their past relevant work and

B) Rule out the possibility of the claimant switching to some form of other work (that without their condition they might have been thought capable of performing but due to their condition are deemed incapable of transitioning to based on a combination of medical and vocational factors).

In other words, when a medical vocational allowance is given, the claimant's medical records and work history have both been evaluated and the determination has been made that they cannot work in a former job and cannot work at some type of other other work while earning a substantial and gainful income.

Most social security disability and SSI disability cases that are approved are approved via medical vocational allowances. However, some cases are approved according to what is, arguably, a stricter standard. And that is by satisfying the listing requirements for a given impairment.

In the case of PTSD, or post traumatic stress disorder, the listing used to consider an application for benefits is the anxiety disorder listing. By reading the listing you may note that there are three separate sets of criteria, neatly designated as A and B and C. In order to be approved for PTSD on the basis of this listing (though, please recall as we mentioned above, the listing is not the only way for a PTSD applicant to be approved for disability benefits), a claimant's medical records must always satisfy the A criteria and, in addition to this, satisfy either the B or C criteria. In other words, satisfying the listing means satisfying the A and B criteria OR satisfying the A and C criteria.

To satisfy the A criteria, a claimant's records must document at least one of five separate findings, including:

1) Recollections of a traumatic experience,

2) Obsessions or compulsions of a recurring nature,

3) A fear of a situation, object, or activity that is irrational and so persistent that it results in a compulsion to avoid the source of the fear,

4) The occurrence, at least once per week on average, of severe panic attacks, characterized and accompanied by fear, intense apprehension, and feelings of impending doom, and terror, and finally

5) Generalized persistent anxiety which is accompanied by at least 3 out of 4 signs or symptoms which may include autonomic hyperactivity, apprehensive expectation, motor tension, or vigilance and scanning behavior.

To satisfy the B criteria, there must be documentation available to prove to a disability claim decision-maker that at least two of the following apply:

1) That the claimant is restricted in his or her normal daily activities, to a level that is marked,

2) That the claimant has marked difficulties in maintaining social functioning,

3) That the claimant has difficulty in maintaining their concentration, persistence, or pace to a level that is marked,

4) That the claimant has episodes of decompensation, that are repeated and of extended duration.

To satisfy the C criteria, the claimant's medical record documentation must satisfy the A criteria listed above and must also prove that the claimant's condition results in the complete inability to function independently ouside of their home.

So, to recap again, for an individual with post traumatic stress disorder to be approved for disability benefits on the basis of the anxiety disorder listing, their medical records must show that the A and B criteria are met, or that the A and C criteria are met.

As you should take note, what is in your medical records means everything to the processing of a social security disability or SSI disability claim. What should your mental records have to say about your condition? Ideally, they should address what the social security administration has indicated in the handbook used by disability examiners. As the blue book states, for cases involving PTSD "documentation of the anxiety reaction is essential". The manual further states that:

1) There should be at least one description of the anxiety reaction that is detailed.

2) The description of the claimant's typical anxiety reaction should include information regarding its nature, how long it lasted (duration), how often such reactions occur, the effect that the anxiety reaction has on the claimant's ability to function, as well as incidental factors that may exacerbate or precipitate the ocurrence of the anxiety reaction.

3). The description of the claimant's anxiety reaction, if it is provided by a physician or a psychologist, should indicate whether or not the description of the anxiety reaction is reflected by the doctor's own observations.

To find more information about the ssd and ssi programs, view the links below. What follows after is an informational write-up on PTSD:

1. How to apply for social security disability

2. How to qualify for social security disability or SSI disability

3. Before you apply for social security disability... (consider these things)

4. Don’t Miss Your Social Security Medical Exam Appointment

5. Social Security Disability May be From Several Impairments, Not Just One

6. Is Winning Disability From Social Security Quickly Really Possible?

7. How does social security decide disability appeals?

Post Traumatic Stress Disorder

Post traumatic stress disorder (PTSD) is just as the name implies: a stress disorder that develops after a highly traumatic event, whether the event is physical or psychological. In the past it has also been called post-traumatic stress syndrome, war neurosis or shell shock and is an anxiety disorder due to trauma. While it is common that post traumatic stress disorder affects servicemen or servicewomen who have been exposed to combat, it is also common due to childhood abuse, physical violence, sexual assault or any other act that may be perceived as life-threatening and traumatic, such as a fire, earthquake, hurricane or another catastrophic event.

Post traumatic stress disorder happens when the psyche has been shocked and traumatized so badly that it is unable to cope. This is unlike simple shock, depression or stress, in the fact that the body and brain chemistry actually change with post traumatic stress disorder. Those with the disorder usually show a high level of catecholamine and a low level of cortisol in their urine and a decrease in the volume of their hippocampus, a part of the frontal lobe of the brain that is also damaged during Alzheimer’s disease.

The criteria for post traumatic stress disorder is exposure to a traumatic event at some point in one’s life, flashbacks or nightmares related to the event, extreme fear of the event reoccurring, being significantly impaired in normal daily activities, avoidance, feeling hyper (sleeplessness, anxiety, anger) and having these symptoms for more than one month.

Treatment for post traumatic stress disorder can involve counseling, cognitive-behavioral therapy, psychotherapy, antidepressant drugs, antipsychotic medications, or a combination of one or more of these treatments. Also, sometimes Eye Movement Desensitization and Reprocessing (EMDR) helps to reduce the effect of traumatic events.