Social Security Disability and Major Depressive Disorder:
Major depressive disorder is a disabling condition that adversely affects a person's family, work or school life, sleeping and eating habits, and general health.
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.True clinical depression is an illness. It is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with daily life for weeks or longer.
Typically, patients are treated with antidepressant medication and may also receive psychotherapy or counseling services. Inpatient hospitalization may be necessary in situations which suggest a significant risk of harm to self or others. The course of the illness varies widely, from a single episode lasting weeks, to a chronic disorder with recurrent major depressive episodes.
A depressed person may report multiple physical symptoms such as fatigue, headaches, or digestive problems. Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. Acquaintances may notice that the person's behavior is either agitated or lethargic. Depression often coexists with physical disorders common among the elderly, such as stroke, other cardiovascular diseases, Parkinson's disease, and chronic obstructive pulmonary disease.
Various aspects of personality appear to be integral to the occurrence and persistence of depression. Although depressive episodes are often associated with adverse events, a person's characteristic style of coping may determine their outward coping ability. Low and distorted thinking are related to depression. It is not always clear which factors are causes and which are effects of depression.
For purposes of evaluating for Social Security disability entitlement the following criteria are consistent considerations of determining “disability” for depression:
Major depression includes at least one two-week period where at least five of the following symptoms are present: depressed mood most of the day for most days, diminished interest in activities once enjoyed, significant weight loss or weight gain, insomnia or hypersomnia nearly every day, psychomotor agitation or retardation, fatigue, feelings of worthlessness or hopelessness, poor concentration and/or recurrent thoughts of death. At least one of the symptoms must be depressed mood or loss of interest or pleasure.
Definition of Disability
SSA considers an individual to be disabled because of major depression if the symptoms prevent him from working and are expected to last at least 12 months or longer. For disability purposes, it is necessary to show that depressive episodes are recurrent. Having a single major depressive episode is usually sufficient for making a diagnosis of major depression. However, this fails to show that the condition is likely to last for more than a year.
SSA relies heavily on existing medical records, especially those within the past 12 months, for making a disability determination. This means that it is necessary that an individual who is applying for disability on the basis of major depression seek and comply with recommended treatment for the condition. Often, the Social Security Administration will schedule a Consultative Exam (CE) in order to document those aspects of the illness that may not be clear in existing medical records.
- Indicators are measurements that added to the diagnosis to help further explain features of the diagnosis. Mild, moderate, and severe are used to describe the severity of symptoms. If psychotic features, including delusions and/or hallucinations, are present, the indicator "with psychotic features" may be added to the diagnosis. If no symptoms of major depression have been present in more than two months, SSA may determine that the condition is in full remission. Indicators such as "severe" and "with psychotic features" increase the likelihood of an individual being awarded disability, while others such as "mild" and "in remission" significantly reduce the likelihood of disability benefits being awarded.
Once again, it is important that individuals applying for SSDI based on a diagnosis of major depressive disorder clearly articulate:
- How the condition impairs their ability to work. This can be accomplished by illustrating what their job entailed and how they did it before the onset of disability versus how their impairments impedes their ability to do their work after onset of disability.
- Describing ADL (Activities of Daily Living). This can be best be accomplished by illustrating what daily routine before the onset of disability versus activities of daily living after onset of disability. Individuals with major depressive disorder will have marked changes in social interaction and diminished interest in activities once enjoyed. These changes need to be accurately described.
- Establishing duration (Expected to last 12 months or longer) is a critical part of obtaining a favorable SSDI outcome. Chronic and/or recurrent episodes must be documented and their severity must also be consistent with SSA requirements for establishing “severity”.
An experienced and professional Social Security representative will know what documentation is required and how the claim needs to be presented to support both severity and duration of the major depressive disorder.
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