Ultimate Guide to Bipolar and Social Security Disability Benefits: 2022 Update

Bipolar disorder is a mental illness belonging to the group of affective disorders that is characterized by extreme emotional swings.  People with bipolar disorder typically experience mood “cycling” from emotional highs, referred to as mania or hypomania,  to emotional lows in the form of depression.    According to the Harvard Medical School each year 2.8% of Americans will be diagnosed with bipolar disorder.

Bipolar can adverserly affect the ability to work, and be the basis for social security disability benefits.

In one survey 88% of bipolar patients reported that their bipolar adversely affected their ability to work.  Bipolar syndrome is a serious mental illness, often downplayed in public discourse as lack of discipline or self-control.  Yet on average, it is estimated that having bipolar disorder decreases the life expectancy of those who suffer from it by 8 to 12 years.

With each manic, hypomanic, or depressive episode, the patient’s general health can deteriorate and, over time, the imprint of the disease makes it increasingly difficult to return to work.

Understanding  the Bipolar Disorder diagnosis

Bipolar affective disorder, formerly known as manic-depressive disorder, is a mental illness that is usually detected in the 20s or between 40s and 50s.

There are two types of bipolar disorder: type I and type II.  These two diagnosis share many characteristics, but differ fundamentally as follows:

• Bipolar type I includes manic episodes.  Bipolar type 2 does not but may include hypomanic episodes.
  • Manic episode is more serious and long lasting than a hypomanic episode.  Manic symptoms  create serious problems at home, work, or school and can result of psychiatric hospitalization and even psychosis (a break with reality).
  • Hypomanic episode symptoms are not as severe as those of a manic episode. While friends and coworkers may notice differences in behavior (“you sure are hyper today”)they don’t interfere much with daily activities, do not result in psychosis or end in hospitalization
• In Bipolar type II depression is the more dominant feature.

“Mania” is a key feature of Bipolar I.   It is a clinical terms that is important to understand when consideration disability and Bipolar I.  Mania is characterized by the following:

Inflated self-esteem and “grandiosity” often tied to fantasies or dramatically alterated perceptions

Grandiosity means having an elevated sense of self that does not reflect reality. For example, a bipolar sufferer in the midst of a manic episode might brag she possesses unique and extraordinary knowledge, ability and insight, and perhaps even that she has “magical powers.”

Decreased need for sleep

Increased sexual desire – often hyper and compulsive sexual activity

Irresponsible behavior such as compulsive shopping or gambling

 Irritability

 Disinhibition

This often leads to reckless behavior such as:

• Binge-drinking

• Risky sexual activity

• Excessive eating

• Impulsive and excessive spending

• Drunk driving

• Speeding

• Taking drugs

Increased productivity

Being more productive might sound like a good thing, but productivity during a manic episode is taken to the extreme. People may become hyper-focused on an individual task. They may spend an unusual amount of time on a task, such as chores, work, homework, or artistic projects. Often, they do this on very little sleep, yet they don’t feel tired.

 Pressured speech

A hallmark feature of a bipolar syndrome manic episode is fast and loud speech. Indeed, the words of a manic bipolar person can seem frenzied, urgent, and difficult to interrupt. The speaker may seem almost unable to control the pace and content of their speech, as if they are compelled to continue their loud and fast talking.  Pressured speech is further characterized as follows:

• unclear thought process when speaking
• presenting numerous ideas at once that don’t connect and clearly confuse the listener
• difficulty articulating thoughts

Bipolar II disorder is characterized by the appearance of hypomanic episodes (similar to mania but does not require hospitalization) that alternate with depressive episodes.

As noted above, in contrast to Biplar I, Bipolar II is characterized by-

• Hypomanic episodes not manic episodes. Think about the fact that the prefix “hypo” means “beneath” or “less than”. So hypomanic episodes are “not as bad” as manic episodes
• Depression in more predominant with Bipolar II.

Is Bipolar Disorder Disabling?

Bipolar I and II are  chronic affective disorders that typicially do not go away and can be disabling illnesses.  So can Texans suffering from Bipolar Disorder I or II qualify for social security disability benefits?  Yes, if the mental condition precludes any and all work activity. Let’s dig deeper into how social security analyzes a disability claim ased upon Bipolar Disorder.  One study indicates that bipolar I and II are among the top 20 causes of disability worldwide.  Inability to work and function can remain despite the bipolar syndrome being in remission: one study indicated taht from 30% to 60% of such in remission bipolar sufferers remained unable to work.

How to Get Disability for Bipolar Disorder in Dallas: 2 Paths

It is important to know that all disability claims are assessed using the same framework: The 5-step Sequential Evaluation Process. Take a look at “are you disabled?” to better understand the “roadmap” that social security will follow in determining if you are disabled.

The most direct path to a favorable social security disability decision based upon Bipolar Disorder is for the government to find that the condition “meets a listing”. A listing is simply a set on findings for a given illness that social security has found, through consultation with medical experts, would bee expected to result in inability to work. In general, listings are hard to meet (failure to meet a listing is not the end of the road for the disability claimant under the 5-step Sequential Evaluation Process) but are a more common path to victory in mental disability cases. So lets take a close look at the listing for Bipolar Disorder.

The Social Security Agency (SSA) establishes a series of requirements to determine if you are disabled. When the case of disability is specifically related to bipolar disorder, it is necessary to comply with the requirements stipulated in the list 12.04 of the SSA, which are similar to those described by the DSM-V.

Path 1: Blue Book Criteria for Bipolar Disability – Meeting the 12.04 Listing

1. The Blue Book states that your bipolar disorder medical history must prove that you have had three or more of the following:

• Pressured speech;
• Flight of ideas;
• Inflated self-esteem;
• Decreased need for sleep;
• Distractibility;
• Involvement in activities that have a high probability of painful consequences that are not recognized; or
• Increase in goal-directed activity or psychomotor agitation

AND

12. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:

• Understand, remember, or apply information
• Interact with others
• Concentrate, persist, or maintain pace
• Adapt or manage oneself

OR

1. Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
2. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder ; and
3. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life

Your case of disability for bipolar disorder satisfies the SSA requirements by meeting A + B or A + C criteria.

OK, that is a lot of words. But basically the listing for Bipolar Disorder presents 2 possible avenues to a favorable disability finding. The first requires at least 3 of a set of symptoms like pressure speech or flight of ideas, PLUS limitations resulting from the Bipolar Disorder in mental functions like interacting with others and managing oneself. The second way is for the Bipolar Disorder to be “of longstanding” (at least 2 years) and has simply been unresponsive to medical treatment and medication.

Path 2: You do no have the “Residual Functional Capacity” to Do Any Work

There is widespread misinformation on the internet on how to qualify for social security disability benefits based upon Bipolar Disorder.  Many present “meetin a listing” as the only way to qualify.  This is incorrect.

If the administrative law judge has found that you do NOT meeting the listing for Bipolar Disorder, under the required 5-step evaluation process she must continue to consider if you are disabled.  She must determine your residual functional capacity – your work-related functional abilities that remain after your bipolar symptoms are taken into account.   Simply put, what can you do despite your bipolar?  Administrative Law Judges typically focus on these critical functional abilitues:

• carry out simple instructions
• make simple work-related decisions
• respond appropriately to supervision and to co-workers, and
• handle changes in routine.
• Demonstrate reliability (chronic absences or time “off-task”)

The ability to maintain employment can be particularly important in a Bipolar Disorder social security disability case.  Manic and hypomanic phases often interrupt work attendence and performance.  The Bipolar Disorder sufferer usually has no trouble getting a job, and performing the job well at times, but often cannot live up to the reliability expectation of employers.