Bipolar Disorder - SSA Listing Level? Your Psychiatrist/Psychologist records are KEY.
Note: This article is for general information only and is not legal advice to any particular reader or individual. For legal advice, you must specifically retain a lawyer who evaluates your specific situation.
Impairment vs. Legally Disabling Impairment: Bipolar Disorder can be very limiting for some people in functioning reliably on a sustained basis in the realm of a full time job. This generally occurs if that occupation's requirements are incnsistent with those kinds of, or degree of, limitations.
Sometimes, despite the limitations, the SSA will find that there are other jobs that one can successfully perform with his level of limitation, even if he can't perform his prior job demands.
Everyone's Bipolar symptoms and limitations are not the same. At times, when treatment is not so effective as to allow someone the capacity to fulfill any occupation* (even simple, unskilled, no-education, routine, 'low-stress'), a person with a severe impairment of Bipolar Disorder will be found disabled by the SSA. Such a finding depends largely on the medical evidence and how the acceptable medical provider articulates the medical diagnosis, signs and symptoms, so that the extreme limitations are clear. All to often, mental health professionals (psychiatrist, psychologist and supporting therapist) fail to adequately record those details that would be illustrative of the true limitations, and this is to the great detriment of the patient/client.
It may be helpful for a claimant or would-be claimant to share to her mental health professional(s), the Blue Book Listing for Bipolar Disorder (see below) and ask that provider to carefully review each element and decide if his professional opinion of the claimant's condition a severity is that indeed meeting the Listing 12.04. The provider should point to specific medical documentation supporting her opinion on that element. Any experienced Social Security Disability representative or attorney can review the provider's opinion for completeness and determine if it demonstrates a listing has been met.
NOTE: The professional can best serve disabled patients/clients if she has, routinely in her historical documented records of her patient that are ultimately shared to the SSA, the "medical documentation" of each element required to meet the listing level. This, found properly in Mental Status Examinations performed at every session, or in psychotherapy notes** is OFTEN the biggest hurdle. If one's provider does not practice such a recording now (and officially ordering the records will let you know this, via an attorney you may ask to review same), NOW may be the time to ask him to start. Be careful, however. For some providers, not understanding SSA principles or having a bias against disability claims (while not bias against the need for treatment), this may backfire. Know your provider and whether he is a cooperative opinion sharer. The SSA Blue Book Listing for Bipolar Disorder, Depression and related disorders, found at https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#12_04 dictates as follows (emphasis ours):
12.04 Depressive, bipolar and related disorders (see 12.00B3), satisfied by A and B, or A and C:
A. Medical documentation of the requirements of paragraph 1 or 2:
1.Depressive disorder, characterized by five or more of the following:
b.Diminished interest in almost all activities;
c. Appetite disturbance with change in weight;
d. Sleep disturbance;
e. Observable psychomotor agitation or retardation;
f. Decreased energy;
g. Feelings of guilt or worthlessness;
h. Difficulty concentrating or thinking; or
i. Thoughts of death or suicide.
2. Bipolar disorder, characterized by three or more of the following:
a. Pressured speech;
b. Flight of ideas;
c. Inflated self-esteem;
d. Decreased need for sleep;
f. Involvement in activities that have a high probability of painful consequences that are not recognized; or
g. Increase in goal-directed activity or psychomotor agitation.
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
Understand, remember, or apply information (see 12.00E1).
Interact with others (see 12.00E2).
Concentrate, persist, or maintain pace (see 12.00E3).
Adapt or manage oneself (see 12.00E4).
C. 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:
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 (see 12.00G2b); and
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 (see 12.00G2c).
 "We will determine the degree to which your medically determinable mental impairment affects the four areas of mental functioning and your ability to function independently, appropriately, effectively, and on a sustained basis..." https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm
**See upcoming article regarding the HIPAA-derived voluntary excludability of psychotherapy notes from those medical records a provider is required to provide patient access to. The Mental Health Professional has the sole discretion to refuse to provide the patient this portion of his records, despite the patient's signed HIPAA request. While there are undoubtedly some valid reasons for the damaging exclusion, some Social Security professionals agree that a patient should have the right to "be excluded from the exclusion" at least within the context of a Social Security Title 2 or Title 16 claim. This exclusion has resulted in far to many actually disabled claimants being unable to prove his claim, due to the mass of supporting records being withheld. This attorney has personal knowledge of the forced homelessness and under-the-bridge-residence of a claimant after continued denial of a claim for this reason (later won, thankfully, but a painful journey).
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