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Originally Posted On: https://cannondisability.com/blog/disability-benefits-for-depression-listing-12-04/
DISABILITY BENEFITS FOR DEPRESSION – LISTING 12.04
WHAT IS DEPRESSION?
Depression is a mental health condition that brings on chronic feelings of sadness and low mood, loss of interest in activities, and trouble doing your daily activities. A case of depression can be mild or severe and last for a short or long time. For example, you may have a mild case of depression after a death in your family. Usually, if your depression is based on a certain event, like the death of a loved one, then the symptoms will not last for a long time.
However, depression is different for each person. For some, it may be feeling hopeless. While for others, it may occur along with physical symptoms such as fatigue and being unable to sleep. When it is severe, you may think about or act on thoughts of suicide.
Your mental symptoms may result in trouble with relationships at work, school, or in your home. Emotional symptoms of depression are a combination of feeling sad, anxious, and having problems dealing with your emotions. For example, you may find yourself feeling like you are on an emotional roller coaster. Additionally, you may avoid other people, when you used to be a social person.
Most people treat their mental health problems with medications and therapy. Sometimes, this helps reduce mental symptoms. When your symptoms are ongoing and keep you from working, then they become a serious issue that prevents you from working.
DEPRESSION CAN WIN SSD & MEDICARE BENEFITS
SSA benefits for depression are available if your mental symptoms are severe under SSA’s Listing 12.04. If your mental health symptoms prevents you from working for over 12 months, then submit an application for Social Security Disability Insurance (SSDI) & SSI benefits. Learn about how to file an application for SSD benefits.
There are two types of SSA benefits: Social Security Disability Insurance benefits (SSD) and Supplemental Security income benefits (SSI). If you are unable to work due to your mental health symptoms, then the SSA should pay you benefits. The SSA pays a monthly payment that replaces your income from work. Your monthly SSD payment amount is based on your past income. SSD benefits come with Medicare, a form of health insurance. Learn more about Medicare benefits.
Supplemental Security Income (“SSI”) benefits are different than SSD benefits. SSI benefits are an addition to SSD benefits. They are paid to you if your monthly SSD benefit is a low amount of money.
It is also a benefit you can receive if you have never had a job or even if you have only worked for a short period of time. In order to be paid SSI benefits you must meet SSA’s income and asset rules. SSI benefits, however, come with Medicaid benefits which provides health insurance. But, you must meet your state’s Medicaid income and asset rules. Read more information about Medicaid benefits.
WORK CREDITS AND HOW TO QUALIFY FOR SSD BENEFITS
To win SSD benefits, you must have earned enough work credits to qualify. You must have held a job in the past ten years where you paid taxes into the Social Security system. The number of Social Security work credits you need to earn is based on your annual wages and your age.
The amount of income required to earn a work credit changes every year. However, it is not very high. Every year of work earns a maximum of 4 credits per year. One for each quarter of work.
The number of work credits you need to qualify for SSDI depends on the age you are when you file for benefits. You can review your work history to find out how many work credits you have. In order to review your work history, create a MySSA account on Social Security’s website. It only takes about five minutes to create an account and then you have access to your personal work information.
You may already know that depression can impact your ability to work. Likewise, mental symptoms can make it difficult to concentrate at work. The symptoms can interfere with your ability to be on time. Also, they can make you call in sick to work. You may have already been fired from your job.
To get Social Security benefits, you will need ongoing treatment for your major depression. Ongoing treatment and being unable to recover is the evidence that will prove your case to the Social Security Administration. Remember, the burden to prove you should be paid benefits is on you. Therefore, make sure you submit all of your medical records to the SSA.
WARNING SIGNS & SYMPTOMS OF DEPRESSION
According to the National Institute of Mental Health (NIMH), about 20 million adults, which is around 8% of the US population, experienced at least one major episode of depression in the past year. Additionally, women are more likely than men to experience depression. For example, in 2019, the NIMH stated that 9.5% of adult women and 5.5% of adult men had an episode of major depression.
Furthermore, depression is not limited to adults. Mental health doctors report that about 3.4 million teenagers in the US, from age 12 to 17, had at least one major episode of depression in the past year. This accounts for 14% of the teenage population.
The main concern with these numbers is that depression carries a high risk of suicide. Thoughts and plans of suicide are serious in adults and teenagers. The warning signs include:
- Switching suddenly from sadness to being very calm
- Talking or thinking about death on a daily basis
- Loss of interest in activities or things you did before
- Ongoing trouble with sleeping at night
- Risky behavior that could result in death, such as speeding through red lights
- Making comments about being hopeless or worthless
- Putting your legal affairs in order
- Talking about suicide with friends and family
If you see these warning signs in yourself or others, then you should call your local suicide hotline. Additionally, you should contact a mental health professional and seek treatment. If you can’t afford to pay for mental treatment, we have a list of free and low cost mental health professional to help you. If all else fails, then visit the closest emergency room.
HOW TO WIN SSD BENEFITS FOR DEPRESSION
There are a number of forms of depression. For example, there is depression that can be brought on by circumstances. This can occur if you lose or loved one or go through a divorce. Typically, these kind of symptoms are temporary and will not prevent you from working on a long term basis. The kind of depression that results in benefits is chronic depression. It is also known as clinical major depression.
Chronic mental symptoms may start with a difficult life event, like a divorce. However, if you have ongoing depression, then once the event is over the symptoms continue. The symptoms prevent you from working. And, they can even stop you from doing your daily activities at home.
Don’t believe friends and family that say feeling depressed is a choice and you need to just get over it. Depressive symptoms don’t go away if you change your attitude. Instead, you need to understand that depression is a chemical issue in your brain. Like a broken bone, it needs to be treated in order to heal. Therefore, get treatment.
Additionally, in order to receive benefits for depression, you will need to file an application. You will also need to show that you meet or equal the elements of SSA listing 12.04. Remember, your symptoms must also prevent you from working for over one year. If you can work, then you do not qualify for SSD benefits.
Listing 12.04 is what the SSA uses to determine the symptoms of your mental health symptoms. If your depression is severe it will prevent you from doing your daily activities, dealing with other people, and working. You can apply for benefits, including SSI benefits, online at the Social Security Website.
SSA LISTING 12.04 FOR DEPRESSION BENEFITS
The SSA listing for depression is listing 12.04. There are three parts to the listing. In order to meet the listing, you must have part A and B or part A and C.
12.04 Depressive, bipolar and related disorders, satisfied by A and B, or A and C:
- Medical records that document the symptoms in paragraph 1 or 2:
THE PART B AND C CRITERIA OF THE DEPRESSION LISTING
AND
OR
- Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the condition over a period of at least 2 years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support, or a highly structured setting that is ongoing and that diminishes the symptoms and signs of your mental condition; 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.
Meeting listing 12.04 requires you to prove the above. However, the symptoms under Part B can be broken apart into single elements. For example, you would meet the Part B criteria if you had an extreme limit in the ability to “remember.”
You do not need to have an extreme symptom for every element under Part B. It only needs to be at the extreme level in one of the symptoms on the list. The same is true for marked limitations. For example, you could have a marked limit in your ability to concentrate and remember. That would meet Part B of the listing. In order to win benefits for depression, you can meet or equal listing 12.04. Learn more about using Part B to win mental health benefits.
SYMPTOMS OF DEPRESSION – LISTING 12.04 – PART A
Depression symptoms under Part A are fairly easy to prove. But, only if you have the proper medical records. The best medical records are from your psychologist or doctor. Not everyone can afford a doctor, but a treating doctor will usually be able to give you medications.
Medications that your doctor might give you could be Prozac, Wellbutrin, Effexor, Lexapro, or Paxil. These are only some standard examples of what your doctor may use to treat a mental health condition like depression. Additionally, you might be taking other medications for not being able to sleep, like Trazadone or Xanax. Medication, along with therapy, may give you relief from your symptoms.
Clinical depression is one of the most common mental health conditions. The symptoms in Part A can happen for a variety of reasons. But to win benefits under listing 12.04, your doctor should outline the following symptoms:
- sadness
- feeling hopeless
- chronic anxiety
- changes in your desire to eat
- sudden weight gain or loss that is more than just a few pounds
- feelings of guilt and also feeling worthless
- aches and pains with no injury
- sleeping too few or sleeping too many hours
- severe fatigue during the day
- concentration issues
- memory problems
- thoughts and actions of suicide
Some people with Depression receive treatment from a psychologist or counselor. If you get mental treatment, then you will have talk therapy. Likewise, a counselor provides weekly talk therapy or counseling.
Counseling is a useful therapy, because it can give you the tools and skills to deal with depression and symptoms of anxiety. Winning SSD benefits for depression requires you to present evidence of the Part A criteria.
DEPRESSION SEVERITY UNDER PART B
Part B of the listing shows that your symptoms are severe. In order to win benefits, you will need to prove two marked or one extreme element under Part B.
1. UNDERSTANDING, REMEMBERING AND APPLYING INFORMATION
Under Part B, the SSA is looking to see whether your symptoms are severe enough to keep you from working. First, you will need a marked limit in your ability to understand, remember, and apply information. This refers to having a serious limits in the ability to learn, recall, and use information at work. For example, this includes serious limits in the following:
- understand and remember instructions and procedures
- following one or two step instructions in order to perform a task
- identify and solve problems
- recognize a mistake and correct it
- asking questions of fellow workers and your boss, and
- using reason and judgment to make decisions at work
2. INTERACTING WITH OTHERS
Second, the Part B rules require a marked limit in dealing with others. For instance, this means serious limits in your ability to relate to and work with others. By others, they mean your boss, other workers, and the public. If you have trouble getting along, then you may have problems with:
- handling conflicts with others
- asking for help when needed
- sustain conversation with others at work
- understanding social cues, such as verbal or emotional cues of others
- being able to respond to criticism from your boss
- keeping social relationships free of problems
- get along with other workers
3. CONCENTRATION, PERSISTENCE AND PACE
There is also, under Part B, the issue of being able to concentrate, persist, or maintain pace. While this may seem like common sense, at work an employee must be able to complete tasks. If you are unable to do this because of depression, you cannot sustain a 40 hour work week. You must be able to:
- finish assigned tasks
- persist on a work task if there is a problem, instead of giving up
- maintain a required pace, one that is set by the work standard
- being able to focus on assigned projects
- work at a reasonable production rate
4. ADAPTING AND MANAGINE ONESELF
Finally, a marked limit in adapting and managing oneself refers to being seriously limited in the ability to control your emotions and personal behavior. This includes the ability to:
- respond to demands
- adapt to changes
- manage mental symptoms
- know the difference between good and poor work performance
- set goals
- make plans for yourself without the help of others
- maintain personal hygiene and attire appropriate to a work setting, and
- be aware of normal hazards and take appropriate safety steps
WHAT TO DO IF YOU DO NOT HAVE INSURANCE AND YOU NEED SSD BENEFITS FOR DEPRESSION
If you do not have health insurance, then there are still ways to get mental health treatment. If you are from Utah, then go to Utah’s Free and Low Cost Health Services. There you will find mental health resources that are free or low cost. Learn more information about Utah mental conditions.
Likewise, if you are from Nevada, you can go to Nevada’s Free and Low Cost Mental Health Services on our site. There you will find examples of clinics and treatment centers. These places provide mental health therapy. Sometimes they offer free therapy. Others offer it on a sliding scale. Don’t wait, call these resources today. Get yourself into treatment. Learn more about Nevada mental SSD benefits.
Make sure the psychologist or doctor you choose will support you through the benefit process. Also, ask your counselor to support you too. Some treating sources refuse to provide progress notes. Or, they refuse to write letters on your behalf. Don’t let this happen.
Ask you mental health source to keep and provide their notes to the SSA. Also, seek treatment from someone who will help you. You should also ask your treating mental health counselor if they will support you in your benefit claim. If they won’t submit their records. Or, if they refuse to help, then find a new counselor. Learn more, if you need free or low cost mental health care in Colorado.
MEDICAL EVIDENCE TO PROVE YOUR DEPRESSION
The hard part of winning benefits for depression is the burden of proving you need SSD benefits is on you. You must prove your case at each step of the five step SSA review process. Therefore, you must show with medical evidence, that you have the symptoms in Part A. But, what kind of medical evidence do you need? For example, you need progress notes from your doctor. Or, you need treating notes from your counselor.
In addition, you must also show your symptoms are so severe that they also meet the rules under Part B and/or C. You can learn more about how the Part B mental rules wins benefits. There are times where proving Part C is easier than proving Part B. This is particularly true if you are living in a “highly structured setting.” Learn more about the importance of medical evidence in proving your case for benefits.
For example, if you live in a state mental hospital or in housing that also provides mental health treatment, then you live in a controlled setting. If leaving that setting would make your mental symptoms worse, then you are probably meet the Part C rules. Therefore, you should be paid benefits.
Another important aspect of winning SSD benefits, is that the benefits also help your family members. For example, if you have a child under the age of 18, then they get benefits too. Likewise, if you win benefits such as SSD, after 24 months you can get Medicare benefits. Learn more about Medicare benefits.
If you receive SSI benefits, then you will also receive Medicaid benefits. These benefits are a form of health insurance and they help pay for mental health treatment. The goal is to use your health insurance to seek treatment. Then, hopefully, you will recover and be able to return to work.
DEPRESSION AND ANXIETY – TWO SIDES OF THE SAME COIN
Depression and Anxiety are two sides of the same coin. This means that mental symptoms can also include anxiety. For example, you may experience these symptoms: crying spells, sadness, and loss of interest in activities or hobbies. Likewise, you may isolate yourself. You might stay away from friends and family members. Or worse, you may have thoughts of suicide.
You may also experience anxiety symptoms. Anxiety presents symptoms such as racing thoughts, sleep trouble, lack of focus and panic attacks. An individual can have one or all of these symptoms and have Generalized Anxiety, Depression, or even Bipolar Disorder.
If you can’t work due to these symptoms, apply for SSD and SSI benefits for depression. Many people think that filing for SSDI and SSI benefits means they can never return to work. This is not true. In fact, once you are on benefits, the SSA allows you to attempt work using a trial work period. Learn more about the trial work period.
People who receive the proper treatment and medications are often able to return to work. However, SSD benefits are due to you for the time you cannot work. As long as you have been off work for 12 months due to your mental condition, you should be paid benefits during that time period. Also, you should receive benefits until you can return to work.
Contact our law firm. Start your application for SSD benefits today. You can receive benefits, even if you are able to return to work at a later date. Please call us. Let us help you file your application for benefits. We are available to answer your questions about Social Security benefits and Supplemental Security Income benefits. Also, we will answer your questions about mental health.
OUR LAW FIRM CAN WIN BENEFITS FOR DEPRESSION
At our law firm we are experts in helping you win your benefits for depression. However, we must prove your medical condition meets SSA’s benefit rules. We do that by getting your medical records. Your records show the SSA you cannot work because of your mental health symptoms.
In order to do this, you will need mental health treatment. Likewise, we will need the support of your mental health counselor. We need to prove that your depression has the elements under Listing 12.04. Usually your counselor or doctor helps you by writing a letter about your mental symptoms. In their letter, they should state you cannot work due to your mental health.
If you do not have a mental health doctor, then you need to get one. You will never win benefits if you don’t have ongoing medical treatment from a professional. It is your responsibility to find a doctor who will help you and then, you need to go to the doctor as often as possible. Your visits to the doctor will build the medical evidence you need to win your SSD case.
The other reason you need your treating doctor to provide medical evidence is that the SSA has their own medical experts. Their doctor reviews your case prior to your hearing and they can call a medical expert to testify at your hearing. Learn more about the medical expert.
WHAT WE DO TO HELP YOU WIN DEPRESSION BENEFITS
You do not need to try to win SSD benefits by yourself. We can help file your SSD application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork and forms you need to become our client
- Help you file your application for SSD and SSI benefits
- Inform the SSA that they should pay your benefits under the Compassionate Allowance Rules
- Request an appeal if you receive a denial from DDS
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your SSD hearing and question the expert witnesses
- Read more about job expert testimony
- Learn more about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Try not to take that long to finish it. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you need help to file your application, we will help you.
IS IT WORTH THE ATTORNEY FEE TO HIRE AN SSD LAWYER?
It isn’t easy to get Social Security benefits and the application process can be frustrating for most people. But, having an attorney throughout the appeal process can make it easier. It is our belief that when you have a law firm with experience handling your Social Security case, the SSA makes sure that they follow their own procedures.
Additionally, when you have an attorney with legal experience, they will have access to Social Security’s decisions throughout the process. They can also submit medical evidence that may be missing from your case.
There is evidence that hiring an attorney with the proper experience raises your chances of winning your SSDI and SSI benefits by 30%. It is also smart to hire an attorney to help you at your hearing. After all, you are the star witness at your hearing. If you hire an attorney with experience, they can prepare you to be a good witness at your hearing. Learn more about how to prepare for your SSD hearing.
WHAT WILL IT COST YOU IF YOU DON’T HIRE THE RIGHT LAWYER?
What will it cost you if you don’t hire a lawyer with the legal experience to win your case? If you win your benefits, you will be paid monthly benefits for the rest of your life. For example, if you win benefits at 50 years old, then you will be paid monthly for the next 17 years. You may also win two of years of past due benefits. That means 19 years of payments to the average 50 year old.
Nineteen years is is 228 months. At $1200 a month (which is a lower than average benefit amount), that is $273,600. Additionally, you will win a higher retirement benefit at the age of 67. Let’s say the average higher retirement benefit is $300 a month and you live to be 90 years old. That is another $82,800.
It costs 25% of your back benefit OR $7200 from your back benefit to pay your attorney. You pay whatever is less and only if you win. Let’s pretend you pay the maximum fee of $7200. If you win your case, then your attorney has just won you $356,400, plus early Medicare benefits. You attorney will be paid $7200 and you will be paid $349,200.
All attorneys charge the same amount. So, you can go it alone and not hire an attorney, but chances are you will lose $356,400. Or, you can hire an attorney with no experience and still pay $7200. Finally, you can hire an attorney with over 30 years of experience and still pay $7200 and win $349,200. The choice is yours. But, we hope you can see that the cost of a lawyer with 30 years of experience is “worth it.”
HOW WILL YOU PAY THE ATTORNEY FEE?
We will use our legal skills to help you through the Social Security appeal process. It is our goal to win your case. But, it also our goal to make the appeal process easier for you.
We offer a free review of your case. If you call, there is no pressure to become our client. You ask questions, we answer. Even if we don’t accept your case, we will still try to help you.
It also doesn’t cost you any upfront money to hire us. Why? Because you only pay us an attorney fee if we win your case. If we win, then the SSA pays us out of your back benefits. Learn more about past due benefits. If you do not win, then you do not pay an attorney fee.
How much is the attorney fee? The attorney fee is whatever is less between 25% of your back benefit and the fee cap. This is best understood through an example. If your back benefit is $10,000, then your attorney fee would be $2500.
However, if your back benefit is $100,000, you would not pay 25% or $25,000 in attorney fees. Instead, you would pay the amount of the fee cap. In November 2022, the fee cap will be $7200. Therefore, if you win your case, then your fee is capped at the $7200 amount.
Regardless, you pay whatever is less between 25% of your back benefit and the fee cap. Additionally, you only owe an attorney fee if we win your case. Find out more here about what it will cost.
OUR LEGAL TEAM HELPS YOU WIN SSD BENEFITS FOR DEPRESSION
It is possible for you to have both Depression and Anxiety at the same time. Anxiety is commonly known as Generalized Anxiety Disorder. It is not unusual for one person to be found to have two or three types of mental conditions at once. However, for the SSA, if you have severe anxiety you can be paid SSD and SSI benefits under listing 12.06.
Under SSA’s rules, each mental condition has its own listing. To meet a listing, the SSA considers only the elements under that specific listing. If you meet the listing, then you should be paid benefits. Equalling the listing, however, allows the SSA to consider the combination of all of your severe conditions, including physical conditions.
Hire us. We know how to prove to the SSA that you should be paid benefits for depression. Our legal team prepares you for success. During your case, we collect your medical records. All you have to do is get treatment from your doctor. Medical records from your treating sources prove you deserve benefits. Medical records prove the case, whether you have a physical or mental condition that prevents you from working.
We know you need benefits to replace your income. Over the past 30 years, we have won over 20,000 SSDI and SSI cases. We want to win your case too. Contact us today for your free review of your case. Let us help you win SSDI and SSI benefits for depression.