How Do You Prove You Cannot Work Due To Depression
Anyone who has suffered clinical depression understands that it can ruin your career and relationships alike. However, you should never assume the insurance company will understand how your individual symptoms impact you and your job. To increase your chances of claim approval, you must explain why each of your symptoms prevents you from performing your job duties.
For example, during a depressive episode, you be unable to get out of bed due to your severely depressed mood and fatigue forcing you to call in sick. You may be preoccupied with your debilitating symptoms and unable to focus, concentrate, or pay attention during an important meeting or telephone call with your biggest client. Or your lack of interests, low energy and feelings of hopelessness may make routine tasks seem overly stressful or cause you to procrastinate and miss a strict deadline.
There are many ways depression symptoms can impair your ability to work. These need to be explicitly outlined in your evidence when submitting your claim.
Va Disability Benefits For Depression And Ptsd
VA Disability Benefits for Depression and PTSD
What is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is a psychiatric condition that can present itself in people who have experienced or witnessed a traumatic event. People with PTSD often have intense, disturbing thoughts and feelings related to their experience that lasts long after the traumatic event. These individuals may also relive the event through flashbacks or nightmares and deal with feelings of sadness, fear, or anger by avoiding situations that remind them of the traumatic event.
Symptoms of PTSD fall into four categories:
- Intrusive Thoughts. Repeated, involuntary memories distressing dreams or flashbacks of the traumatic event.
- Avoidance. Avoiding people, places, activities, objects, and/or situations that bring on distressing memories.
- Negative Thoughts and Feelings. Ongoing and distorted beliefs about oneself or others ongoing fear horror, anger, guilt, or shame loss of interest in activities previously enjoyed feeling detached.
- Arousal and Reactive Symptoms. Being irritable and having angry outbursts reckless or self-destructive behavior being easily startles or having problems concentrating or sleeping.
What is Depression?
Depression is mental health condition that affects the way an individual thinks, feels, and acts. Symptoms of depression tend to vary among individuals, but common symptoms include:
Service Connection for PTSD and Depression
- Combat exposure
Direct Service Connection For Depression
In order to establish service connection for depression on a direct basis, veterans must show evidence of the following:
- A current diagnosis of depression. The easiest way to show proof of a diagnosis for depression is through medical records. It is important to note that the diagnosis must be current in order to qualify for VA disability benefits.
- An in-service event. The best forms of evidence to prove an in-service event include service treatment records as they will have documented any injury or illness, including depression, for which you were treated while on active duty. This is very beneficial in proving a condition arose during service or shortly after service. Unfortunately, not all veterans have this type of evidence available to them. In this case, lay statements from the veteran and/or his or her family members can be particularly effective. These statements can be used to describe both the onset and progression of the veterans depression, as well as how it relates to service.
- A medical nexus between the depression and the in-service event. A statement from a qualified healthcare professional affirming that they believe your condition was at least as likely as not caused by your military service can serve as a medical nexus.
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How The Va Rates Depression
The VA rates depression, along with all other mental disorders, according to a “General Rating Formula for Mental Disorders.” Depression is rated according to how much it impairs a veteran’s social and occupational ability. While depression symptoms are relevant to the particular diagnosis a veteran is given, they have no impact on the actual rating. The rating is based on the effects of the symptoms on a veteran’s ability to function, not on the symptoms themselves.
The available ratings for depression are 0%, 10%, 30%, 50%, 70%, or 100%. A 100% rating is warranted only where a veteran has absolutely no ability to function socially or at work. A 0% rating is assigned where, despite depression symptoms, a veteran’s ability to function is not actually impaired. A 0% rating is still helpful, however, as it entitles the veteran to VA benefits such as health care.
To Appeal A Denied Claim Or Add Depression To An Existing Claim The Veteran Would Need To Submit:
- Current medical records of examination, diagnosis and treatment for depression, including a statement that the depression is a primary disabling condition or a secondary disability, as appropriate.
- Service records or in-service medical records that provide evidence of an incident or conditions during military service that caused or aggravated the Vets depression and/or primary disabling condition.
Even with such evidence submitted, the VA may require you to go to a local VA medical center for a Compensation and Pension Examination, or C& P exam, to determine whether a diagnosis of depression is valid in the VAs eyes.
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Establishing A Connection Between Your Military Service And Depression
Before you can qualify for military disability benefits, a professional must establish a connection between your depression and military service. The requirements you must meet in order to prove your depression is service-connected are:
- A current depression diagnosis
- Evidence showing an incident that occurred during your military service likely caused your depression
- Medical evidence linking or showing causation between your current depression diagnosis and that service-related incident
Classification In Relation To Depression Rating Scales And Questionnaires
Depression rating scales and questionnaires give ranges that are proposed to describe different severities of depression. Some of these were described in of the first NICE depression guideline. In reconsidering this for this guideline and the guideline update, it quickly became apparent not only that there is no consensus for the proposed ranges but also that the ranges in different rating scales and questionnaires do not correspond with each other. In addition, there a variable degree of correlation between different scales, which indicates that the they do not measure precisely the same aspects of depression. When these factors are added to the need to consider more than symptoms in determining severity, and more than severity in considering diagnosis, the GDG was concerned not to perpetuate a spurious precision in relating scores in depression rating scales and questionnaires to the diagnosis or severity of depression, which must in the end be a clinical judgement.
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Why Are There Different Va Disability Rates For Depression
There are different ways to define depression, and no two people diagnosed with it share the exact same experience. In order to qualify for VA disability benefits, however, you must prove your depression is related to your military service. VA disability rates for depression vary based on the severity of your symptoms and how depression affects your daily life.
Since most experts believe your genes combined with stressful life events can cause depression, veterans are especially vulnerable. Since military personnel often face traumatic events during active service, theyre presumably more likely to struggle with depression than civilians. In fact, the VA estimates that 1 in 3 veterans visiting primary care clinics in 2008 reportedly had depressive symptoms. Within that depressed group, 1 in 5 showed symptoms severe enough to warrant an immediate medical evaluation for major depression. And another 15-20% were diagnosed with major depression, which requires treatment either with psychotherapy or antidepressant medication.
Is Depression Classified As A Disability
Yes, depression is a disability if it significantly limits your ability to function in everyday life and treatment isnât working. According to the Anxiety and Depression Association of America, Major Depressive Disorder is a leading cause of disability in the United States for people aged 15 to 44.
As defined by the Social Security Administration , disability means the inability to engage in any substantial gainful activity because of a physical or mental problem.
In order to qualify, you must not be able to work at all in the next 12 months and have a disability thatâs expected to last for more than one year. However, it can sometimes take several months of trying before youâre approved for disability benefits, but you will receive retroactive payments based on your application date.
The SSA has strict requirements for receiving supplemental security income and disability benefits. Although having treatment-resistant depression is a disability, you wonât automatically qualify for benefits. Your depression must substantially limit one or more significant life activities.
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Are You Covered By The Ada
The ADA, along with the 2008 amendment, states that persons qualify for disability if they:
- Have a physical or mental impairment that substantially limits one or more major life activities and/or bodily functions . Major life activities include, but are not limited to, caring for yourself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
- Have a history of such an impairment
- Are regarded as having such an impairment
Do Veterans Have To File Separate Va Claims For Depression And Anxiety
Importantly, VA recognizes that veterans are not qualified psychological experts. Therefore, it is unreasonable to expect veterans to be certain of their exact mental health diagnosis. Veterans can only attest to their symptomatology and how it affects them on a daily basis. Clemons v. Shinseki held that a service connection claim for one psychiatric condition must be considered a claim for any psychiatric condition that may be reasonably raised by several factors . In other words, if there are other psychological diagnoses on record, VA is required to consider whether those diagnoses are related to a veterans service even if the veteran did not specifically file claims for those conditions. In short, veterans do not have to file separate VA claims for depression and anxiety.
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Use Of Specialist Assessments
In very limited circumstances, an external specialist assessment by a clinical psychologist or psychiatrist may need to be considered where a person is unable to access an assessment via other means. Where a specialist assessment occurs, consideration should be given by the clinical psychologist or psychiatrist to the diagnosis, reasonable treatment options, likely response to treatment, functional impact and the likelihood of significant improvement within 2 years.
Where a specialist assessment is being undertaken and the formal diagnosis is being made for the first time, consideration should be given as to whether the condition is also fully diagnosed, treated and stabilised.
Example: Joe lives in an isolated community and has experienced severe depression with suicidal ideation for a number of years. He has been treated by his GP with medication for several years and has seen a psychologist for cognitive behavioural therapy. The diagnosis has not been made by a psychiatrist or with the assistance of a clinical psychologist. As Joe lives in an isolated community, a specialist assessment was undertaken, which concurred with the GP diagnosis of major depressive disorder. Joe’s condition of major depressive disorder was regarded as unlikely to significantly improve with further treatment due to the limited response to prolonged and reasonable treatment undertaken to date. As such, he was found to be fully diagnosed, treated and stabilised.
Hospitalization And Temporary Total Ratings
If a veteran is hospitalized for 21 days or more due to their depression, they may be eligible to receive a temporary total rating of 100 percent. In order to qualify for a temporary hospitalization rating, veterans must be receiving treatment at a VA medical center or other VA-approved hospital. If a veteran is assigned a temporary hospitalization rating, their effective date will be that of when continuous hospitalization began. Benefits will continue until the last day of the month in which the veteran stopped receiving treatment for their service-connected conditions.
According to 38 CFR § 4.29, if a veteran is hospitalized for more than six months, their claims folder will be referred to the rating activity for consideration of a schedular 100 percent rating.
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Depression Disability And Your Job: What It Means To Be Disabled
If youâre feeling overwhelmed and donât have the energy for daily tasks or self-care, there may be a chance that you qualify for disability benefits because of depression.
The question of whether depression makes you eligible for disability is complex. Itâs true that many people with depression are able to work, but some are not. A lot depends on the severity of your symptoms and how they affect your ability to function in everyday life.
In this disability benefits review, we take a look at what it means to be disabled by a mental illness, as well as how you can qualify for disability benefits.
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Va Rating For Depression Frequently Asked Questions
Is Depression a VA disability?
Yes, Depression is a VA disability.
Depression can be rated at 0 percent, 10 percent, 30 percent, 50 percent, 70 percent, or 100 percent, depending upon the Frequency, Severity, and Duration of your mental health symptoms.
The VA recognizes Major Depressive Disorder as one of 31 mental health conditions that may be related to military service, and thus, Depression is a VA disability, and is eligible for VA disability compensation under federal law.
What are the VA disability ratings for Depression?
The VA will give you a disability rating based upon the severity of your Depression, specifically related to your level of occupational and social impairment.
If you are considered service-connected for Depression, you will receive one of six possible VA disability ratings, broken out as follows: 0%, 10%, 30%, 50%, 70%, or 100%.
Can I have more than one mental health rating, such as PTSD and Depression?
You can, but its unlikely.
The reason is because Depression is normally an underlying symptom of another mental health condition, such as PTSD.
The only time a Veteran will be rated for more than one mental health condition is if the mental health symptoms and level of occupational and social impairment can be clearly differentiated among the different diagnosis.
Can I receive Special Monthly Compensation for Depression?
Veterans can get an extra $364.77 or more each month, tax-free, if you meet the mental health housebound criteria.
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Connecting Your Military Service With Depression
To show that your depression is connected to your military service in some way, a doctor or professional must establish that connection. To be eligible for benefits, you need to meet these requirements:
- You must have a current diagnosis of depressioneither dysthymic disorder or major depressive disorder.
- You must provide evidence that shows an incident or event that took place during your military service likely caused your depression.
- You must provide medical evidence, reports, and documentation that show causation between the service-related event and your diagnosis of depression. Most often, your doctor needs to include a written letter of opinion that links your current diagnosis of depression to your service-connected disability.
Somatic Symptom And Related Disorders
Section 12.07s disorders include hypochondria and other psychosomatic disorders where your brain interprets physical sensations as illness, and can actually make your body sick. Proving these disorders is difficult, as many of the sensations the patient experiences are not medically provable and may seem fake. However, the SSA does recognize the disorder and must pay Social Security to patients with real cases of these disorders.
Symptoms include preoccupation with having a physical illness, discomfort, fatigue, and anxiety about your health, as well as physical symptoms that are not faked but have no medical explanation.
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Common Ways Depression And Anxiety Can Be Related To Military Service
Importantly, in-service causes of depression and anxiety do not have to be due to a military activity. Rather, the cause merely needs to have happened during service. Oftentimes veterans are experiencing problems not directly related to the military that still affect their functioning during service. For example, if a veteran is deployed to another country and they are experiencing problems with their family at home, they might become depressed and anxious over their inability to be with their family while stationed abroad. Again, as long as the factors causing the veterans symptomatology, or the symptomatology itself, manifested during service, they are eligible for service connection.
Three Types Of Depression
The AmericanPsychiatric Association’s Diagnostic and Statistical Manual of MentalDisorders , on which Social Security bases its disability listings, describes three distinct depressive disorders that canbe debilitating and interfere with an individual’s ability to work,attend school, or interact socially with others.
Secondary Service Connection For Depression
Veterans can also receive service-connected compensation for depression on a secondary basis if their depression is the result of another service-connected condition. For example, veterans with orthopedic conditions may become depressed due to the constant pain they experience or their functional limitations that prevent them from doing everything they used to do. In cases of secondary service connection, the nexus between a veterans primary service-connected disability and his or her depression must be clearly established. Therefore, to establish secondary service connection for depression, veterans must demonstrate the following:
- A current diagnosis of depression
- Medical evidence showing the relationship between his or her service-connected disability and his or her depression
Importantly, secondary service connection can also apply to a situation in which the veterans depression causes another condition. For example, many psychotropic medications that are prescribed to treat depression can result in significant weight gain. Such weight gain may then cause or aggravate orthopedic conditions. Here, the orthopedic condition may warrant secondary service connection. Therefore, secondary service connection works both ways insofar as a pre-existing injury might cause depression, or the depression itself can lead to a new condition.