Clients with severe personality disorders tax the patience of all who come into contact with them. They are a treatment challenge, and a legal challenge when it comes to proving personality disorders for Social Security or SSI disability benefits.
Social Security says that personality disorders are disabling when the dysfunctional traits are “inflexible and maladaptive” and also cause other significant impairments in social and occupational functioning. The regulation goes on to say that these characteristics are typical of a person’s long term functioning, and are not “limited to discrete episodes of illness.”
When considering whether we can help you win such a case, we look for exactly what is in the regulation – long term patterns of behaviors that preclude ability to work. It is often somewhat easier to help a client who is older. A forty-five year old man may have a long history of failed short-term work attempts, relationship instability and often an arrest record for altercations. Together with competent psychological evaluations these can illustrate an inability to work on a predictable, full time basis.
In the past, many people with personality disorders came to Social Security with a dual diagnosis – an alcohol or drug addiction problem in addition to this underlying psychiatric disorder. When substance abuse was a basis for disability payments, evidence of personality disorder was often unnecessary for the success of the claim. With substance abuse long gone as a basis of disability – in fact it has become a strong negative factor – it becomes more important to carefully develop the psychiatric evidence. A judge will want to know whether the condition exists in the absence of substance abuse.
Many people with personality disorders are very intelligent and highly verbal. They can appear extremely functional in short-term contact. However, a review of the social and vocational history will often tell the story. Ideally, there will have been a substance-free period to determine whether the symptoms persist in sobriety.
As with all mental disorders in Social Security cases, first the symptoms are considered – reclusiveness, hostility or aggression, paranoia, oddities of thought or behavior, pathological dependence, unstable relationships, and impulsive and destructive behaviors. Along with symptoms, the constellation of functional impairments resulting from the symptoms are evaluated and a decision on disability can be made.
Contact us if we can be of assistance in filing a claim on personality disorders as a basis for Social Security or SSI disability benefits.
Mental Health America: Personality Disorders– Personality disorder must fulfill several criteria – see more information here.
Personality Disorders: MedlinePlus – Personality disorders are long-term patterns of thoughts and behaviors that cause serious problems with relationships and work.
Disability Evaluation Under Social Security – Most mental illness fall under this listing under the Listings of Impairments.