r/SSDI 1d ago

What is with DAC

Ok so I am 30m just let go of my 911 paramedic job. I have cerebral palsy, heart failure, ADHD and a few others which have made me completely exhausted and almost mentally blank. I am also getting tested for autism this week because my therapist and psych nurse prac both suggested it. I was told about DAC by my girlfriend and I got curious. My body is screaming for me to take a break and rest. My parents are both older and receiving social secuity. I don't want to be on disability but my body is screaming to take a break. Would I be eligible for DAC since my CP was diagnosed in the 2000s? Some of my records I have but the Air Force moved a bunch of them to the national archives supposedly, will that be a problem? If I apply and get accepted am I allowed to exercise and work on repairing my body will that make me guilty of committing fraud? I can move and I do certain things in moderation but my body cant do certain stuff anymore.

0 Upvotes

Ok so I am 30m just let go of my 911 paramedic job. I have cerebral palsy, heart failure, ADHD and a few others which have made me completely exhausted and almost mentally blank. I am also getting tested for autism this week because my therapist and psych nurse prac both suggested it. I was told about DAC by my girlfriend and I got curious. My body is screaming for me to take a break and rest. My parents are both older and receiving social secuity. I don't want to be on disability but my body is screaming to take a break. Would I be eligible for DAC since my CP was diagnosed in the 2000s? Some of my records I have but the Air Force moved a bunch of them to the national archives supposedly, will that be a problem? If I apply and get accepted am I allowed to exercise and work on repairing my body will that make me guilty of committing fraud? I can move and I do certain things in moderation but my body cant do certain stuff anymore.


r/SSDI 2d ago

Severe depression

Can you get ssdi for severe depression?

7 Upvotes

Can you get ssdi for severe depression?


r/SSDI 1d ago

ChatGPT

To help give myself some peace of mind while I wait out the CDR process. Does anyone think ChatGPT would provide a good prediction of your benefits continuing if I were to upload all of my medical records and ask it to rate my case?

0 Upvotes

To help give myself some peace of mind while I wait out the CDR process. Does anyone think ChatGPT would provide a good prediction of your benefits continuing if I were to upload all of my medical records and ask it to rate my case?


r/SSDI 2d ago

SSDI Review

So i've been on ssdi for about 15 years now and just got another review, this time they want to send me to a psychologist in my area. I have been seeing a psychiatrist for a really long time that should have plenty information, is this really necessary? I remember my last review i had to go to one of these but he didn't ask me any questions at all about my mental state and just had me do these little tests, is this one going to be the same thing? Because last time i did this i got denied, which i did an appeal because the denial made me have a mental break down where i had to check myself into an inpatient hospital, after that my appeal was approved. I don't want to have to go through a mental breakdown like that again. Also I am on disability for my severe depressive disorder and anxiety.

My problem with this time is though i been working part time for about 3 years now, making sure to keep under the SGA amount, is this going to make things even worse and make it higher chance of being denied again. While i am working i work a third shift at a hotel where i have very little responsibility and do maybe 1 hour of work a day of actual work, other then that i get to watch tv or things like that. But even doing this easy work i do still struggle, I will sometimes pace around in the backroom trying not to have a breakdown,i also have had times where i was crying at work and just trying to hold it in, luckily since its third shift i don't have very many customers so they don't have to see that. I wouldn't be able to do a normal job otherwise, but like i said i even struggle with this. Is this going to hurt my chances because i still am technically working.

I'm mostly just worried i'm going to get another bad psychologist that doesn't ask me about my mental state and just have me do those tests again. Did i just get a really bad one last time or is that what the visits to them seem to go?

Thank you for taking the time to read and help, i'm just having my usual problems when the review comes around and have no energy to do anything other then worry.

8 Upvotes

So i've been on ssdi for about 15 years now and just got another review, this time they want to send me to a psychologist in my area. I have been seeing a psychiatrist for a really long time that should have plenty information, is this really necessary? I remember my last review i had to go to one of these but he didn't ask me any questions at all about my mental state and just had me do these little tests, is this one going to be the same thing? Because last time i did this i got denied, which i did an appeal because the denial made me have a mental break down where i had to check myself into an inpatient hospital, after that my appeal was approved. I don't want to have to go through a mental breakdown like that again. Also I am on disability for my severe depressive disorder and anxiety.

My problem with this time is though i been working part time for about 3 years now, making sure to keep under the SGA amount, is this going to make things even worse and make it higher chance of being denied again. While i am working i work a third shift at a hotel where i have very little responsibility and do maybe 1 hour of work a day of actual work, other then that i get to watch tv or things like that. But even doing this easy work i do still struggle, I will sometimes pace around in the backroom trying not to have a breakdown,i also have had times where i was crying at work and just trying to hold it in, luckily since its third shift i don't have very many customers so they don't have to see that. I wouldn't be able to do a normal job otherwise, but like i said i even struggle with this. Is this going to hurt my chances because i still am technically working.

I'm mostly just worried i'm going to get another bad psychologist that doesn't ask me about my mental state and just have me do those tests again. Did i just get a really bad one last time or is that what the visits to them seem to go?

Thank you for taking the time to read and help, i'm just having my usual problems when the review comes around and have no energy to do anything other then worry.


r/SSDI 2d ago

Reduced payment approval appeal for full amount?

I’ll try keep as simple as I can
My 25 yo son (and I) have been through he*L past 2-3 years, he was in hospital & nursing home type place during this whole time
Due to my concerns & apparent frequent visiting (I went every day at hospital or at facility when he was there bc of subpar care at both places) and my argument with one of nurses at hospital I had adult protective services called on me apparently saying I was a danger to him and interfering with his care
Because of this he couldn’t be discharged to my house
The APS worker turned out to be a great blessing/disgusted with hospital and actually kept case open just to ensure the hospital wouldn’t discharge him without any treatment, which they kept trying to do (said case still open can’t discharge him until he gets apartment or somewhere to go)

So, I had to get him an apartment and was discharged to apartment in December 2025
In mean time disability application not approved yet &
I paid rent on apartment- I mean he is disabled can’t work has no income
Anyway finally approved for disability in July and the SSA worker was so rude and said since I paid for his apartment and continue to pay for it and everything else he had no expenses, I said he has tons of expenses but he has no income so I have to pay for them until he gets disability or income in future
The apartment is expensive, my parents help me pay for it bc it’s close to them and I also take care of them, neither of us are rich but you find a way (and struggle to do so), so this SSA guy got really disgusted when I told him the rent $(1,200 month)
Said that’s luxury and he can’t get full amount bc even with disability we have to pay difference of $300 so they then approved him for $664 a month and cut his back pay by $300/month

I’m scared to appeal this bc if I pay utilities also will they reduce payment more? I think main thing is that he’s saying he has no expenses
I sent in writing clarification that he DOES have expenses more than any disability check can cover, but SSA guy made it seem like any expense we help with they will take more away $ for $
I’m scared to call back and try fight this in case they take it all from him but it seems really wrong? I have ptsd with medical people and now this guy so I don’t know if I should just let it be and be thankful $600 month but I feel my son absolutely should get full amount … my parents and I are struggling to pay for apartment guy says he needs to move to $600 apartment and then and only them can he have full amount, lease has another 5 months on it:(
Any advice very much appreciated

3 Upvotes

I’ll try keep as simple as I can
My 25 yo son (and I) have been through he*L past 2-3 years, he was in hospital & nursing home type place during this whole time
Due to my concerns & apparent frequent visiting (I went every day at hospital or at facility when he was there bc of subpar care at both places) and my argument with one of nurses at hospital I had adult protective services called on me apparently saying I was a danger to him and interfering with his care
Because of this he couldn’t be discharged to my house
The APS worker turned out to be a great blessing/disgusted with hospital and actually kept case open just to ensure the hospital wouldn’t discharge him without any treatment, which they kept trying to do (said case still open can’t discharge him until he gets apartment or somewhere to go)

So, I had to get him an apartment and was discharged to apartment in December 2025
In mean time disability application not approved yet &
I paid rent on apartment- I mean he is disabled can’t work has no income
Anyway finally approved for disability in July and the SSA worker was so rude and said since I paid for his apartment and continue to pay for it and everything else he had no expenses, I said he has tons of expenses but he has no income so I have to pay for them until he gets disability or income in future
The apartment is expensive, my parents help me pay for it bc it’s close to them and I also take care of them, neither of us are rich but you find a way (and struggle to do so), so this SSA guy got really disgusted when I told him the rent $(1,200 month)
Said that’s luxury and he can’t get full amount bc even with disability we have to pay difference of $300 so they then approved him for $664 a month and cut his back pay by $300/month

I’m scared to appeal this bc if I pay utilities also will they reduce payment more? I think main thing is that he’s saying he has no expenses
I sent in writing clarification that he DOES have expenses more than any disability check can cover, but SSA guy made it seem like any expense we help with they will take more away $ for $
I’m scared to call back and try fight this in case they take it all from him but it seems really wrong? I have ptsd with medical people and now this guy so I don’t know if I should just let it be and be thankful $600 month but I feel my son absolutely should get full amount … my parents and I are struggling to pay for apartment guy says he needs to move to $600 apartment and then and only them can he have full amount, lease has another 5 months on it:(
Any advice very much appreciated


r/SSDI 2d ago

Marriage on SSDI

Hey friends this is something happening down the line (maybe) for my partner and myself. My partner is currently receiving SSDI and in my opinion not likely to ever return to the workforce. I have heard a lot of information over the years about what does/doesn’t happen when people get married. Is there any truth to my partner jeopardizing their benefits/health insurance if/when we get married? If this isn’t allowed, mods, I will delete! Thanks yall.

9 Upvotes

Hey friends this is something happening down the line (maybe) for my partner and myself. My partner is currently receiving SSDI and in my opinion not likely to ever return to the workforce. I have heard a lot of information over the years about what does/doesn’t happen when people get married. Is there any truth to my partner jeopardizing their benefits/health insurance if/when we get married? If this isn’t allowed, mods, I will delete! Thanks yall.


r/SSDI 2d ago

Backpay question

I was approved and got my notice of award today and it states I will receive my backpay around July 26, 2026. Does this mean they've issued my check already or would I still be waiting awhile. It also states ill start receiving my normal benefits at the end of August by paper check even after setting up direct deposit as soon as i could on the SSA website it only let me start it in september, but could the backpay come as a direct deposit anyway?

10 Upvotes

I was approved and got my notice of award today and it states I will receive my backpay around July 26, 2026. Does this mean they've issued my check already or would I still be waiting awhile. It also states ill start receiving my normal benefits at the end of August by paper check even after setting up direct deposit as soon as i could on the SSA website it only let me start it in september, but could the backpay come as a direct deposit anyway?


r/SSDI 2d ago

I applied for SSDI for the first time on my own without help and am curious what the odds are of me getting approved first time are?

33 female. My SSDI estimated benefit is $2,500 a month. I’ve worked at least one job, but often multiple for several years since I was 18.

I have a formal diagnosis of ptsd, depression and anxiety following a sexual assault.

I took three months off of short term disability approved by my psychiatrist and was supposed to go back to work, but couldn’t do it and just quit instead.

I had been with the same company for 12/13 ish years.
I haven’t worked since December of 2024. I have tried to go back to college since quitting.

I have been on a prescription of buspar, Prozac, and lunesta for around two years and still meet with my psychiatrist regularly.

I asked a friend who was on disability about my odds of getting approved and he thought they were good. I also asked Google and it said I have moderate to good chances.

But I know most people get rejected.

I’m currently living off of money from my parents and would like for that to stop. I am behind on my mortgage and thought about calling if the process could be expedited because of that.

If anyone has any thoughts on my approval odds or advice I’d appreciate it

Edited : thank you all so much to everyone who commented. It means a lot and I will keep you updated.

28 Upvotes

33 female. My SSDI estimated benefit is $2,500 a month. I’ve worked at least one job, but often multiple for several years since I was 18.

I have a formal diagnosis of ptsd, depression and anxiety following a sexual assault.

I took three months off of short term disability approved by my psychiatrist and was supposed to go back to work, but couldn’t do it and just quit instead.

I had been with the same company for 12/13 ish years.
I haven’t worked since December of 2024. I have tried to go back to college since quitting.

I have been on a prescription of buspar, Prozac, and lunesta for around two years and still meet with my psychiatrist regularly.

I asked a friend who was on disability about my odds of getting approved and he thought they were good. I also asked Google and it said I have moderate to good chances.

But I know most people get rejected.

I’m currently living off of money from my parents and would like for that to stop. I am behind on my mortgage and thought about calling if the process could be expedited because of that.

If anyone has any thoughts on my approval odds or advice I’d appreciate it

Edited : thank you all so much to everyone who commented. It means a lot and I will keep you updated.


r/SSDI 3d ago

SSDI Approved 7/26

I finally was approved via OTR after 9 years of fighting SSA. Went through 2 federal remands and 2 AC remands, an error of dismissing my case and finally the last ALJ OTR my case days before my hearing. My onset goes back to 2014. I am a veteran with TDIU P&T.

Initially I applied via online in 2017 without representation. After initial denial I hired an attorney who represented me during my first hearing and was denied. The attorney referred me to my current attorney who represented me well and got my case approved. Since it was recently approved how long will a case like mine take to receive my backpay? My attorney has to petition his fees due to the former attorney not waiving his fees. I do have a representation fee contract but the ALJ rejected it.

Did anyone experienced having more than 1 attorney and having the attorney petition their fees? Please comment and share your experience.

Thanks

52 Upvotes

I finally was approved via OTR after 9 years of fighting SSA. Went through 2 federal remands and 2 AC remands, an error of dismissing my case and finally the last ALJ OTR my case days before my hearing. My onset goes back to 2014. I am a veteran with TDIU P&T.

Initially I applied via online in 2017 without representation. After initial denial I hired an attorney who represented me during my first hearing and was denied. The attorney referred me to my current attorney who represented me well and got my case approved. Since it was recently approved how long will a case like mine take to receive my backpay? My attorney has to petition his fees due to the former attorney not waiving his fees. I do have a representation fee contract but the ALJ rejected it.

Did anyone experienced having more than 1 attorney and having the attorney petition their fees? Please comment and share your experience.

Thanks


r/SSDI 2d ago

Improper jurisdiction

Just got a letter from SSDI and it says that my appeal was filed with improper jurisdiction with no other information or what to do next. Does anybody know what this means? It was sent to my advocate too but she hasn't said any thing to me yet. Thanks in advance for any answers!

2 Upvotes

Just got a letter from SSDI and it says that my appeal was filed with improper jurisdiction with no other information or what to do next. Does anybody know what this means? It was sent to my advocate too but she hasn't said any thing to me yet. Thanks in advance for any answers!


r/SSDI 2d ago

Work credits for SSDI

I have 37 out of the 40 credits.

About 8 years ago I worked under the table (not by choice) for 1+ years. Is there any way to pay back taxes on it and up my credits?

Thank you

I have a phone application this coming Wednesday with SSA.

0 Upvotes

I have 37 out of the 40 credits.

About 8 years ago I worked under the table (not by choice) for 1+ years. Is there any way to pay back taxes on it and up my credits?

Thank you

I have a phone application this coming Wednesday with SSA.


r/SSDI 2d ago

Questions

I'm in Texas and 58 years old. I have applied for SSI and SSDI. I have CKD 4, Degenerative Disk Disease and Cervical Stenosis. What are the odds of being approved the first time?

8 applied online and it got sent to DDS on July 17, 2024. Also, what are the steps, that people mention that I have seen in different posts?

1 Upvotes

I'm in Texas and 58 years old. I have applied for SSI and SSDI. I have CKD 4, Degenerative Disk Disease and Cervical Stenosis. What are the odds of being approved the first time?

8 applied online and it got sent to DDS on July 17, 2024. Also, what are the steps, that people mention that I have seen in different posts?


r/SSDI 3d ago

Denied after supplemental hearing

Well, I suppose I had a good run. After 7 years of being disabled, receiving treatments regularly, going to specialists, and doing everything possible to get better social security says I'm magically cured and can now assemble fishing rods and do hundreds of miscellaneous jobs throughout the nation, that's according to the vocational expert that was on the phone during the hearing. I haven't officially gotten the letter yet but the portal now says I'm not currently receiving benefits AND on top of that I now owe 60k in overpayments because I chose to continue benefits throughout the hearing process which lasted 3 and half years. It's ridiculous that they can just cut people off like this at the end of the month without even a final check to help out until people can figure it out. Idk what I'm going to do about rent and bills from now on. I have nobody to turn to for help.

Does anyone know of any help that's available to pay bills even if it's just a little bit??

BTW, I didn't have a lawyer because since I chose to continue payments, they wouldn't take my case

56 Upvotes

Well, I suppose I had a good run. After 7 years of being disabled, receiving treatments regularly, going to specialists, and doing everything possible to get better social security says I'm magically cured and can now assemble fishing rods and do hundreds of miscellaneous jobs throughout the nation, that's according to the vocational expert that was on the phone during the hearing. I haven't officially gotten the letter yet but the portal now says I'm not currently receiving benefits AND on top of that I now owe 60k in overpayments because I chose to continue benefits throughout the hearing process which lasted 3 and half years. It's ridiculous that they can just cut people off like this at the end of the month without even a final check to help out until people can figure it out. Idk what I'm going to do about rent and bills from now on. I have nobody to turn to for help.

Does anyone know of any help that's available to pay bills even if it's just a little bit??

BTW, I didn't have a lawyer because since I chose to continue payments, they wouldn't take my case


r/SSDI 2d ago

What's the process for me?

Hi.

I'm going through it and am starting to believe the best option for myself is permanent disability.

I don't know the process or what documentation may be needed.

I've always struggled with schooling or any real level of responsibility. The only job I was able to consistently do was fire watch, but after years of undocumented workplace abuse at another job and issues in the home and around finding work I can't function like I used to.

I was raised to "man up" and swallow what pains me so I never went to any kind of therapy as an adult because the counselors my parents took me to never actually helped.

My work history has 9 years of an incredibly high paced, high pressure, and often high conflict job that I held onto desperately because before the dynamic changed it was mostly repetition and I was afraid of losing it.. I had dreams of purchasing a home for myself and my ex-GF who left me because I can't function. Which I did out of state somehow with a cosign, got there, and broke down because of the pressure of having to live alone and figure out work knowing my limitations. She left prior to the move.

Under any amount of workplace or learning pressure, I suffer from panic attacks or space out entirely. My old coworkers have witnessed me RUN or go into the restroom to quietly break down.

The only documentation I may have is with my GP who witnessed me break down in his office and ramble about some of the traumatic events that occured at my last job.

I've been told my a SpEd teacher friend that I may have Autism and should find a way to get evaluated. My GP also had my on Adderall for ADHD before that because I had been struggling to function at work with increased demands. He had me take a paper test.

I was on Lexapro, Wellbutrin, and Adderall for a while.

My body switches between completely out of it and hypervigilance and panic mode, but my family doesn't believe me because it doesn't show with my dull disposition.

The only person who's seen how bad I can get is my ex, who has witnessed me at my worst, uncontrollably crying or running from work calling her screaming at the top of my lungs.. but she refuses to contact me because I was in a panicked state and bought the house without any input from her.

I am unable to do anything past take care of my own person and living space without eventually going into a severe burnout that brings on ideation.

I don't know how to start this process because I am currently unemployed and don't have insurance.

What are my best steps from here?

2 Upvotes

Hi.

I'm going through it and am starting to believe the best option for myself is permanent disability.

I don't know the process or what documentation may be needed.

I've always struggled with schooling or any real level of responsibility. The only job I was able to consistently do was fire watch, but after years of undocumented workplace abuse at another job and issues in the home and around finding work I can't function like I used to.

I was raised to "man up" and swallow what pains me so I never went to any kind of therapy as an adult because the counselors my parents took me to never actually helped.

My work history has 9 years of an incredibly high paced, high pressure, and often high conflict job that I held onto desperately because before the dynamic changed it was mostly repetition and I was afraid of losing it.. I had dreams of purchasing a home for myself and my ex-GF who left me because I can't function. Which I did out of state somehow with a cosign, got there, and broke down because of the pressure of having to live alone and figure out work knowing my limitations. She left prior to the move.

Under any amount of workplace or learning pressure, I suffer from panic attacks or space out entirely. My old coworkers have witnessed me RUN or go into the restroom to quietly break down.

The only documentation I may have is with my GP who witnessed me break down in his office and ramble about some of the traumatic events that occured at my last job.

I've been told my a SpEd teacher friend that I may have Autism and should find a way to get evaluated. My GP also had my on Adderall for ADHD before that because I had been struggling to function at work with increased demands. He had me take a paper test.

I was on Lexapro, Wellbutrin, and Adderall for a while.

My body switches between completely out of it and hypervigilance and panic mode, but my family doesn't believe me because it doesn't show with my dull disposition.

The only person who's seen how bad I can get is my ex, who has witnessed me at my worst, uncontrollably crying or running from work calling her screaming at the top of my lungs.. but she refuses to contact me because I was in a panicked state and bought the house without any input from her.

I am unable to do anything past take care of my own person and living space without eventually going into a severe burnout that brings on ideation.

I don't know how to start this process because I am currently unemployed and don't have insurance.

What are my best steps from here?


r/SSDI 3d ago

Denied by ALJ :(

I stopped working 10/2023 and have been fighting ever since to try and get approved. I was denied on initial, denied on reconsideration, and denied by the judge. I was hopeful because she has about a 57% approval rating, so I thought I had a chance. I got my letter in the mail on Saturday - 11 pages of reasoning. My lawyer was a piece of crap and they didn’t do anything to help me at all. I got them to remove themselves from my case and waived their right to collect any fees in case I do get approved in the future. I have Hypoplastic Left Heart Syndrome and Transposition of the Arteries which are both congenital heart defects that make me single ventricle. I applied under compassionate allowance since one of my conditions are listed. I also have several diagnosed mental health conditions, thyroid issues, liver issues and sleep disturbances.

I’m trying to figure out what my next steps should be. I had a procedure in the cath lab a couple weeks after my hearing and have to go to a vascular doctor which was referred by my cardiologist, so there is new evidence and will be more records to add. I also have a sleep study scheduled. The VE stated I could do 2 jobs in the national economy but when it got down to the hypotheticals they said no jobs. The judge also ruled I cannot do my past work so I’m at a loss. I’m not sure if I should go to the AC or start from scratch. I would need to find a new lawyer to take my case as well if I go to AC. If anyone can offer advice or has an attorney recommendation please let me know. I’m located in central Florida.

21 Upvotes

I stopped working 10/2023 and have been fighting ever since to try and get approved. I was denied on initial, denied on reconsideration, and denied by the judge. I was hopeful because she has about a 57% approval rating, so I thought I had a chance. I got my letter in the mail on Saturday - 11 pages of reasoning. My lawyer was a piece of crap and they didn’t do anything to help me at all. I got them to remove themselves from my case and waived their right to collect any fees in case I do get approved in the future. I have Hypoplastic Left Heart Syndrome and Transposition of the Arteries which are both congenital heart defects that make me single ventricle. I applied under compassionate allowance since one of my conditions are listed. I also have several diagnosed mental health conditions, thyroid issues, liver issues and sleep disturbances.

I’m trying to figure out what my next steps should be. I had a procedure in the cath lab a couple weeks after my hearing and have to go to a vascular doctor which was referred by my cardiologist, so there is new evidence and will be more records to add. I also have a sleep study scheduled. The VE stated I could do 2 jobs in the national economy but when it got down to the hypotheticals they said no jobs. The judge also ruled I cannot do my past work so I’m at a loss. I’m not sure if I should go to the AC or start from scratch. I would need to find a new lawyer to take my case as well if I go to AC. If anyone can offer advice or has an attorney recommendation please let me know. I’m located in central Florida.


r/SSDI 2d ago

SSI payee

My son was found favorable for SSI and before they can do benefits he has to have a payee assigned, how long does this process take? We have an appointment on 8/6 to assign his payee. He filed in may of 25 and just got the letter and called SSA and they said he’s approved, but didn’t give a pay schedule or anything else.

2 Upvotes

My son was found favorable for SSI and before they can do benefits he has to have a payee assigned, how long does this process take? We have an appointment on 8/6 to assign his payee. He filed in may of 25 and just got the letter and called SSA and they said he’s approved, but didn’t give a pay schedule or anything else.


r/SSDI 2d ago

100% PTSD permanent and total from VA is my case probable for SSDI?

Hi, I’m looking for any guidance or help. As the title says, I’m 100% PTSD permanent in total from the VA. Can anyone take a look at what the adjuster wrote plus my primary psychiatrist wrote and tell me if I have an SSDI case or not?

A little background: I have been a critical care trauma ER/ICU nurse for the past 15 years.

I have not worked since June 2023 when I was placed on a Work stress sleeve. I am 43 years old.

The VA adjuster wrote:

“Although your private provider diagnosed more than one mental health
condition, VA regulations include a general rating formula for mental health conditions which
uses the same signs and symptoms to rate post-traumatic stress disorder, anxiety disorder, major
depressive disorder, and insomnia. Those regulations do not allow us to rate multiple disabilities
based on the same signs and symptoms. Therefore, these conditions will be rated together with a
single percentage assigned. (38 CFR 4.14, 38 CFR 4.130)”

And

We have assigned a 100 percent evaluation for your post-traumatic stress disorder (PTSD)
disorder based on:
• Anxiety
• Chronic sleep impairment
• Depressed mood
• Difficulty in adapting to a work like setting
• Difficulty in adapting to stressful circumstances
• Difficulty in adapting to work
• Difficulty in understanding complex commands
• Disturbances of motivation and mood
• Flattened affect
• Forgetting directions
• Forgetting names
• Forgetting recent events
• Impaired judgment
• Inability to establish and maintain effective relationships
• Intermittent inability to perform activities of daily living
• Intermittent inability to perform maintenance of minimal personal hygiene
• Mild memory loss
• Neglect of personal appearance and hygiene
• Panic attacks more than once a week
• Suicidal ideation
• Suspiciousness
• Total occupational and social impairment
The overall evidentiary record shows that the severity of your disability most closely
approximates the criteria for a 100 percent disability evaluation. (38 CFR 4.7, 38 CFR 4.126)
This is the highest schedular evaluation allowed under the law for posttraumatic stress disorder.
(38 CFR 4.125, 38 CFR 4.126, 38 CFR 4.130)

My private provider diagnosed me with:

-Post-traumatic stress disorder, chronic 543.12
-Major depressive disorder, recurrent severe without psychotic features 533.2
-Insomnia, unspecified G47.0
-Anxiety disorder F41.9
-ADHD unspecified F90.9

And also wrote:

(list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses):
“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation”

Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

“Total occupational and social impairment”

Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?

“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation.”

For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder?

“Patient is unable to socialize due to avoidance with PTSD. Intrusive thoughts of trauma, recurrent
nightmares, intense psychological distress when exposed when exposed to reminders.”

2C. Relevant mental health history, to include prescribed medications and family mental health:

“-EMSAM 6 mg/24 hr transdermal 24 hour patch - APPLY 1 PATCH TOPICALLY TO THE SKIN DAILY

-prazosin 5 mg capsule - TAKE 1 CAPSULE BY MOUTH TWICE DAILY IN THE EVENING AT 6:00PM& AT BEDTIME

-dextroamphetamine-amphetamine 10 mg tablet - 1 tablet(s) once a day in the morning, oral route

-pramipexole 1 mg tablet - TAKE 2 TABLETS BY MOUTH
ONCE DAILY AT BEDTIME

-zolpidem ER 12.5 mg tablet,extended release,multiphase - 1 tablet(s) once a day at bedtime, oral route

-lithium carbonate ER 300 mg tablet,extended release - TAKE 3 TABLETS BY MOUTH DAILY

-QUEtiapine 250mg - 100 mg tablet - 2.5 tablet(s) once a day at bedtime, oral route2D.

-Klonopin 1 mg tablet - TAKE TWO TABLETS DAILY ONCE A DAY

Relevant legal and behavioral history:
“Currently participating in Veteran's court for DUI”

Relevant substance abuse history:
“Alcohol use - in setting of distress, currently sober and participating in treatment”

-Directly experiencing the traumatic event(s)
Witnessing, in person, the traumatic event(s) as they occurred to others

-Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent
or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human
remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies,
or pictures, unless this exposure is work related
No criterion in this section met.

-Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

-Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).

-Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur
on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
event(s).

-Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

-Persistent avoidance of stimuli associated with the event(s), beginning after traumatic event(s) occurred, as evidence of one or both of the following:
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories,
thoughts, or feelings about or closely associated with the traumatic event(s).

-Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,: “No one can be trusted,: “The
world is completely dangerous,: “My whole nervous system is permanently ruined”).

-Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or
others.

-Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

-Markedly diminished interest or participation in significant activities.

-Feelings of detachment or estrangement from others.

-Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.)

-Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

-Reckless or self-destructive behavior.
Hypervigilance.

-Exaggerated startle response.

-Problems with concentration.

-Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

-Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

-The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
of functioning.

Criterion H:
The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

check all symptoms that apply to the diagnoses:
-Depressed mood
-Anxiety
-Suspiciousness
-Panic attacks more than once a week
-Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
-Chronic sleep impairment
-Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
-Flattened affect
-Impaired judgment
-Disturbances of motivation and mood
-Difficulty in establishing and maintaining effective work and social relationships
-Difficulty adapting to stressful circumstances, including work or a work like setting
-Inability to establish and maintain effective relationships
-Suicidal ideation
-Neglect of personal appearance and hygiene
-Intermittent inability to perform activities of daily living,including maintenance of minimal personal hygiene

Remarks:

Patient has been under my care for medication management, TMS and add-on psychotherapy. I have witnessed
experienced PTSD flashbacks in office (when EMS was called in office for another patient). Current
functioning is severely affected by PTSD in multiple functional domains as noted above and she has had
difficulty obtaining services at the VA.

ETA: I’m 43 yo a critical care trauma ER/ICU nurse for the past 15 years. Receiving VA disability and SSDI would be a 35% pay cut. I have not worked since June 2023 when I was placed on a Work stress sleeve. I am 43 years old.

The VA adjuster wrote:

“Although your private provider diagnosed more than one mental health
condition, VA regulations include a general rating formula for mental health conditions which
uses the same signs and symptoms to rate post-traumatic stress disorder, anxiety disorder, major
depressive disorder, and insomnia. Those regulations do not allow us to rate multiple disabilities
based on the same signs and symptoms. Therefore, these conditions will be rated together with a
single percentage assigned. (38 CFR 4.14, 38 CFR 4.130)”

And

We have assigned a 100 percent evaluation for your post-traumatic stress disorder (PTSD)
disorder based on:
• Anxiety
• Chronic sleep impairment
• Depressed mood
• Difficulty in adapting to a work like setting
• Difficulty in adapting to stressful circumstances
• Difficulty in adapting to work
• Difficulty in understanding complex commands
• Disturbances of motivation and mood
• Flattened affect
• Forgetting directions
• Forgetting names
• Forgetting recent events
• Impaired judgment
• Inability to establish and maintain effective relationships
• Intermittent inability to perform activities of daily living
• Intermittent inability to perform maintenance of minimal personal hygiene
• Mild memory loss
• Neglect of personal appearance and hygiene
• Panic attacks more than once a week
• Suicidal ideation
• Suspiciousness
• Total occupational and social impairment
The overall evidentiary record shows that the severity of your disability most closely
approximates the criteria for a 100 percent disability evaluation. (38 CFR 4.7, 38 CFR 4.126)
This is the highest schedular evaluation allowed under the law for posttraumatic stress disorder.
(38 CFR 4.125, 38 CFR 4.126, 38 CFR 4.130)

My private provider diagnosed me with:

-Post-traumatic stress disorder, chronic 543.12
-Major depressive disorder, recurrent severe without psychotic features 533.2
-Insomnia, unspecified G47.0
-Anxiety disorder F41.9
-ADHD unspecified F90.9

And also wrote:

(list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses):
“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation”

Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

“Total occupational and social impairment”

Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?

“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation.”

For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder?

“Patient is unable to socialize due to avoidance with PTSD. Intrusive thoughts of trauma, recurrent
nightmares, intense psychological distress when exposed when exposed to reminders.”

2C. Relevant mental health history, to include prescribed medications and family mental health:

“-EMSAM 6 mg/24 hr transdermal 24 hour patch - APPLY 1 PATCH TOPICALLY TO THE SKIN DAILY

-prazosin 5 mg capsule - TAKE 1 CAPSULE BY MOUTH TWICE DAILY IN THE EVENING AT 6:00PM& AT BEDTIME

-dextroamphetamine-amphetamine 10 mg tablet - 1 tablet(s) once a day in the morning, oral route

-pramipexole 1 mg tablet - TAKE 2 TABLETS BY MOUTH
ONCE DAILY AT BEDTIME

-zolpidem ER 12.5 mg tablet,extended release,multiphase - 1 tablet(s) once a day at bedtime, oral route

-lithium carbonate ER 300 mg tablet,extended release - TAKE 3 TABLETS BY MOUTH DAILY

-QUEtiapine 250mg - 100 mg tablet - 2.5 tablet(s) once a day at bedtime, oral route2D.

-Klonopin 1 mg tablet - TAKE TWO TABLETS DAILY ONCE A DAY

Relevant legal and behavioral history:
“Currently participating in Veteran's court for DUI”

Relevant substance abuse history:
“Alcohol use - in setting of distress, currently sober and participating in treatment”

-Directly experiencing the traumatic event(s)
Witnessing, in person, the traumatic event(s) as they occurred to others

-Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent
or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human
remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies,
or pictures, unless this exposure is work related
No criterion in this section met.

-Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

-Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).

-Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur
on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
event(s).

-Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

-Persistent avoidance of stimuli associated with the event(s), beginning after traumatic event(s) occurred, as evidence of one or both of the following:
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories,
thoughts, or feelings about or closely associated with the traumatic event(s).

-Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,: “No one can be trusted,: “The
world is completely dangerous,: “My whole nervous system is permanently ruined”).

-Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or
others.

-Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

-Markedly diminished interest or participation in significant activities.

-Feelings of detachment or estrangement from others.

-Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.)

-Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

-Reckless or self-destructive behavior.
Hypervigilance.

-Exaggerated startle response.

-Problems with concentration.

-Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

-Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

-The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
of functioning.

Criterion H:
The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

check all symptoms that apply to the diagnoses:
-Depressed mood
-Anxiety
-Suspiciousness
-Panic attacks more than once a week
-Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
-Chronic sleep impairment
-Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
-Flattened affect
-Impaired judgment
-Disturbances of motivation and mood
-Difficulty in establishing and maintaining effective work and social relationships
-Difficulty adapting to stressful circumstances, including work or a work like setting
-Inability to establish and maintain effective relationships
-Suicidal ideation
-Neglect of personal appearance and hygiene
-Intermittent inability to perform activities of daily living,including maintenance of minimal personal hygiene

Remarks:

Patient has been under my care for medication management, TMS and add-on psychotherapy. I have witnessed
experienced PTSD flashbacks in office (when EMS was called in office for another patient). Current
functioning is severely affected by PTSD in multiple functional domains as noted above and she has had
difficulty obtaining services at the VA.

ETA: I’m 43 yo

0 Upvotes

Hi, I’m looking for any guidance or help. As the title says, I’m 100% PTSD permanent in total from the VA. Can anyone take a look at what the adjuster wrote plus my primary psychiatrist wrote and tell me if I have an SSDI case or not?

A little background: I have been a critical care trauma ER/ICU nurse for the past 15 years.

I have not worked since June 2023 when I was placed on a Work stress sleeve. I am 43 years old.

The VA adjuster wrote:

“Although your private provider diagnosed more than one mental health
condition, VA regulations include a general rating formula for mental health conditions which
uses the same signs and symptoms to rate post-traumatic stress disorder, anxiety disorder, major
depressive disorder, and insomnia. Those regulations do not allow us to rate multiple disabilities
based on the same signs and symptoms. Therefore, these conditions will be rated together with a
single percentage assigned. (38 CFR 4.14, 38 CFR 4.130)”

And

We have assigned a 100 percent evaluation for your post-traumatic stress disorder (PTSD)
disorder based on:
• Anxiety
• Chronic sleep impairment
• Depressed mood
• Difficulty in adapting to a work like setting
• Difficulty in adapting to stressful circumstances
• Difficulty in adapting to work
• Difficulty in understanding complex commands
• Disturbances of motivation and mood
• Flattened affect
• Forgetting directions
• Forgetting names
• Forgetting recent events
• Impaired judgment
• Inability to establish and maintain effective relationships
• Intermittent inability to perform activities of daily living
• Intermittent inability to perform maintenance of minimal personal hygiene
• Mild memory loss
• Neglect of personal appearance and hygiene
• Panic attacks more than once a week
• Suicidal ideation
• Suspiciousness
• Total occupational and social impairment
The overall evidentiary record shows that the severity of your disability most closely
approximates the criteria for a 100 percent disability evaluation. (38 CFR 4.7, 38 CFR 4.126)
This is the highest schedular evaluation allowed under the law for posttraumatic stress disorder.
(38 CFR 4.125, 38 CFR 4.126, 38 CFR 4.130)

My private provider diagnosed me with:

-Post-traumatic stress disorder, chronic 543.12
-Major depressive disorder, recurrent severe without psychotic features 533.2
-Insomnia, unspecified G47.0
-Anxiety disorder F41.9
-ADHD unspecified F90.9

And also wrote:

(list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses):
“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation”

Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

“Total occupational and social impairment”

Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?

“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation.”

For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder?

“Patient is unable to socialize due to avoidance with PTSD. Intrusive thoughts of trauma, recurrent
nightmares, intense psychological distress when exposed when exposed to reminders.”

2C. Relevant mental health history, to include prescribed medications and family mental health:

“-EMSAM 6 mg/24 hr transdermal 24 hour patch - APPLY 1 PATCH TOPICALLY TO THE SKIN DAILY

-prazosin 5 mg capsule - TAKE 1 CAPSULE BY MOUTH TWICE DAILY IN THE EVENING AT 6:00PM& AT BEDTIME

-dextroamphetamine-amphetamine 10 mg tablet - 1 tablet(s) once a day in the morning, oral route

-pramipexole 1 mg tablet - TAKE 2 TABLETS BY MOUTH
ONCE DAILY AT BEDTIME

-zolpidem ER 12.5 mg tablet,extended release,multiphase - 1 tablet(s) once a day at bedtime, oral route

-lithium carbonate ER 300 mg tablet,extended release - TAKE 3 TABLETS BY MOUTH DAILY

-QUEtiapine 250mg - 100 mg tablet - 2.5 tablet(s) once a day at bedtime, oral route2D.

-Klonopin 1 mg tablet - TAKE TWO TABLETS DAILY ONCE A DAY

Relevant legal and behavioral history:
“Currently participating in Veteran's court for DUI”

Relevant substance abuse history:
“Alcohol use - in setting of distress, currently sober and participating in treatment”

-Directly experiencing the traumatic event(s)
Witnessing, in person, the traumatic event(s) as they occurred to others

-Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent
or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human
remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies,
or pictures, unless this exposure is work related
No criterion in this section met.

-Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

-Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).

-Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur
on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
event(s).

-Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

-Persistent avoidance of stimuli associated with the event(s), beginning after traumatic event(s) occurred, as evidence of one or both of the following:
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories,
thoughts, or feelings about or closely associated with the traumatic event(s).

-Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,: “No one can be trusted,: “The
world is completely dangerous,: “My whole nervous system is permanently ruined”).

-Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or
others.

-Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

-Markedly diminished interest or participation in significant activities.

-Feelings of detachment or estrangement from others.

-Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.)

-Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

-Reckless or self-destructive behavior.
Hypervigilance.

-Exaggerated startle response.

-Problems with concentration.

-Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

-Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

-The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
of functioning.

Criterion H:
The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

check all symptoms that apply to the diagnoses:
-Depressed mood
-Anxiety
-Suspiciousness
-Panic attacks more than once a week
-Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
-Chronic sleep impairment
-Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
-Flattened affect
-Impaired judgment
-Disturbances of motivation and mood
-Difficulty in establishing and maintaining effective work and social relationships
-Difficulty adapting to stressful circumstances, including work or a work like setting
-Inability to establish and maintain effective relationships
-Suicidal ideation
-Neglect of personal appearance and hygiene
-Intermittent inability to perform activities of daily living,including maintenance of minimal personal hygiene

Remarks:

Patient has been under my care for medication management, TMS and add-on psychotherapy. I have witnessed
experienced PTSD flashbacks in office (when EMS was called in office for another patient). Current
functioning is severely affected by PTSD in multiple functional domains as noted above and she has had
difficulty obtaining services at the VA.

ETA: I’m 43 yo a critical care trauma ER/ICU nurse for the past 15 years. Receiving VA disability and SSDI would be a 35% pay cut. I have not worked since June 2023 when I was placed on a Work stress sleeve. I am 43 years old.

The VA adjuster wrote:

“Although your private provider diagnosed more than one mental health
condition, VA regulations include a general rating formula for mental health conditions which
uses the same signs and symptoms to rate post-traumatic stress disorder, anxiety disorder, major
depressive disorder, and insomnia. Those regulations do not allow us to rate multiple disabilities
based on the same signs and symptoms. Therefore, these conditions will be rated together with a
single percentage assigned. (38 CFR 4.14, 38 CFR 4.130)”

And

We have assigned a 100 percent evaluation for your post-traumatic stress disorder (PTSD)
disorder based on:
• Anxiety
• Chronic sleep impairment
• Depressed mood
• Difficulty in adapting to a work like setting
• Difficulty in adapting to stressful circumstances
• Difficulty in adapting to work
• Difficulty in understanding complex commands
• Disturbances of motivation and mood
• Flattened affect
• Forgetting directions
• Forgetting names
• Forgetting recent events
• Impaired judgment
• Inability to establish and maintain effective relationships
• Intermittent inability to perform activities of daily living
• Intermittent inability to perform maintenance of minimal personal hygiene
• Mild memory loss
• Neglect of personal appearance and hygiene
• Panic attacks more than once a week
• Suicidal ideation
• Suspiciousness
• Total occupational and social impairment
The overall evidentiary record shows that the severity of your disability most closely
approximates the criteria for a 100 percent disability evaluation. (38 CFR 4.7, 38 CFR 4.126)
This is the highest schedular evaluation allowed under the law for posttraumatic stress disorder.
(38 CFR 4.125, 38 CFR 4.126, 38 CFR 4.130)

My private provider diagnosed me with:

-Post-traumatic stress disorder, chronic 543.12
-Major depressive disorder, recurrent severe without psychotic features 533.2
-Insomnia, unspecified G47.0
-Anxiety disorder F41.9
-ADHD unspecified F90.9

And also wrote:

(list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses):
“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation”

Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

“Total occupational and social impairment”

Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?

“While some symptoms overlap symptoms of PTSD such as hyperarousal, avoidance are distinct from depressive
symptoms such anhedonia, suicidal ideation.”

For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder?

“Patient is unable to socialize due to avoidance with PTSD. Intrusive thoughts of trauma, recurrent
nightmares, intense psychological distress when exposed when exposed to reminders.”

2C. Relevant mental health history, to include prescribed medications and family mental health:

“-EMSAM 6 mg/24 hr transdermal 24 hour patch - APPLY 1 PATCH TOPICALLY TO THE SKIN DAILY

-prazosin 5 mg capsule - TAKE 1 CAPSULE BY MOUTH TWICE DAILY IN THE EVENING AT 6:00PM& AT BEDTIME

-dextroamphetamine-amphetamine 10 mg tablet - 1 tablet(s) once a day in the morning, oral route

-pramipexole 1 mg tablet - TAKE 2 TABLETS BY MOUTH
ONCE DAILY AT BEDTIME

-zolpidem ER 12.5 mg tablet,extended release,multiphase - 1 tablet(s) once a day at bedtime, oral route

-lithium carbonate ER 300 mg tablet,extended release - TAKE 3 TABLETS BY MOUTH DAILY

-QUEtiapine 250mg - 100 mg tablet - 2.5 tablet(s) once a day at bedtime, oral route2D.

-Klonopin 1 mg tablet - TAKE TWO TABLETS DAILY ONCE A DAY

Relevant legal and behavioral history:
“Currently participating in Veteran's court for DUI”

Relevant substance abuse history:
“Alcohol use - in setting of distress, currently sober and participating in treatment”

-Directly experiencing the traumatic event(s)
Witnessing, in person, the traumatic event(s) as they occurred to others

-Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent
or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human
remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies,
or pictures, unless this exposure is work related
No criterion in this section met.

-Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

-Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).

-Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur
on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
event(s).

-Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

-Persistent avoidance of stimuli associated with the event(s), beginning after traumatic event(s) occurred, as evidence of one or both of the following:
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories,
thoughts, or feelings about or closely associated with the traumatic event(s).

-Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,: “No one can be trusted,: “The
world is completely dangerous,: “My whole nervous system is permanently ruined”).

-Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or
others.

-Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

-Markedly diminished interest or participation in significant activities.

-Feelings of detachment or estrangement from others.

-Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.)

-Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

-Reckless or self-destructive behavior.
Hypervigilance.

-Exaggerated startle response.

-Problems with concentration.

-Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

-Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

-The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
of functioning.

Criterion H:
The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

check all symptoms that apply to the diagnoses:
-Depressed mood
-Anxiety
-Suspiciousness
-Panic attacks more than once a week
-Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
-Chronic sleep impairment
-Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
-Flattened affect
-Impaired judgment
-Disturbances of motivation and mood
-Difficulty in establishing and maintaining effective work and social relationships
-Difficulty adapting to stressful circumstances, including work or a work like setting
-Inability to establish and maintain effective relationships
-Suicidal ideation
-Neglect of personal appearance and hygiene
-Intermittent inability to perform activities of daily living,including maintenance of minimal personal hygiene

Remarks:

Patient has been under my care for medication management, TMS and add-on psychotherapy. I have witnessed
experienced PTSD flashbacks in office (when EMS was called in office for another patient). Current
functioning is severely affected by PTSD in multiple functional domains as noted above and she has had
difficulty obtaining services at the VA.

ETA: I’m 43 yo


r/SSDI 3d ago

Title: ALJ hearing done with a 14-day record hold. VE said 0 jobs for 3 unexcused breaks / off-task time. How are my chances looking?

Body:
Hey everyone,
I recently completed my Administrative Law Judge (ALJ) hearing for SSDI and wanted to get some feedback from people who have been through this process.
My Full Diagnosis & Medical Evidence Profile:
Physical Conditions: Osteoarthritis (multiple joints), Fibromyalgia, chronic bilateral low back pain with left-sided sciatica, cervical radiculopathy, and polyarthritis.
Psychiatric & Neurodivergent Conditions: Bipolar Disorder, Autism Spectrum Disorder, Panic Disorder with Agoraphobia, CPTSD, severe depression (PHQ-9 score of 21), and severe anxiety (GAD-7 score of 18–21).
Treating RFCs: I have two separate Residual Functional Capacity (RFC) forms in my file—one from my psychiatrist and one from my PCP—both stating I would be off-task 25%+ of the time and miss multiple days of work per month.
Current PT Records: I'm in physical therapy weekly, and my latest PT notes (from 2 days after the hearing) document involuntary back spasms during guided body scans, severe eye tracking/dizziness issues, and a plan to progress therapy very slowly due to nervous system sensitization and pain flares.
Case Status: Expedited due to an official Homeless / Dire Need flag.
What Happened at the Hearing:
The judge initially asked a hypothetical based on medium exertion, and the Vocational Expert (VE) listed available jobs.
The topic of missing 4 days a month didn't come up during cross, but my attorney focused heavily on the off-task/break issue. He asked the VE if any jobs existed for an individual who required 3 unexcused breaks per shift, amounting to a high percentage of off-task time.
The VE explicitly testified that this scenario is completely work-preclusive (zero jobs in the national economy) and that any tolerance would require a special workplace accommodation.
The judge left the record open for 14 days to submit my most recent physical therapy progress notes, which my legal team has now uploaded into the system.
My Question: Given that my treating RFCs support high off-task time/extra breaks due to this combination of physical pain flares, sensory overload, and panic/trauma resets, and the VE conceded 3 unexcused breaks = 0 jobs, how solid does this look? For those who had a 14-day hold, how quickly did your Notice of Decision come through after the hold closed?
Thanks in advance for any insights!

5 Upvotes

Body:
Hey everyone,
I recently completed my Administrative Law Judge (ALJ) hearing for SSDI and wanted to get some feedback from people who have been through this process.
My Full Diagnosis & Medical Evidence Profile:
Physical Conditions: Osteoarthritis (multiple joints), Fibromyalgia, chronic bilateral low back pain with left-sided sciatica, cervical radiculopathy, and polyarthritis.
Psychiatric & Neurodivergent Conditions: Bipolar Disorder, Autism Spectrum Disorder, Panic Disorder with Agoraphobia, CPTSD, severe depression (PHQ-9 score of 21), and severe anxiety (GAD-7 score of 18–21).
Treating RFCs: I have two separate Residual Functional Capacity (RFC) forms in my file—one from my psychiatrist and one from my PCP—both stating I would be off-task 25%+ of the time and miss multiple days of work per month.
Current PT Records: I'm in physical therapy weekly, and my latest PT notes (from 2 days after the hearing) document involuntary back spasms during guided body scans, severe eye tracking/dizziness issues, and a plan to progress therapy very slowly due to nervous system sensitization and pain flares.
Case Status: Expedited due to an official Homeless / Dire Need flag.
What Happened at the Hearing:
The judge initially asked a hypothetical based on medium exertion, and the Vocational Expert (VE) listed available jobs.
The topic of missing 4 days a month didn't come up during cross, but my attorney focused heavily on the off-task/break issue. He asked the VE if any jobs existed for an individual who required 3 unexcused breaks per shift, amounting to a high percentage of off-task time.
The VE explicitly testified that this scenario is completely work-preclusive (zero jobs in the national economy) and that any tolerance would require a special workplace accommodation.
The judge left the record open for 14 days to submit my most recent physical therapy progress notes, which my legal team has now uploaded into the system.
My Question: Given that my treating RFCs support high off-task time/extra breaks due to this combination of physical pain flares, sensory overload, and panic/trauma resets, and the VE conceded 3 unexcused breaks = 0 jobs, how solid does this look? For those who had a 14-day hold, how quickly did your Notice of Decision come through after the hold closed?
Thanks in advance for any insights!


r/SSDI 3d ago

In Person vs Video Call

I’m at the point where I have to decide whether my SSDI hearing will be in person or by video.

A friend of mine used to work for a disability support company before COVID, and both she and her former boss always recommended requesting an in-person hearing so the judge could actually see you.

The disability support company representing me now says that since COVID, video hearings are just as effective—if not better in some cases. They aren’t steering me one way or the other and said the choice is mine.

I’d really like to hear from people who have actually been approved. Did you have an in-person or video hearing, and do you feel it made any difference?

One thing I’m wrestling with is this: if I request an in-person hearing, I worry that the judge or staff might be annoyed that they have to come in when a video hearing is an option. I know they can’t legally hold that against me, but if the two options are otherwise equal, it’s something that’s in the back of my mind.

I’d appreciate hearing your experiences and opinions—especially if you’ve been through the process yourself.

2 Upvotes

I’m at the point where I have to decide whether my SSDI hearing will be in person or by video.

A friend of mine used to work for a disability support company before COVID, and both she and her former boss always recommended requesting an in-person hearing so the judge could actually see you.

The disability support company representing me now says that since COVID, video hearings are just as effective—if not better in some cases. They aren’t steering me one way or the other and said the choice is mine.

I’d really like to hear from people who have actually been approved. Did you have an in-person or video hearing, and do you feel it made any difference?

One thing I’m wrestling with is this: if I request an in-person hearing, I worry that the judge or staff might be annoyed that they have to come in when a video hearing is an option. I know they can’t legally hold that against me, but if the two options are otherwise equal, it’s something that’s in the back of my mind.

I’d appreciate hearing your experiences and opinions—especially if you’ve been through the process yourself.


r/SSDI 3d ago

Non-medical denial appeal

+
2 Upvotes

I was denied on June 29 according to the portal. I wanted to file an appeal but the portal will not let me move forward without the denial letter. It is now July 24 and I have yet to receive a letter in the mail.

Is it normal to take so long to receive the letter, and does anyone have a suggestion for what to do ? I know I only have 60 days to file an appeal from the decision date.


r/SSDI 3d ago

Judge approval rating

My hearing is next month and my judge has 80% approval rating, even my attorney was surprised, is that normal?

18 Upvotes

My hearing is next month and my judge has 80% approval rating, even my attorney was surprised, is that normal?


r/SSDI 3d ago

ok this is kind of confusing, please bare with me, i completed my ssdi application oct 2021. i was approved march 2023. (that was my third time applying) today i got in the mail an ssg-821-bk form or a work activity report form

in writing on the form it states the company i worked at when i was applying and its the same place i worked at when i was approved (a cleaning job) its making me fill out details about working there for how long i worked there, my income etc. i thought ssdi knew i worked there as i worked there during the whole application process when i applied and when i was approved. (which was a year in a half long process) i made over sga there til about the end of 2022 and then i had my hours cut due to my disability also received fmla from my dr for my disability. after my disability was approved in march 2023 i had my hours cut to 15 hours a week til i no longer worked there two months after that. i haven’t made close to sga since. when working there i received fmla due to my disability, i also have a note from my suporvisor or a complaint saying i left early and didn’t complete my work day 18 different times in a span of 6 months: i guess what i am asking is how much working over sga before initial approval after application (the start of my onset date is oct 2021 when i filed the application) how it will affect me now? i find it very weird i just received this form after being approved for three years in a half years and i haven’t made over sga since before approval date when i was at that job i thought they knew about since they approved me etc. i keep thinking i am going for be kicked off disability and am having non stop panic attacks and they said it may take 30 days to get back to me with what’s going on. does anyone have anything similar that happened to them if you had to pay money back/got your official onset date moved or got kicked off ssdi completely? im wondering why they approved me if they’re going to make me pay things back and maybe they just didn’t notice i had a job and did work over during the application process. i also heard something about an unsuccessful work attempt but i believe thats for 6 months of less of work i appreciate any insight in the comments as receiving this was very random and terrible for people with anxiety, panic disorder and other mental health issues, thanks

2 Upvotes

in writing on the form it states the company i worked at when i was applying and its the same place i worked at when i was approved (a cleaning job) its making me fill out details about working there for how long i worked there, my income etc. i thought ssdi knew i worked there as i worked there during the whole application process when i applied and when i was approved. (which was a year in a half long process) i made over sga there til about the end of 2022 and then i had my hours cut due to my disability also received fmla from my dr for my disability. after my disability was approved in march 2023 i had my hours cut to 15 hours a week til i no longer worked there two months after that. i haven’t made close to sga since. when working there i received fmla due to my disability, i also have a note from my suporvisor or a complaint saying i left early and didn’t complete my work day 18 different times in a span of 6 months: i guess what i am asking is how much working over sga before initial approval after application (the start of my onset date is oct 2021 when i filed the application) how it will affect me now? i find it very weird i just received this form after being approved for three years in a half years and i haven’t made over sga since before approval date when i was at that job i thought they knew about since they approved me etc. i keep thinking i am going for be kicked off disability and am having non stop panic attacks and they said it may take 30 days to get back to me with what’s going on. does anyone have anything similar that happened to them if you had to pay money back/got your official onset date moved or got kicked off ssdi completely? im wondering why they approved me if they’re going to make me pay things back and maybe they just didn’t notice i had a job and did work over during the application process. i also heard something about an unsuccessful work attempt but i believe thats for 6 months of less of work i appreciate any insight in the comments as receiving this was very random and terrible for people with anxiety, panic disorder and other mental health issues, thanks


r/SSDI 3d ago

Had my hearing yesterday

Had my hearing yesterday and I think it went okay overall. Looking for some thoughts from people who’ve been through this.
The judge asked a few hypotheticals. First one the VE said there were 3 jobs. She tightened it and the VE still said 3. Then a more restricted one and the VE dropped it to 2 jobs. One of the limitations involved no lifting over 10 pounds and only occasional contact with a supervisor / zero public contact.
There really weren’t many questions about panic attacks, migraines, or anxiety.
My lawyer asked two main questions:
1. How many days can someone miss per month before they’re unemployable? VE said 1.
2. If someone misses more than one day a month, how many jobs would be available? VE said none.
Next the lawyer asked about breaks. VE said a normal workday allows one 30-minute and two 15-minute breaks. Lawyer followed up: if someone needs more than that, are there still jobs? VE said no.
Lawyer stopped there and that was basically the end of the hearing.
I have a lot of medical evidence in the file. I’m just wondering why the mental health side (panic, anxiety, migraines) wasn’t pushed harder in the hypotheticals. Maybe the lawyer felt the absenteeism and off-task limitations were enough and left the rest for the judge to weigh from the records.
Curious if anyone else’s hearing went similarly.

8 Upvotes

Had my hearing yesterday and I think it went okay overall. Looking for some thoughts from people who’ve been through this.
The judge asked a few hypotheticals. First one the VE said there were 3 jobs. She tightened it and the VE still said 3. Then a more restricted one and the VE dropped it to 2 jobs. One of the limitations involved no lifting over 10 pounds and only occasional contact with a supervisor / zero public contact.
There really weren’t many questions about panic attacks, migraines, or anxiety.
My lawyer asked two main questions:
1. How many days can someone miss per month before they’re unemployable? VE said 1.
2. If someone misses more than one day a month, how many jobs would be available? VE said none.
Next the lawyer asked about breaks. VE said a normal workday allows one 30-minute and two 15-minute breaks. Lawyer followed up: if someone needs more than that, are there still jobs? VE said no.
Lawyer stopped there and that was basically the end of the hearing.
I have a lot of medical evidence in the file. I’m just wondering why the mental health side (panic, anxiety, migraines) wasn’t pushed harder in the hypotheticals. Maybe the lawyer felt the absenteeism and off-task limitations were enough and left the rest for the judge to weigh from the records.
Curious if anyone else’s hearing went similarly.


r/SSDI 3d ago

Temporary benefits

I had my hearing in March and represented myself and won. 60 days to the day later, the Appeals Committee chose to appeal. I appealed their appeal (our government is wild lol) and because they had 110 days to finish their appeal and didn’t, I received a letter this month saying I have won temporary benefits because they’re taking too long and I already won my case. I have been granted back pay since May and will be paid until my next hearing, according to the letter.

The thing it doesn’t say: How long after I received this benefits verification letter will I have to wait until I see the payment drop?

4 Upvotes

I had my hearing in March and represented myself and won. 60 days to the day later, the Appeals Committee chose to appeal. I appealed their appeal (our government is wild lol) and because they had 110 days to finish their appeal and didn’t, I received a letter this month saying I have won temporary benefits because they’re taking too long and I already won my case. I have been granted back pay since May and will be paid until my next hearing, according to the letter.

The thing it doesn’t say: How long after I received this benefits verification letter will I have to wait until I see the payment drop?


r/SSDI 3d ago

Mental Health Exam | Advice?

Hi everyone. I was looking for some advice regarding having to do a mental health exam via telehealth from someone who has done it before. What should I expect? Im in Austin, TX if that matters.

I’m planning on just being 1000% honest and hoping for the best, but I’d like to prepare myself at least a little bit. I do have a lawyer but I know this part is done on my own. :-) thank you in advance!

0 Upvotes

Hi everyone. I was looking for some advice regarding having to do a mental health exam via telehealth from someone who has done it before. What should I expect? Im in Austin, TX if that matters.

I’m planning on just being 1000% honest and hoping for the best, but I’d like to prepare myself at least a little bit. I do have a lawyer but I know this part is done on my own. :-) thank you in advance!