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BIPOLAR DISORDER, DEPRESSION, AND SOCIAL SECURITY DISABILITY: 5 TIPS FOR WINNING YOUR CASE * TIP 1: Tell Your Doctor If you have been experiencing problems from your bipolar disorder or depression, tell your doctors about them! Also, be specific. If feelings of depression cause you to shut yourself alone in your room for several days, make sure to tell your doctor the whole story. How often do you do this? When your depression is this severe, do friends or family members have to help make sure you eat or remind you to dress or bathe? Unfortunately, doctors are often too busy to ask as many questions as they should. Take the initiative and tell them what your medical condition is putting you through. Medical records are vital to your disability claim. If you haven't told your doctor about your symptoms then your medical records won't show the full severity of your condition. Be sure to tell your primary doctor about your symptoms even if you have a specialist such as a psychiatrist or psychologist. Why is this important? Assume that Joe Claimant is applying for disability. Joe suffers from severe depression and sees a psychiatrist. Joe's primary doctor is treating him only for headaches and high blood pressure. Joe is still having insomnia and crying spells from his depression but his headaches are doing better, and so when he goes to his checkup he tells his primary doctor he is doing fine. Joe's doctor writes in his notes "patient is doing fine, no complaints". What happens when a Social Security disability decision-maker sees this note. Very often they will take it to mean that Joe was not having problems with his depression at that time, even though that is not what Joe or possibly even his doctor meant to say. Take the time to tell your doctors how you are doing physically and mentally. This isn't important for only your disability claim. Your doctors need to know about all your health problems in order to treat them correctly. * TIP 2: Details, Details, Details Social Security disability judges hear literally hundreds of bipolar disorder and depression cases a year. Of course, you can't diagnose these conditions using x-rays, physical exams, or other "objective" testing. And so disability judges are often skeptical about bipolar and depression disability claims. The fact that even doctors can confuse bipolar disorder and depression doesn't help the situation. How can you distinguish your case and convince Social Security that your case is the real thing? The answer is to give your disability attorney details, details, details. This starts with the history of your condition. When did you first start having symptoms? Why did you decide to seek treatment? If you have insomnia, what do you do while awake at night? When your depression is at its worst, how do you spend your day? Details bring your case to life. They help Social Security see you as an individual suffering from your own specific set of health problems instead of "just another bipolar case". Details are especially useful for individuals with manic episodes. Social Security disability decision-makers know that people suffering from mania can have symptoms such as racing thoughts and rapid speech, going several days without sleep, feelings of grandiosity, and engaging in impulsive behavior such as shopping sprees, heightened sexual activity, and spontaneous vacations. Simply reciting these symptoms won't influence a judge, but the details can. One of my clients drafted a formal business plan for a shoplifting ring while she was going through a three-day manic episode. She recruited friends to participate and planned the enterprise down to the smallest detail. After she crashed down off her mania into depression she never thought about the plan again. While the judge who heard her case wasn't thrilled that she designed an elaborate illegal enterprise, the incident helped convince him that my client's manic symptoms were genuine. * TIP 3: Make it Personal Bipolar disorder and depression affect every aspect of life. They put a strain on family relationships and friendships. They damage your sense of self worth by limiting your ability to contribute to the household or to even just enjoy a regular life. It's important to let your disability attorney know exactly how your life has been affected by your disability. Has your marriage or family suffered from your behavior or from financial strain due to your inability to work? Has your disability affected the way you see yourself? Understandably, many people are reluctant to share personal details with their lawyer or a Social Security disability judge. However, describing the toll your condition has taken on your life can convince a judge of your disability just as effectively as an x-ray can show a bone fracture. For instance, one judge, normally very reluctant to award bipolar cases, approved benefits for my client after listening to him describe his difficult decision to stop visiting his daughter because of his emotional instability. This one piece of testimony changed the outcome of the case. Sometimes the personal events that are important to a disability claim occurred long ago, even as far back as childhood. Many people struggle with bipolar symptoms and depression but are able to cope with them well enough to keep a job for a time. Later events in life can bring back their symptoms or make them much worse. I'll use two of my former clients to explain. One client had a long history of depression going back to her childhood. Still, she was able to work until her depression worsened after a car accident that injured her back and ankle. Another client was doing well until the death of his father brought back memories of abuse he suffered as a child. The judges hearing these cases could not understand why these two clients could not work until they understood the emotional difficulties they had dealt with since early in their lives. * TIP 4: Use Your Work History Social Security disability judges like to see claimants with a long, steady work history. Judges like to help out these hard workers. However, in bipolar disorder and depression cases less can be more. Each job you lost because of your symptoms provides an illustration of how your medical conditions are disabling. Once again, details are important. How did each job end? Were you having arguments with your bosses? Were you making errors because of problems concentrating? Were you missing work because you did not feel able to leave your home and face the day? Make a list of your past jobs. Write down how long they lasted and why they ended. Try to be impartial. It's human nature to blame others such as bosses or co-workers when things go wrong. However, if you didn't believe your medical conditions kept you from working then you wouldn't be filing for disability. * TIP 5: Use Your "ADLs" The Social Security disability process is about determining your ability to function in the workplace. In order to do this Social Security looks at your ability to do normal activities like caring for yourself, cooking, cleaning, driving, grocery shopping, and managing your money. Social Security calls these "ADLs", or, "Activities of Daily Living". Just like your work history, your ADLs provide concrete examples of how your medical conditions affect you. Make sure to give your disability attorney a full description of what you can do as well as what you can't do around the home. Many disability claimants fear their claim will be denied if they tell Social Security that they help with household chores or care for young children or a disabled or elderly person. Helping out around the home doesn't mean you aren't disabled. A person is disabled unless they can sustain work. Individuals with bipolar disorder or depression are sometimes productive one day but unable to do much at all the next. At times they might require help from friends or family to do even basic activities and care for themselves. These individuals would miss too much work to keep a job, or, if they did go to work on their bad days they would make too many mistakes or work too slowly. Everyone has seen T.V. shows where the police say "Anything you say can and will be used against you in a court of law". A Social Security disability hearing is not a court of law. It is in informal proceeding and the disability judge's job is to make an unbiased decision. Social Security disability judges know enough about bipolar disorder and depression to know that people with these conditions have their ups and downs. The key is to give them the full picture of your day-to-day functioning. It's helpful to have a qualified disability attorney to assist you with this and other aspects of presenting your disability claim.