Mental Disorders Rule Update

Woman with documents sitting on the deskOn Monday, September 26, Social Security will publish a final rule to update the criteria we use to evaluate disability claims involving mental disorders. This rule, “Revised Medical Criteria for Evaluating Mental Disorders,” is the most comprehensive revision to the criteria since 1985.

Upon publishing this final rule, our standards and terminology for evaluating claims involving mental disorders reflect information from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition — the mental health profession’s current standard classification of mental disorders.

While updating this rule, the public had questions about our criteria for evaluating intellectual disability. From childhood onward, people with intellectual disabilities experience deficits in intellectual functioning and lack many basic daily practical and social skills. We decided it was critical to ensure these individuals receive necessary assistance as soon as possible. Therefore, we updated the diagnostic and functional criteria for this disorder and are using IQ test score criteria to identify quickly people who may qualify for disability benefits based on an intellectual disability.

Besides reflecting comments from members of the public, the rule reflects the expertise of disability policy experts, adjudicators, psychiatric professionals, and vocational experts.

During the careful, considered process of updating the rule, we’ve engaged with stakeholders, including: disability beneficiaries and their family members; psychiatrists, psychologists, and other mental health treatment providers; and advocacy groups for those with mental disorders. We also solicited, responded to, and incorporated public comments, and considered an intellectual disability report we commissioned from the National Academy of Sciences.

People with mental disorders are some of the most vulnerable members in our society, and we take our duty to provide them with effective service and support seriously. Publishing this rule is just one way we’re meeting our priority to secure today and tomorrow for millions throughout life’s journey.

You can learn more about the rule here.

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231 thoughts on “Mental Disorders Rule Update

  1. My son has been on SSI since 2009 with Bipolar and schizoaffective disorder diagnosis, going to Indian Rivers Mental Health Clinic since 2001. 17 yrs. He had a breakdown in 2009. Now, he has decided he doesn’t need any meds or shot. We have talked and talked to him. He says he is going to be the next President. My question is. Will his SSI stop if he continues to not take his meds and shot. He is 43 yrs old now. Been dealing with this for 17 yrs. He lives with us and pays us rent. He sits in a chair practically all day on medicine or not. He has been in State Hospital several times. He has been very medication compliant etc until now.
    I am his mother. Gayle Elliott

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  3. I am totally disappointed in our system my grandson has had Schizophrenia for 6 years and have applied for social security but they say it may take up to 2 more years so that would be 7 years since we have applied. He lives in a group home has been homeless over the years been in a program for the last 2 years for the mentally disabled, our system has failed him.

  4. Thanks. A friend who has applied and been too ill and or socially dysfunctional to complete process has been turned down several times. Knowing he was “one of the most vulnerable of society…:in the hearing, they ordered and canceled tests w no exp. and then at a table of about 7 in hearing including him and myself, they reported his ability to work was, “that of a bottle washer or broom pusher..” How was that even appropriate. Why would he at 1 point be approved, receive benefits only to be discontinued in aprox 4 mos w/o explanation?

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  6. We have a claim for a patient in a state mental health institution. Issue is the institution will not pay, as patient was medically discharged to be readmitted to our medical facility as inpatient. Medicare has not been updated with the institutional days and will not pay either as file not updated. Who is responsible for updating a mental health patient in the Medicare system with days outside the mental institution such as a hospital stay when they are not able?

    • Hi Jane. For specific billing questions and questions about claims, medical records, or expenses, visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). You may also contact the local Medicaid office in your area. Thanks!

  7. If U have a disability because U are bipolar, ect! Will U lose your disability if you have a breakdown and have to go into treatment?For how long?

  8. yea take years to get ssi make it like pulling teeth to get it if you can get it… you all need to clean up ssi alot of people on it dont need to be on it.

  9. I do not understand how a person that seeks no medical attention to help their condition to help better their way of life not only for themselves but for their family members are allowed to continue receiving
    SSI payments?

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