Key Takeaways:
Official Listing: PTSD is evaluated under SSA Listing 12.15.
The Standard: To qualify for SSDI, you must prove “Marked Limitations” in areas like interacting with others or concentrating.
Veterans: VA benefits require proof of a “service-connected stressor,” often verified using VA Form 21-0781.
Medical Evidence: Success requires longitudinal records (history over time), not just a one-time diagnosis.
Post-Traumatic Stress Disorder (PTSD) is more than just “stress”—it is a protected disability under the Americans with Disabilities Act (ADA) and a qualifying condition for both Social Security Disability (SSDI) and Veterans Affairs (VA) compensation. It often occurs alongside other mental disorders, making the claim process complex.
However, having a diagnosis is not enough. To get approved, you must meet specific medical criteria known as Listing 12.15.
H2: Can You Get SSDI for PTSD? (The “Blue Book” Rules)
Yes, the Social Security Administration (SSA) evaluates PTSD under Listing 12.15 (Trauma- and stressor-related disorders). To qualify, you generally need to meet the criteria from Paragraph A and Paragraph B.
The “Paragraph A” Criteria: Medical Documentation
First, you must have medical documentation of all the following:
Exposure to actual or threatened death, serious injury, or violence.Involuntary re-experiencing of the event (flashbacks, nightmares).
Avoidance of external reminders of the event.
Disturbance in mood and behavior.
The “Paragraph B” Criteria: Functional Limitations
This is where most claims are denied. You must prove you have an “Extreme limitation” of one or a “Marked limitation” of two of the following mental functioning areas:
- Understand, remember, or apply information (e.g., following instructions at work).
- Interact with others (e.g., handling conflicts with supervisors or peers).
- Concentrate, persist, or maintain pace (e.g., finishing tasks on time).
- Adapt or manage oneself (e.g., personal hygiene and emotional regulation).
What if I Don’t Meet the Listing? (Paragraph C & RFC)
If you don’t meet the criteria above, you may still qualify if:
- Paragraph C: Your PTSD is “serious and persistent,” documented for at least 2 years, and you rely on ongoing medical treatment or a highly structured setting to manage daily life.
- Medical-Vocational Allowance: The SSA determines that your Residual Functional Capacity (RFC) prevents you from doing any job you are qualified for.
H2: How PTSD Symptoms Impact Your Ability to Work (RFC)
Yes, the Social Security Administration (SSA) evaluates PTSD under Listing 12.15 (Trauma- and stressor-related disorders). To qualify, you generally need to meet the criteria from Paragraph A and Paragraph B.
The “Paragraph A” Criteria: Medical Documentation
First, you must have medical documentation of all the following:
Exposure to actual or threatened death, serious injury, or violence.Involuntary re-experiencing of the event (flashbacks, nightmares).
Avoidance of external reminders of the event.
Disturbance in mood and behavior.
The “Paragraph B” Criteria: Functional Limitations
This is where most claims are denied. You must prove you have an “Extreme limitation” of one or a “Marked limitation” of two of the following mental functioning areas:
- Understand, remember, or apply information (e.g., following instructions at work).
- Interact with others (e.g., handling conflicts with supervisors or peers).
- Concentrate, persist, or maintain pace (e.g., finishing tasks on time).
- Adapt or manage oneself (e.g., personal hygiene and emotional regulation).
What if I Don’t Meet the Listing? (Paragraph C & RFC)
If you don’t meet the criteria above, you may still qualify if:
- Paragraph C: Your PTSD is “serious and persistent,” documented for at least 2 years, and you rely on ongoing medical treatment or a highly structured setting to manage daily life.
Medical-Vocational Allowance: The SSA determines that your Residual Functional Capacity (RFC) prevents you from doing any job you are qualified for.
H2: How PTSD Symptoms Impact Your Ability to Work (RFC)
Even if you don’t perfectly meet Listing 12.15, you can win if your Residual Functional Capacity (RFC) shows you cannot hold a job. Common long-term effects that limit work capacity include:
- Insomnia and Sleep Disturbances: Frequent nightmares may lead to chronic fatigue, making it impossible to maintain a full-time schedule or focus on tasks.
- Social Withdrawal: If you avoid family or colleagues due to anxiety, you may be unable to work in environments requiring teamwork or public interaction.
- Intrusive Thoughts & Flashbacks: Unexpected memories can disrupt concentration, leading to lower productivity or time off-task.
- Reactivity: A constant feeling of being “on edge” (hyperarousal) can lead to aggressive behavior or inability to handle normal workplace stress.
- Mood Instability: Severe depression or irritability often accompanies PTSD, leading to crying spells, lack of motivation, or conflicts with coworkers.
H2: VA Disability for PTSD: Proving the “Service Connection”
For veterans, the process is different. You typically do not need to prove you cannot work; you must prove your PTSD is connected to your service.
Eligibility Requirements
According to the VA.gov PTSD eligibility page, you are eligible if:
- The stressor happened during your service (service-connected).
- You cannot function as well as you once could because of symptoms.
- A doctor has formally diagnosed you with PTSD.
What Counts as a “Stressor”?
You may need to submit VA Form 21-0781 to detail your stressor. Qualifying events include:
- Combat experiences: Engaging with enemy forces or fear of hostile activity.
- Non-combat trauma: Sexual assault, severe car accidents, or witnessing a natural disaster while serving.
H2: Why You Need Medical Evidence (And How to Get It)
Whether filing for SSDI or VA benefits, your word isn’t enough. You need “longitudinal evidence”—records that show your history over time.
- Psychiatric Notes: Detailing the frequency of your panic attacks or flashbacks.
- Buddy Statements: Letters from family or fellow soldiers describing how the trauma changed your personality.
H2: Why Are PTSD Disability Claims Denied?
Simply having a diagnosis is not enough. The SSA and VA frequently deny claims for the following reasons:
- Lack of Longitudinal Evidence: You need records showing a history of symptoms over time, not just a one-time exam.
- Failure to Follow Treatment: If you are not undergoing ongoing medical treatment or therapy, the SSA may argue your condition isn’t severe or could improve.
- Substance Abuse: Many people use alcohol or drugs to cope with PTSD. However, if the agency believes your symptoms would go away if you stopped using substances, your claim may be denied.
- Inconsistent Statements: Your “Buddy Statements” and your doctor’s notes must match your self-report. If you have been denied, you have 60 days to appeal the denial.
Conclusion
Meeting the requirements for Listing 12.15 is difficult without legal help. If you have been denied or are preparing to file, contact Nationwide Disability Representatives today for a free case evaluation. We help you gather the specific medical evidence needed to prove your “marked limitations” to the SSA.
H2: Frequently Asked Questions About PTSD Disability
Q: Is PTSD considered a permanent disability?
A: For the VA, PTSD can be considered a permanent and total disability if it is rated at 100% and unlikely to improve. For Social Security, specific “permanent” labels are less common, but benefits continue as long as the condition prevents you from working.
Q: Can I get both VA disability and SSDI for PTSD?
A: Yes, you can receive both benefits simultaneously. However, approval for one does not guarantee approval for the other, as they use different criteria (Listing 12.15 vs. Service Connection).
Q: How much does disability pay for PTSD?
A: SSDI payments are based on your work history and average earnings. VA disability compensation is tax-free and based on your disability rating (from 0% to 100%).
Q: What is the “Blue Book” listing for PTSD?
A: PTSD is listed under Section 12.15 (Trauma- and stressor-related disorders) in the SSA Blue Book.
