Can you win Social Security disability benefits based on a mental health issue like PTSD, anxiety, depression or bipolar disorder if the only records in your case file are VA (Veterans Administration) medical notes?

My experience over the past few years has been that you can win Social Security disability for mental health claims using VA records but it is becoming increasingly difficult to win benefits with only VA records. This is true even in the case of veterans who have a 100% service connected VA disability rating.

VA Disability Ratings Are Not Binding on Social Security

I have always found it odd that a VA disability determination is not binding at all on the Social Security Administration. VA disability is different from Social Security in that the VA system issues ratings in percentages whereas Social Security is “all or nothing.” You can have a 70% VA rating but there is no equivalent in Social Security – either you are 100% disabled or you are not disabled at all.

You may be frustrated and disappointed that your 100% VA disability rating is not binding in any way on Social Security in disability determinations.’

I fully understand the frustration of military veterans who are struggling with PTSD, depression, anxiety and perhaps a variety of physical problems who cannot understand why they have to go through another disability adjudication process after they have fought the VA for months or years.

Consider this comment from a potential SSD claimant who emailed me as follows:

I am a 100% Permanent/Total Disabled Veteran. The SSA Disability Determination Service Rep is saying that they are not getting enough medical information from the VA. They are only looking at a few hospital records, NOT my VA claim file (which is massive). They are talking about scheduling me for a medical eval, which is preposterous!!! My claim file has extensive records and copious evaluations.

Unfortunately this gentleman’s experience is common. Worse, there is a very strong likelihood that his SSD claim will be denied.

VA Records Do Not Address What Social Security Judges Need to Know

In a Social Security disability hearing, the judge is focused on one issue – do your medical/mental health problems limit you from reliably performing even a simple, entry-level job?

My experience has been that if your inability to work arises from mental health issues like depression, anxiety, PTSD, bi-polar disorder or similar conditions judges expect to see:

• one or more inpatient hospitalizations and/or
• one or more documented suicide attempts and/or
• prescriptions by a psychiatrist for potent medications and evidence that medication dosages need to be increased or medications changed because they are not working and/or
  records from long time treating psychologists or psychiatrists that your mental state is not improving and that you no longer have the ability to function in a work environment; and
  a completed functional capacity evaluation (provided by your lawyer) that identifies specific work limitations

VA records rarely provide this type of evidence.

Often VA medical treatment consists of periodic office visits with a staff psychiatrist, over-medication with multiple psychotropic medications; only very occasional changes to dosage, and records of group talk therapy.

VA doctors generally will not fill out functional capacity forms, and it is rare that a VA patient will see the same VA doctor more than a few times before doctor moves on.

Social Security Judges Expect Every Veteran to Have Some Level of PTSD

Further, Social Security disability judges expect that every soldier will have some element of PTSD. This is certainly the case for soldiers who were on active duty overseas and often the case for soldiers who were stationed stateside but may have been exposed to training accidents or even physical or sexual abuse.

To put this another way, almost every military veteran who pursues Social Security disability will allege PTSD, depression, anxiety, low back pain and possibly residual effects from chemical exposure. There is often evidence of alcohol or street drug abuse which can further cloud the question of work capacity.

Without specific evidence in the record that these medical issues create specific work impairments, or a functional capacity evaluation that identifies work limitations, many judges will assume that your limitations are mild or that if the VA just cut back on the over medication you could return to work.

VA Records are Voluminous and Repetitive

I would also add that VA records tend to be voluminous – often consisting of hundreds or even thousands of pages, much of which are copies of copies. Often Social Security judges don’t have the time to read through these records because it is so difficult to actually find relevant information.

This may not be fair or accurate but this is the reality we have to deal with.

When I work on a case with VA records I will often outsource the process of abstracting the record since it is so time consuming to slog through VA records. I have used these summaries in pre-hearing briefs and judges do appreciate the time savings. I suspect that most Social Security disability judges find VA records as difficult to work with as I do.

What do Disabled Veterans Need to Win Social Security Disability?

So, when I speak to a VA disabled veteran I am going to ask him/her:

• are you getting treatment from a non-VA doctor?
• will your non-VA doctor fill out a functional capacity form?
• do you have a history of non-VA inpatient hospitalizations, suicide attempts or unsuccessful medication management?

I ask these questions because you can greatly increase your chances at winning if you can obtain psychiatric treatment and/or counseling from a non VA source. If the non-VA mental health provider will fill out a functional capacity form your chances for an approval go up significantly.

VA Records are Often Insufficient to Document Non-Mental Health Impairments as Well

The same idea holds true with non-mental health ailments like disc issues in your lower back, knee deterioration, or other joint issues that impact your work capacity. Many times non-VA orthopedists will be willing to address functional issues in medical notes or in a functional capacity form.

I can also tell you that VA records rarely speak in detail about any autoimmune conditions you may have developed from exposure to toxic chemicals while in service. This may be VA policy to minimize VA disability claims due to chemical exposure or it may be because the VA does not have the equipment or staff to properly evaluate such claims. Either way, you are much better off seeking evaluation and treatment for autoimmune conditions with a non-VA source.

The Bottom Line: Seek Treatment Outside the VA if You Hope to Win Social Security Disability

So, to summarize, if you are a veteran who uses VA hospitals and clinics for all of your medical care, your VA records will not be a good fit in a Social Security disability claim. Your VA records are relevant in documenting ongoing treatment and medication management but VA records rarely, if ever, address work capacity issues and VA doctors generally will not complete the functional capacity forms that can make the difference in your SSDI or SSI case.

Your chances of success in your Social Security disability claim will increase greatly if you file contains non-VA treatment records and functional capacity evaluations.