What is decompensation when filing for disability benefits?

Claimants in Florida seeking Social Security Disability (SSD) benefits for mental conditions will often hear a term known as “decompensation” when their symptoms are discussed. Many, however, are not fully aware of what the Social Security Administration means by this. Before seeking disability benefits, it is important to be able to recognize the symptoms and if decompensation is occurring as one of the symptoms.

When a claimant is experiencing an exacerbation or temporary increase in the signs and symptoms that are part of a loss of adaptive functioning, it is known as an episode of decompensation. The manifestation of this is indicated by a difficulty in performing normal activities that are done on a daily basis, an inability to maintain social relationships or an issue with concentrating, persisting or pacing. The medical records can show the following: that decompensation has occurred by a change in medication; the documentation that the person requires a psychological support system that is more structured with examples being hospitalization, being a resident in a halfway house, or a household that is highly structured and directed; or other information detailing its existence, severity and duration.

When repeated episodes of decompensation are mentioned and each are of an extended duration, this means that there are three within a single year or an average of one every four months. Each must last a minimum of two weeks. Judgment will be used if these occur more frequently for a shorter time or episodes that happen less often but are of longer duration. This might lead to a determination that these episodes are of equal severity to the detailed durations.

Those who are considering filing for disability benefits need to have a grasp of qualifying mental conditions, what is meant by decompensation, and the details regarding its diagnosis. Speaking to a legal professional can help with understanding decompensation and how it is factored in to a decision on disability status.

Source: SSA.gov, “12.00 Mental Disorders — Adult — 4. Episodes of decompensation,” accessed on Dec. 7, 2015


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