Panic Attacks and Social Security Disability

Panic Attacks - Condition and Symptoms

A Panic Attack is a sudden, intense feeling of fear that triggers severe physical reactions that oftentimes include: a pounding heart, dizziness, nausea, flushed feeling(s), and shortness of breath. For some people, Panic Attacks can be isolated events. For others, Panic Attacks can be a more frequent occurrence.

Usually, Panic Attacks have no apparent cause. Nonetheless, they are incredibly frightening and can cause person having the Panic Attack affected to believe that they are dying from a heart attack and/or going crazy.

Oftentimes, people who have had more than one or two Panic Attacks begin to live in fear of these attacks. Sometimes these individuals go above and beyond to try to avoid the specific, or any, situation(s) they may have found themselves in when they suffered a previous Panic Attack. In some cases, this avoidance behavior can get to a point at which it is so extreme that these Panic Attack victims feel unsafe anywhere outside of their home.

When a person has suffered a series of four or more Panic Attacks, and if they have spent more than a month in constant fear of another Panic Attack, then that individual may be diagnosed as having Chronic Panic Disorder. Chronic Panic Disorder is a type of chronic anxiety disorder. Conversely, an isolated Panic Attack may be a symptom of other types of anxiety disorders. 

Panic Attacks can significantly affect a person’s quality of life. If left untreated, Panic Attacks and Chronic Panic Disorder can lead to phobias, depression, substance abuse, difficulty at work and/or school, and, tragically, even suicidal thoughts and actions.

The causes of Panic Attacks are not known. And, while there has been some research into the role of genetics, stress, trauma, brain chemistry and function, and a malfunction of the natural adrenaline rush produced by sudden danger, there is little conclusive proof of this cause.

Although a Panic Attack is generally not life-threatening, seeking medical help—either during or after a Panic Attack—is highly advisable. Seeking medical attention and help is especially important for Panic Attack victims because the symptoms of Panic Attacks are so  similar to those of life-threatening conditions.

The more common physical symptoms of Panic Attacks are a rapid heart rate, trembling, hyperventilation, sweating, nausea, chest pain, dizziness, and shortness of breath. And, beyond intense fear, psychological symptoms of Panic Attacks include a sense of impending doom as well as a belief that the sufferer is dying or has gone insane.

Panic Attacks almost always have a sudden onset, with no particular time or place consistently triggering an attack. Thus, Panic Attacks can happen in almost any situation, even while a patient is asleep. Most attacks peak within 15 minutes and last less than an hour, leaving most sufferers feeling physically and mentally depleted.

Examination by a doctor can absolutely help determine if a patient is suffering from Panic Attacks, Chronic Panic Disorder, or any other medical or psychological condition which feature Panic Attacks as a symptom. For example, thyroid malfunction can cause similar symptoms to Panic Attack or Chronic Panic Disorder. During diagnosis, a doctor will conduct a thorough physical exam, order laboratory tests as well as an electrocardiogram, and ask the patient questions about exhibited symptoms and life situation.

To be diagnosed with Chronic Panic Disorder, a patient must:

1. Have frequent Panic Attacks,
2. Be so worried for at least one month after the Panic Attack that you experience a significant change in your behavior, such as avoiding situations that might cause an attack, and
3. Have all other possible causes of Panic Attacks, such as an underlying medical or psychological condition, ruled out.

Treatment for Panic Attacks is usually, but not always, effective in reducing or eliminating symptoms. The main treatment options for Panic Attacks are medications, including antidepressants and mild sedatives, and psychotherapy, including behavior therapy, breathing and relaxation techniques, psychodynamic psychotherapy, nutritional supplements, support groups, dietary changes, and an increase in exercise and sound sleep.

Filing for Social Security Disability with a Panic Attack Diagnosis

Unfortunately, the Social Security Administration (SSA) does not have an independent listing for Panic Attacks in the Impairment Listing Manual, or “Blue Book,” used by state-run Disability Determination Services (DDS) to determine if a claimant is totally disabled. Instead, Panic Attacks are described as a symptom of anxiety disorder in general, and of a Chronic Panic Disorder in particular. Therefore, a claimant suffering from isolated Panic Attack symptoms is unlikely to meet the SSA’s requirements for Social Security Disability benefits.

Given that, in order to meet the SSA's eligibility requirements for disability benefits, the SSA requires that a claimant’s condition is severe enough to keep them from achieving or maintaining any type of gainful employment, applying on the basis of Chronic Panic Disorder will provide a much stronger foundation for a disability claim compared to only applying based on symptoms of Panic Attacks alone.

So how does one get disability for anxiety, or disability for Chronic Panic Disorder?

The SSA discusses anxiety-related disorders under Section 12.00 of the Blue Book. The medical documentation required to file for disability due to a Chronic Panic Disorder is detailed under Section 12.00: Mental Disorders, Paragraph D: Documentation, Subparagraph 11: Anxiety disorders.

A claimant’s medical records must document in detail any anxiety reactions (which includes Panic Attacks), and should also include the nature of the reactions, their frequency and duration, the precipitating or exacerbating factors (or lack thereof), and the effect the panic attack has on your ability to function. If possible, the opinion of a qualified medical professional should be presented to corroborate the patient’s description of Panic Attacks and symptoms. If no doctor has observed your attacks, then the description of another first-hand observer can provide crucial support to your application for Social Security Disability benefits.

Section 12.06 of the Blue Book specifically lists the requirements for filing for disability benefits with an anxiety disorder diagnosis.

In order to meet the required level of severity for an anxiety disorder (and hopefully get disability for anxiety), a claimant must meet the requirements of both Paragraph A and Paragraph B below, OR must meet all the requirements of Paragraph A and Paragraph C below:

1. You must have medical documentation that shows at least one of the following:

2. Generalized persistent anxiety accompanied by three out of four of the following signs or symptoms:

   1. Motor tension; and/or
   2. Autonomic hyperactivity; and/or
   3. Apprehensive expectation; and/or
   4. Vigilance and scanning.

   OR

   1. A persistent irrational fear of a specific object, activity, or situation which results in a compelling desire to avoid the dreaded object, activity, or situation; or
   2. Recurrent severe Panic Attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror and sense of impending doom occurring on the average of at least once a week; or
   3. Recurrent obsessions or compulsions which are a source of marked distress; or
   4. Recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress;

   AND

3. These symptoms must result in at least two of the following:

   OR

   1. Marked restriction of activities of daily living; and/or
   2. Marked difficulties in maintaining social functioning; and/or
   3. Marked difficulties in maintaining concentration, persistence, or pace; and/or
   4. Repeated episodes of decompensation, each of extended duration.
   5. Result in complete inability to function independently outside the area of one's home.

Your Panic Attack Disability Case

If you are disabled as a result of the fact that your Panic Attacks are so severe that they prevent you from working, you may be entitled to Social Security Disability benefits. Total disability, based only on a Panic Attack diagnosis, can be difficult. However, if your symptoms are severe enough, you may warrant disability benefits based on a diagnosis of Chronic Panic Disorder. With the assistance of medical professionals, as well as a qualified Social Security disability attorney or advocate to present the appropriate documentation to support your disability claim in front of your local Disability Determination Services (DDS), they can help to ensure that your Panic Attack disability case will have the highest possible chance of success.