Can you get benefits for BPD?

Borderline personality disorder (BPD) is a serious mental health condition characterized by unstable moods, behavior, and relationships. People with BPD often struggle to maintain employment and may qualify for certain disability benefits.

What is borderline personality disorder (BPD)?

Borderline personality disorder (BPD) is a condition marked by instability in moods, behavior, self-image, and functioning. People with BPD often display impulsive actions and have intense episodes of anger, depression, and anxiety that can last from a few hours to days. BPD also frequently causes problems in interpersonal relationships.

BPD causes significant emotional distress and impairment in daily life. Symptoms often begin in the teenage years or early adulthood and occur across many different situations. The disorder is thought to affect 1.6% of adults in the United States.

Some common symptoms of BPD include:

• Intense fear of abandonment, even from close friends and family
• Unstable, intense personal relationships with extreme highs and lows
• Distorted and unstable self-image or sense of self
• Impulsive, risky behaviors like reckless driving, drug use, unsafe sex, spending sprees, binge eating
• Self-harming behaviors like cutting, suicidal threats or attempts
• Intense episodes of depression, irritability, or anxiety
• Chronic feelings of emptiness
• Explosive anger or rage
• Feeling suspicious or out of touch with reality
• Difficulty controlling emotions or impulses

These symptoms often negatively impact the ability to function at work, socially, and in day-to-day activities. People with BPD tend to have trouble keeping a job, maintaining healthy relationships, and controlling their emotions and behaviors.

Getting disability benefits for BPD

Since BPD causes major functional impairment, some people with severe BPD may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

However, BPD is not specifically listed in Social Security’s Blue Book listing of qualifying conditions. This means you cannot qualify for benefits based solely on a BPD diagnosis. Your eligibility will depend on how significantly your symptoms limit your ability to work and carry out daily activities.

To qualify for disability benefits with BPD, you’ll need to show:

• You are not working and earning below Social Security’s Substantial Gainful Activity limits
• You have received appropriate treatment for BPD without improvement in symptoms or ability to work
• Your BPD symptoms prevent you from maintaining substantial gainful employment

Social Security evaluates disability claims on a case-by-case basis. Even if your BPD is not severe enough for disability benefits, you may qualify if you have BPD combined with other mental or physical conditions.

Meeting Social Security’s blue book listings

The Blue Book contains Social Security’s official list of medical qualifications for receiving disability benefits. Each listing specifies criteria involving diagnosis, symptoms, test results, and functional limitations.

While BPD itself is not in the Blue Book, your symptoms may meet or equal the severity of these related listings:

• Listing 12.04 – Depressive, bipolar and related disorders – Requires experiencing three of the following: appetite/weight changes, sleep disturbances, decreased energy, feelings of guilt/worthlessness, difficulty concentrating, suicidal thoughts, hallucinations, delusions, psychomotor abnormalities, or manic syndromes
• Listing 12.06 – Anxiety and obsessive-compulsive disorders – Requires extreme anxiety, apprehensive expectations, motor tension, autonomic hyperactivity, recurrent obsessions/compulsions that interfere with routine activities
• Listing 12.08 – Personality disorders – Requires inflexible personality traits causing impairment in personal/social functioning and one of: seclusiveness, oddities of thought (speech, perception, thinking), persistent disturbances of mood, intense/unstable interpersonal relationships, or impulsive/damaging behaviors

Your medical records, doctor evaluations, and testimony from friends or family will need to provide detailed documentation of how your symptoms align with the Blue Book criteria.

Other ways to qualify for benefits with BPD

If your BPD does not meet or equal a listing, you can still potentially qualify in these ways:

• Medical-Vocational Allowance – Social Security evaluates your residual functional capacity, age, education, and work history to determine if you can adjust to other work
• Equaling a listing – Your symptoms are at least of equal severity and duration to those described in the closest matching Blue Book listing
• Combination of impairments – Your BPD combined with additional mental or physical conditions equals the severity of a listing

Vocational experts may testify at your hearing about whether suitable jobs exist for someone with your limitations. Having an experienced Social Security Disability attorney argue your case can significantly improve your chances of approval.

Getting treatment with no health insurance

Treating your BPD is crucial whether you qualify for benefits or not. Without health insurance, you may need to rely on the following options:

• Look for clinical trials of new BPD treatments you can participate in for free
• Search for free or sliding-scale mental health clinics in your area
• Find therapists who offer reduced rates for lower income patients
• Use online resources like support groups or therapy apps
• Ask your doctor for medication samples when possible
• Talk to your doctor and hospital about charity care, payment plans, or financial assistance programs
• Consider getting evaluated at an emergency room if you feel actively suicidal or unsafe

Treatment like dialectical behavior therapy (DBT) can teach you skills to better manage BPD symptoms. Do your best to secure appropriate care with or without insurance.

Appealing a disability denial

It’s not unusual for BPD claims to get denied initially. Nationwide, only about 33% of all claims get approved the first time. If you get denied disability benefits for BPD, you can appeal the decision.

There are four levels of the Social Security appeals process:

1. Reconsideration – A different examiner reviews your case (denied 75% of the time)
2. Administrative hearing – You present your case before an administrative law judge (denied 60% of the time)
3. Review by Appeals Council – The Appeals Council looks at your case (denied 90% of the time)
4. Federal court – A district court magistrate reviews your appeal (denied 60% of the time)

Each stage gives you a chance to submit additional evidence and make your case again. Having a disability lawyer handle your appeal at the hearing level and beyond can significantly boost your approval odds. An experienced attorney will know how to present your BPD limitations in the best light under Social Security guidelines.

Can you work with BPD?

Some people with mild to moderate BPD can and do work successfully, especially if receiving appropriate treatment. But for others, severe BPD symptoms like mood swings, unstable relationships, and impulsive behaviors make holding down a job extremely difficult.

The types of work difficulties someone with BPD may encounter include:

• Frequently missing work due to mental health crises or hospitalizations
• Having trouble getting along with managers or coworkers
• Unable to deal with workload or normal work stress and pressure
• Difficulty concentrating, remembering instructions, and completing tasks
• Problems with emotional regulation or anger outbursts
• Often needing extra supervision or support
• Impaired executive functioning affecting organization, planning, problem-solving

Even with treatment, some people find their BPD too disabling to maintain steady employment. This is especially true for jobs requiring a lot of social interaction or consistently meeting rigid demands.

Tips for working with BPD

If able to work, people with BPD may find success doing these things:

• Finding a job with limited social contact and more independent tasks
• Disclosing BPD to supervisors and asking for reasonable accommodations
• Avoiding jobs with frequent criticism, high stress, or rigid expectations
• Seeking work environments known to be more understanding of mental health disabilities
• Asking for a flexible or reduced schedule if needed
• Taking regular breaks to decompress when feeling overwhelmed
• Using coping strategies and self-care practices throughout the workday

It can also help to have an understanding of your own strengths and limitations. Know which types of jobs and work settings tend to aggravate your symptoms versus those you can manage well. With appropriate treatment and the right position, some people with BPD can thrive in the workplace.

Getting fired due to BPD

People with BPD may sometimes get fired due to problems like missing work, conflict with coworkers, or emotional outbursts on the job. Under the Americans with Disabilities Act (ADA), firing someone solely due to a disability, without attempting reasonable accommodation, qualifies as disability discrimination.

If you believe your firing was unfairly discriminatory, you can file a complaint with the Equal Employment Opportunity Commission (EEOC). An attorney can also help you explore filing a private lawsuit against your employer alleging wrongful termination under the ADA.

However, employers can legally fire workers with disabilities if:

• They posed a safety threat (ex. verbal abuse, threats, violence)
• They could not perform essential job duties reliably
• Reasonable accommodations did not resolve performance issues
• They violated conduct policies applicable to all employees

So while BPD itself cannot be grounds for automatic termination, symptomatic behaviors that employers apply policy neutrally against may still justify firing in some cases.

Getting and keeping disability benefits

After getting approved for disability benefits, continuing your treatment will help ensure you remain eligible. Social Security periodically reviews claims to confirm disability is still present and severe enough to prevent working. For mental health conditions like BPD, they usually review every 1 to 3 years.

During reviews, Social Security will look at:

• Attendance and compliance with treatment
• Ongoing symptoms and clinical observations
• Statements from your providers about your condition
• Any hospitalizations or changes in medications
• Ability to manage daily activities
• Efforts to work or improvements in functioning

Keeping up consistent treatment, taking medications as prescribed, avoiding drug/alcohol abuse, and reporting any medical or functional changes will help prove your disability is still disabling. Having an experienced attorney handle review paperwork and attend exams with you may also improve your chances of remaining eligible.

Conclusion

Getting disability benefits approved for BPD can be challenging but is certainly possible in cases of severe impairment. Having thorough medical documentation of all symptoms and limitations is key. Ongoing treatment to manage BPD is also essential whether working or on disability. With proper management and support, many people with BPD can stabilize symptoms enough to regain consistent functioning.