Disability Claims and Immigrants With PTSD: What You Need To Know

“I resolve to get social security disability benefits” isn’t a pleasant New Year’s
resolution for anyone. For legal immigrants and refugees, living in the U.S. is a chance at
a fresh start at a better life. But if they suffer from Post-Traumatic Stress Disorder
(known as PTSD) caused by torture and violence, immigrants struggle with life in the
U.S. And when physical illness or injury strikes, immigrants with PTSD lose more than
their health. They can lose their family, income and shelter. Disability may provide a
safety net and in some cases, help to recovery. But like many New Year’s resolutions,
time, persistence, and good advice is the way to succeed.

How PTSD Complicates Disability Claims

Immigrants suffering from PTSD encounter additional obstacles when trying to
recover from injuries. “PTSD is not your typical degenerative disease process,” stated W.
Todd Westmoreland, a disability law attorney practicing in Oregon. Applicants are young
and appear healthy enough to work. Yet immigrants with PTSD have difficulty trusting
anyone outside of their own small family and ethnic circles, and can compromise their
own case by their anxiety in front of officials and judges, Westmoreland added. PTSD
compounds a physical disability because the skills needed to overcome a disability are
themselves compromised. Even learning to speak English is severely hindered because
PTSD makes learning new skills far more difficult than for someone without PTSD. Dr.
J. David Kinzie, professor of psychiatry at Oregon Health Science University (OHSU) at
the Intercultural Psychiatric Program, describes how PTSD and other mental illnesses
caused by severe trauma can make physical changes to the brain area responsible for
maintaining recent memories. “The hippocampus actually shrinks,” Kinzie responded.
“As a consequence, PTSD suffers do not have easy capacity to learn new information as
well, especially learning languages or even new tasks.”

Adil’s Case
One case illustrates typical hurdles immigrants face when applying for social
security disability. Like many immigrant men with PTSD, Adil* lived an isolated life in a
small Portland-area Bosnian community. Adil never learned English, as his anxiety and
fears made communication with non-Bosnians and even fellow Bosnians extremely
difficult. He worked alone on the night shift as a baker for a Bosnian-owned company
for many years. Two years ago, Adil’s body wore out from the repetitive stressful work.
After surgery on both his wrists and elbows, Adil could no longer do the only work he
knew. With the disabling injury and PTSD combined, Adil found it impossible to adapt
to another line of work. PTSD prevented Adil from learning and adapting to new
circumstances because of the neurological damage and social anxiety and depression
caused by his PTSD symptoms.

A Challenging Process
The process of preparing an immigrant’s disability case can reignite her or his
past trauma. Social security disability offices employ claim investigators. One legal note
written by Theodore McCombs in 2007 described how the investigation process terrified

* Name changed to protect identity.

many Bay Area Cambodian applicants with PTSD. Being investigated includes having
neighbors and friends questioned about an applicant’s daily activities. Immigrants suffer
flashbacks of their own torture experiences when disability investigators show up without
warning at their homes. In disability claims, immigrants face judges who may be
suspicious if the applicant can’t acclimate to living in the U.S., or presents with
symptoms that may be interpreted as malingering. And the entire process from initial
claim to decision can take as long as several years.

How to Win PTSD Disability Claims

If you are a refugee or victim of torture or trauma in your country of origin, you
will face extra hurdles to get disability assistance. You will need a good attorney who is
patient enough to reassure you about the process. “Often I am asked whether they will be
deported or arrested for challenging the government’s decision if they lose their disability
case. It is important to reassuring clients that the administrative law process is not like
court they see on U.S. television. It is a fact-finding process without an opposing
counsel.” explains Westmoreland.

Attorneys who educate the administrative judges about the effects of PTSD in
prolonging disabling symptoms or preventing applicants from returning to work rely on
comprehensive psychometric testing. But finding the resources to get the needed
psychological evaluation can prevent an immigrant from proving their disability to a
judge’s satisfaction. In some states, there may only be one resource center offering
public health assistance and evaluations tailored for immigrants suffering from PTSD. At
the Intercultural Psychiatric Program at OHSU, Dr. Kinzie describes that treatment must
occur for three months prior to getting an evaluation for disability purposes.
Nonetheless, without the proper evaluation, an immigrant’s disability case can fail. With
a solid psychological evaluation, the chances of succeeding on the initial claim or on the
appeal increase dramatically. “PTSD and other mental illness symptoms are consistent
and real. We don’t see many immigrants who can fake mental illness symptoms,” stated
Dr. Kinzie.

Persistence Pays
Immigrants legally living in the U.S. considering applying for disability assistance
should know that the process may take up to two years. Nationwide, over 60% of
disability claims are initially denied. But assistance on a claim can speed the process or
help overcome an initial denial. Adil’s story and outcome is not an exceptional story.
What happened next for Adil should reassure most applicants.

After the appeal, Adil’s case was remanded, and thanks to excellent legal
representation and a more thorough neuropsychological evaluation explaining the effects
Adil’s PTSD had on his disability, Westmoreland was able to successfully explain to a
judge how Adil‘s disability prevented him from employment. Adil was granted disability
support.

Not every immigrant with PTSD will succeed in their case. The investigative
process can reignite PTSD symptoms. Obtaining a good psychological assessment can
be a challenge in areas where services are limited. But like much of life in the U.S.,
persistence and obtaining legal assistance and social support during the process will
increase an immigrant’s chances of getting much needed disability assistance. And that
assistance may become a better start for a New Year.

Melissa Kenney Ngaruri, Esq., is an attorney licensed in Maryland.