Conversion Disorder, formally known as Functional Neurological Symptom Disorder (FNSD), is a condition where psychological distress manifests as physical symptoms that cannot be explained by a structural medical condition. The symptoms are genuine and cause distress and functional impairment. Whether FNSD qualifies as a disability depends entirely on the severity and duration of the resulting functional limitations, as judged against the criteria of the Social Security Administration (SSA).
Understanding Conversion Disorder
FNSD is classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The symptoms are involuntary and experienced as genuine, distinguishing FNSD from malingering or factitious disorder. It often presents with symptoms that affect motor or sensory function, despite a lack of underlying neurological disease or structural damage.
Common physical manifestations include altered voluntary motor functions, such as weakness, paralysis, or tremors, and sensory disturbances like blindness or numbness. Another frequent presentation is psychogenic non-epileptic seizures (PNES), which appear similar to epileptic seizures but lack characteristic electrical changes on an EEG. Diagnosis requires clinical findings that demonstrate an incompatibility between the symptom presentation and recognized neurological pathways.
Establishing Legal Disability Standards
A medical diagnosis alone is not sufficient to qualify a person as disabled for government benefits like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). The legal framework focuses strictly on the claimant’s functional limitations and their impact on the ability to work. To meet the criteria, a person must have a medically determinable impairment that prevents them from engaging in Substantial Gainful Activity (SGA).
This inability to work must be expected to last for a continuous period of at least 12 months or result in death. The SSA assesses the severity of the condition by determining the person’s Residual Functional Capacity (RFC). The RFC defines the most a claimant can do despite their limitations, considering how symptoms affect both physical abilities (like standing and lifting) and mental abilities (such as concentration and social interaction).
Evaluation Criteria for Conversion Disorder Claims
FNSD is evaluated by the SSA under the mental disorders listings, specifically Listing 12.07 for Somatic Symptom and Related Disorders. To qualify, the claimant must first provide medical documentation of altered voluntary motor or sensory function that is not explained by another medical condition. This criterion establishes the medical basis of the disorder itself.
The second part of the criteria focuses on the resulting functional severity, measured across four broad areas of mental functioning. The claimant must show an “extreme” limitation in one area, or a “marked” limitation in two of them. These areas include:
- The ability to understand, remember, or apply information.
- The ability to interact with others.
- The ability to concentrate, persist, or maintain pace.
- The ability to adapt or manage oneself.
For example, a person with functional paralysis must demonstrate that this symptom severely limits their ability to function in one or more of those mental domains to meet the listing. Even if the listing is not met, the SSA will still consider the combination of physical and mental limitations to determine if the claimant can perform any past work or adjust to any other work available in the national economy. The physical consequences of the functional symptoms are considered in the overall assessment of the person’s functional capacity.
Essential Documentation for Successful Claims
A successful disability claim for FNSD hinges on providing comprehensive, longitudinal medical evidence detailing both the diagnosis and resulting functional restrictions. Documentation must confirm the diagnosis, including results from neurological testing (MRIs, EEGs, or nerve conduction studies) that rule out organic neurological disease. These “negative” test results are important as they help confirm the functional nature of the symptoms.
The records must clearly demonstrate the severity and duration of the symptoms, showing they have lasted or are expected to last at least 12 months. It is beneficial to have detailed reports from both the treating neurologist, who confirms the physical symptoms and the lack of a structural cause, and the treating psychiatrist or psychologist, who documents the mental health component and functional limitations. The treating physician’s opinion on the claimant’s specific work-related limitations, such as an inability to stand for more than an hour, carries significant weight.
Beyond clinical notes, functional reports from family members, friends, or caregivers are valuable for detailing how the condition limits daily activities outside of a clinical setting. These non-medical source statements provide real-world context for the severity of the symptoms, such as difficulty with self-care, household tasks, or social interactions. Consistent documentation over time that shows adherence to prescribed treatments also strengthens the credibility of the claim.