Post-Traumatic Stress Disorder Benefits in Wisconsin

• To qualify for Social Security Disability Insurance (SSDI), you must have a medical condition that prevents you from working and have enough work credits (usually 40, with 20 earned in the last 10 years) [^1].
• For Supplemental Security Income (SSI), you must have limited income and resources, and your disability must be expected to last at least 12 months or result in death [^1].
• PTSD is listed in Social Security’s Blue Book under mental disorders (Section 12.15). You must provide medical evidence, such as diagnosis, treatment history, and functional limitations [^1].
• Both SSDI and SSI require that your PTSD severely limits your ability to work or do daily activities [^1].

• In Wisconsin, people with PTSD can apply for Medicaid if they meet income and disability requirements. Medicaid covers mental health services, therapy, and medications [^2].
• Wisconsin’s Medicaid waiver programs, like Family Care Partnership and IRIS, provide home and community-based services for people with disabilities, including PTSD [^2].
• The Wisconsin Department of Health Services (DHS) and Aging and Disability Resource Centers (ADRCs) offer support for people with PTSD to access benefits and services [^3].
• Disability Benefit Specialists at ADRCs help people ages 18-59 with PTSD understand and apply for benefits, including Medicaid, SSI, SSDI, and other programs [^3].
• Wisconsin also offers work incentives and support for people with PTSD who want to work, such as the Medicaid Buy-In for Workers with Disabilities [^2].

• Gather medical records and proof of income.
• Contact your local Aging and Disability Resource Center (ADRC) for help with applications.
• Apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) online, by phone, or in person.
• Apply for Wisconsin Medicaid through the DHS website or with help from an ADRC.
• Ask about Medicaid waiver programs if you need home or community-based services [^3].

• Step 1: Get a diagnosis and treatment plan from a mental health professional. Keep all medical records, including therapy notes and medication lists.
• Step 2: Contact your local Aging and Disability Resource Center (ADRC). They can help you understand your options and fill out applications [^3].
• Step 3: Apply for SSDI or SSI online at ssa.gov, by phone at 1-800-772-1213, or in person at a Social Security office. You will need to provide medical evidence and work history [^1].
• Step 4: Apply for Wisconsin Medicaid through the DHS website or with help from an ADRC. You may need to provide proof of income, disability, and residency [^2].
• Step 5: If you need home or community-based services, ask about Medicaid waiver programs like Family Care Partnership or IRIS. These programs require separate applications and eligibility reviews [^2].
• Step 6: If your application is denied, you can appeal. Disability Benefit Specialists can help with appeals and hearings [^3].

• Social Security Disability Insurance (SSDI): Provides monthly payments to people with disabilities who have a work history. PTSD is eligible if it meets Social Security’s criteria [^1].
• Supplemental Security Income (SSI): Provides monthly payments to people with disabilities who have limited income and resources. PTSD is eligible if it meets Social Security’s criteria [^1].
• Medicare: People who receive SSDI for 24 months may qualify for Medicare, which covers medical services [^1].
• Medicaid: Federal program that covers medical services for people with low income and disabilities. Wisconsin Medicaid covers mental health services for people with PTSD [^1].

• Wisconsin Medicaid: Covers mental health services, therapy, and medications for people with PTSD. Eligibility depends on income and disability [^2].
• Family Care Partnership: Medicaid waiver program that provides home and community-based services for people with disabilities, including PTSD [^2].
• IRIS (Include, Respect, I Self-Direct): Medicaid waiver program that lets people with disabilities manage their own care and support services [^2].
• Medicaid Buy-In for Workers with Disabilities: Allows people with disabilities to work and keep Medicaid coverage if they meet income limits [^2].
• Disability Benefit Specialists: Trained professionals at ADRCs who help people with PTSD apply for and manage benefits, including Medicaid, SSI, SSDI, and other programs [^3].
• Wisconsin Retirement System (WRS) Disability Benefits: Provides income if you become disabled while working for a Wisconsin Retirement System employer [^4].

ABLE accounts let people with disabilities save money without losing benefits. In Wisconsin, you can open an ABLE account to save for disability-related expenses. Earnings in the account are tax-free, and withdrawals for qualified expenses do not count as income for SSI or Medicaid. Learn more about ABLE accounts and how to open one in Wisconsin [^5].

• For SSI, the federal income limit in 2025 is $943 per month for an individual and $1,415 for a couple. Wisconsin may have higher limits for some programs [^1].
• For Medicaid, income limits vary by program. For example, the Medicaid Buy-In for Workers with Disabilities allows people to earn up to 250% of the federal poverty level and keep Medicaid coverage [^2].
• If you work while receiving disability benefits, your earnings may affect your benefits. Wisconsin has work incentives to help people with PTSD keep benefits while working [^2].

If you receive too much in benefits, you may have to pay it back. Report changes in income, work, or living situation to Social Security and Wisconsin DHS to avoid overpayments. Wisconsin offers resources to help people with PTSD understand and report changes [^6].

• Aging and Disability Resource Centers (ADRC)
  Phone: 1-877-847-7597

  Website

  Find your local ADRC for personalized help with disability benefits.
• Disability Rights Wisconsin
  Phone: 1-877-781-1574

  TTY: 1-800-926-0752

  Email: info@disabilityrightswi.org

  Hours: Monday-Friday, 8:00 AM - 4:30 PM

  Website

  Free legal advocacy and support for people with disabilities.

• Can I get disability benefits for PTSD in Wisconsin?

  Yes, people with PTSD can qualify for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) in Wisconsin if they meet medical and financial criteria. Wisconsin Medicaid also covers mental health services for people with PTSD.

• How do I apply for disability benefits for PTSD in Wisconsin?

  You can apply for SSDI or SSI online, by phone, or in person. For Medicaid, apply through the Wisconsin DHS website or with help from an Aging and Disability Resource Center (ADRC). ADRCs can help with applications and appeals.

• What medical evidence do I need for PTSD disability benefits?

  You need a diagnosis from a mental health professional, treatment records, and evidence that PTSD limits your ability to work or do daily activities. Social Security requires detailed medical documentation for PTSD claims.

• Does Wisconsin Medicaid cover therapy for PTSD?

  Yes, Wisconsin Medicaid covers mental health services, including therapy and medications, for people with PTSD. You may also qualify for home and community-based services through Medicaid waiver programs.

• Can I work while getting disability benefits for PTSD in Wisconsin?

  Yes, Wisconsin has work incentives that let people with PTSD work and keep their benefits. The Medicaid Buy-In for Workers with Disabilities allows people to earn up to 250% of the federal poverty level and keep Medicaid coverage.

• What is the role of Disability Benefit Specialists in Wisconsin?