Is OCD considered a disability? Here’s what experts say

Obsessive-compulsive disorder (OCD) can be incredibly debilitating, interfering with one’s ability to function in almost every aspect of their life. But does that make OCD a disability, and what would this mean for people who live with the condition? 

We spoke with our experts here at NOCD to learn about what disability means, if and when OCD may qualify as one, and what this means for people with OCD, from work and school accommodations to treatment.

What is a disability?

Terms that feel easy to use are often hard to define clearly—and disability is no exception. Different groups have come up with different accounts of what a disability is for various purposes.

Three models of disability

There are three commonly recognized models of disability.

The medical model

The medical model describes disability in terms of physical or biological differences and the way they impact people’s lives. Specifically, it states that:

• Disabilities involve pathological or dysfunctional conditions of the body or brain 
• Disability must result in some sort of disadvantage, exclusion, or functional limitation
• Limitations faced by individuals with a disability are the direct result of their bodily or biological differences 

This model defines disability from a medical perspective: by treating a person’s physical or biological conditions, we can reduce or remove the harm or limitation they cause.  

The social model

The social model of disability emphasizes the role of one’s social and physical environment in causing or perpetuating the limitations and disadvantages faced by people with disabilities. Specifically, it states that:

• Disability does not necessarily involve pathological states or dysfunctional conditions of the body or brain
• Disability must result in some sort of disadvantage, exclusion, or functional limitation
• The barriers or impairments individuals with disabilities experience result from their environment and the social conditions that cause it. This may include negative stereotypes, social exclusion, harmful public policy, and lack of physical accessibility.

From this perspective, the way to address disabilities is by changing society, public policy, physical structures, or other external circumstances, not just someone’s condition. 

The affirmative model

According to the affirmative model of disability:

• Disability is not fundamentally a matter of disadvantages. For example, someone with blindness may experience improvements in other senses
• Disabilities can be cause for pride and celebration
• Impairments can result from biological or social factors or some combination of the two

The affirmative model proposes that treatment and accommodation can be helpful and necessary, but that disability and difference should also be respected and accepted.

U.S. legal definition

The Americans with Disabilities Act (ADA) was created to protect people with disabilities from discrimination. The ADA defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activities. It’s worth noting that the ADA considers someone to have a disability if:

• They have a record of such an impairment, even if they are not currently impaired
• They are “regarded” as having a disability, meaning their impairment does not substantially limit a major life activity, but limits their activities only as a result of others’ attitudes towards them, or if they are treated as having a disability by some entity

Is OCD a disability?

Obsessive-compulsive disorder is a mental health condition characterized by two primary symptoms: obsessions and compulsions. Obsessions are thoughts, images, or urges that are intrusive, involuntary, and cause distress. Compulsions are mental or physical actions done to reduce or get rid of this distress or to prevent a feared outcome from occurring.

Is OCD a disability? That depends on which model of disability we consider. Let’s look at the medical model first. We know OCD can cause significant impairments, disadvantages, and functional limitations. As April Kildiff, MA, LCPC, LMHC notes, OCD can result in the following:

• Inability to maintain a job
• Financial hardship
• Difficulties in maintaining relationships
• Self-isolation
• Depression and other mental health conditions

We have good reason to believe that the underlying issues or symptoms of OCD that cause impairments or disadvantages are associated with specific things in the brain. For example, a recent meta-analysis of brain imaging in patients with OCD found certain abnormalities associated with specific features related to OCD. 

Is society the cause of the impairments and limitations that people with OCD experience? While society can certainly make having OCD more challenging, it would be difficult to argue that the majority of the impairments and disadvantages people with OCD face are the direct result of anything other than the condition itself. By the medical model, OCD can be considered a disability, while the social model of disability is more difficult to apply to OCD.

Obsessive-compulsive disorder can also clearly meet ADA’s requirements as the condition can substantially limit one or more major life activities. In fact, OCD is listed by the Social Security Administration (SSA) as a disability that qualifies for Social Security disability benefits.

OCD may certainly be considered a disability within the definitions and goals of the affirmative model as well. Though OCD can cause significant distress, there’s no reason that the experiences and identities of people with OCD can’t be a source of community and pride. No therapist would say that people with OCD should feel ashamed of their condition. Whether OCD can result in advantages in other areas or improve one’s ability to function is less clear. No studies seem to suggest that the condition provides any cognitive, emotional, or physical benefits. 

Can you receive legal accommodations for OCD?

Yes, people with OCD may be entitled to certain benefits and accommodations at work or school. 

For example, OCD is listed by the Social Security Administration (SSA) as a disability that qualifies for Social Security disability benefits. However, as Dr. Patrick McGrath, Chief Clinical Officer at NOCD notes, “just because you’re diagnosed with OCD doesn’t mean that it’s a disability or that you qualify for social security.” Your condition must be at a certain level of severity, interfering with your ability to function in ways that impact your ability to work, for example.

If you can perform parts of your job but have a disability, the ADA requires that your employer offer “reasonable accommodations.” These include any changes that would help you do your job but aren’t excessively expensive or such that they would cause your employer undue hardship. Some examples of these sorts of changes may include:

• Providing a quiet place to work
• Offering assignments and instructions in writing instead of orally
• Modifying work schedules
• Adjusting examinations, training materials, or policies
• Offering additional time for assignments and projects

It’s possible to receive accommodations in academic settings as well. In particular, The Individuals with Disabilities Education Act (IDEA), Rehabilitation Act, and the ADA allow children with OCD to receive certain services and accommodations in school settings. Some examples of common accommodations offered by schools to children with OCD include:

• Counseling
• Extra time to take tests
• Special passes to leave the classroom
• Preferred seating
• Ability to opt out of specific classes

Are there downsides to labeling OCD a disability?

While the ability to label OCD a disability comes with important legal accommodations, there may be some unexpected downsides. Here are a few important points worth considering. 

#1: Some accommodations may make OCD worse

While some accommodations are appropriate and beneficial, some may only provide short-term relief and exacerbate symptoms in the long run. “We know that certain accommodations perpetuate OCD, and if OCD is the thing that’s causing you to have a disability in different areas, then we wouldn’t want to do anything to further that,” explains Dr. McGrath.

He illustrates this with an example: “Say you’ve got a kid in school with Scrupulosity OCD. If you excuse them from religion class for a week or two while I work with them to manage it and gradually put them back in, that’s fine. But if you just say, ‘well, you don’t have to go to school,’ that could ultimately make it worse over time. In that case, you’re teaching people to run away from something difficult, and that’s not our goal.”

As a result, when asking for accommodations, it’s important to be mindful of how they serve long-term recovery, as well as short-term accessibility. A trained therapist can help you determine whether your accommodations are genuinely beneficial and work on strategies for obtaining longer-term relief. 

#2: It doesn’t match much of the community’s self-identity

The disability label has various connotations, many of which people with OCD may not like or feel accurately describe their experience. For example, the notion of being disabled may suggest that it’s part of one’s identity, and while some people with OCD feel it’s part of who they are, others don’t, and many prefer it that way. 

As with all conditions that are often considered disabilities, the label may not be accurate for everyone, and each person with OCD is free to decide if the concept of disability is true to their own experiences.

#3: Calling OCD a disability can make it sound untreatable

To some, calling OCD a disability might make it seem like there’s nothing to be done about it or that they’ll never get better. 

While OCD is chronic, meaning that you may always need to manage your symptoms to some degree, there are highly effective treatments. Exposure and response-prevention (ERP) therapy is the gold standard for OCD, in which obsessions are triggered in controlled settings while people resist the urge to engage in compulsions to alleviate anxiety. Over time, this helps them learn to live with uncertainty, reduces the frequency of obsessions, and decreases the amount of distress they feel when obsessions pop up. 

With that said, some people with OCD may find understanding or comfort in identifying with disabled communities. In particular, it may help challenge the feelings of guilt or self-blame that can be so common and intense in people with OCD.