Tuesday, May 22, 2007

Why is it hard to get approved for social security disability with a mental condition?

Round up a hundred people who had to go through the social security disability - SSI appeal system and you'll quickly learn that it can be difficult to get approved for disability benefits no matter what your condition is. Speaking from my own experience as a disability examiner, I've seen claimants with very low IQ get denied, claimants with multiple, severe psychotic breaks get denied, and individuals with bipolar disorder (whose work history and treatment history makes it quite obvious that they cannot sustain competitive employment and, thus, cannot support themselves) get routinely denied.

Disability cases filed with the social security administration, primarily on the basis of a mental condition, can often be difficult to win. And a large part of the problem has to do with the competency of DDS (in most states, the agency that evaluates social security disability and SSI claims is called DDS, or disability determination services) itself. What do I mean by this? Here's a short list.

1. Disability examiners (the case specialists who actually make decisions on disability applications and reconsideration appeals) get very little training for the purpose of evaluating mental ( psychological and psychiatric ) impairments. And this renders their insight into mental conditions to practically nil. It also severely inhibits their ability to interpret medical evidence that is mental in nature. Yes, they can read and synopsize the records and they can then take this write-up to a unit psychological consultant for review (examiners have psychologist and physician consultants, who are attached to their unit, sign off on their cases). But their ability to abstract and interpret is very limited. In the end, they are no more qualified to evaluate mental medical records than an xray technician might be---which is to say not at all.

2. The Ph.D.s who serve as unit psychological consultants for disability examiners who work at the various state agencies...tend to be of very poor quality. I will admit that this is a subjective assessment to some extent. But I have seen many of them deliver mental residual functional capacity assessments that were completely ridiculous. And, as a consequence, a great many individuals whose mental condition precluded the ability to hold a job were denied benefits.

3. The social security administration, in its evaluation of disability claims involving mental conditions, does not seem to adequately take into consideration the fact that certain conditions have the characteristic of "exacerbation and remission".

That is, some conditions tend to slide back and forth on a regular basis. Bipolar disorder is a great example of this. A person with bipolar disorder will, by the definition of the disorder, experience depression, manic states, and often will experience mixed states.

How does social security often evaluate a claim based on bipolar disorder? Very often, the claim is denied with the reasoning that the condition will resolve to a non-severe state within the twelve month timeframe needed to substantiate a state of disability (the social security administration's definition of disability states that, to qualify for benefits, a condition must be disabling for a period of not less than 12 months, though this can be actual or projected).

In later posts, I'll discuss what claimants with mental conditions may wish to consider when they file a claim for social security disability or SSI benefits.

Return to the Social Security Disability SSI Benefits Blog

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