Monday, November 12, 2007

Filing for Disability based on Depression and Medical Evidence

It is often the case that applicants who apply for social security disability or SSI disability benefits do not have the best medical record profile. What do I mean by this? Simply the following:A) not having recent medical records; B) not having extensively developed medical records, C) not having a history of treatment for a particular physical or mental impairment.

For item A, this is often the result of not having access to medical treatment, due to a lack of health insurance coverage, and an inability to pay for treatment out-of-pocket. Regarding item B, this may be the result of deficient documentation, such as a physician who poorly documents a patient's treatment. Item C, however, often applies to individuals who file for disability based on depression, or file for disability on the basis of a number of conditions, one of which is depression.

As a disability examiner for the social security administration, I saw both types of applications. On applications for which depression was listed as a single or primary allegation, there was sometimes very little history of treatment, or a history of treatment that was either A) very short-lived and in the past or B) only recently begun. In cases involving a disability application for which depression was listed in a secondary sense, there was, very often, almost no history of treatment aside from a prescription being filled by a general practitioner.

As I said in an earlier post, a claimant's medical records are crucial and central, as they form the basis for every approval of a disability case, and, likewise, every disability denial. However, the specificity of one's medical treatment (and the medical records that are derived from such treatment) is important as well. What do I mean by this? Simply that if you have depression, are being treated for depression, and are listing depression as an impairment on a disability application, you need to be in the position of presenting records from a psychiatrist to fully enhance your case. This may be conceptually problematic for some individuals who believe that they require nothing more than the prescriptions that are routinely filled by their treating physician, or who are averse to establishing a relationship with a qualified mental health professional. However, for a disability claim based on depression, a claimant needs to show:

1. A history of mental health problems (in this case, a medically documented history of depression).

2. A history of treatment provided by a qualified mental health professional (you may receive counseling from a Ph.D. level psychologist, but social security considers records from a physician to be pre-eminent. And that means records from a psychiatrist, as all psychiatrists are M.D.s

In brief, the office notes of a family doctor who prescribes an anti-depressant simply will not cut it for disability evaluation purposes because such notes will not sufficently document a claimant's psychiatric problems and history of mental health treatment. Such records will also generally fail to document a claimant's functional limitations as a result of depression. And lastly, of course, such records will not emanate from what is considered to be an appropriate source of treatment, i.e. a psychiatrist.

The post following this one (or possibly several posts from now) briefly describes what happens when a claimant files for disability based on depression and has little to no history of treatment for depression, or an insufficient record of documentation.

Return to the Social Security Disability SSI Benefits Blog

Other Posts:
Social Security Back pay
Disability Hearing
SSI disability
SSI Requirements