Mental Evaluation for Social Security Disability and SSI

Social Security disability examiners are obligated to deal with any allegations or indications of mental health problems contained within your disability file (your application and related forms and your medical records). Social Security will send you to an independent physician for a mental evaluation exam if there isn’t sufficient information about your mental condition on your medical record.

This does not automatically mean there’s a lot of significance when social security requests that you go to a CE or consultative examination. At this point, a lot of people wonder why the social security administration would bother to arrange for a consultation with a physician and ask someone filing for disability to go to the appointment if the appointment itself was not significant; in other words, the mental evaluation examination might not have some considerable effect on the outcome of the individual’s disability case.

Assessments are scheduled for the following reasons.

1. In some cases, an exam will be scheduled since the claimant has alleged a condition (for example, carpal tunnel syndrome, bipolar disorder, depression, or back pain) for which they have never received treatment. Believe it or not, this is not an unusual occurrence.

In such cases, where there is simply no way for a disability examiner to obtain medical evidence for rendering a decision, it is practically guaranteed that the examiner will send the claimant to an examination (note: exams are paid for by social security and performed by individual doctors, i.e. they are not employed by SSA).

2. In other cases, and this is most likely the majority of these, the claimant has a history of receiving treatment for a condition but hasn’t been treated for that condition in the last 90 days, or hasn’t seen a physician for any reason whatsoever in the last 90 days. In these cases, it is crucial for the disability examiner to acquire recent evidence and hence the examiner will send the claimant.

Why Are Social Security Exams Required?

Consultative exams are usually ordered because there is absolutely no recent information in a patient’s file. Both Social Security disability (SSD) and Supplemental Security Income (SSI) Programs require that recent information for the applicant be on file before a disability decision can be rendered.

Quite frequently, disability candidates will list ongoing mental symptoms such as depression, anxiety, memory loss, or sleeplessness on their program, but either hasn’t received medical treatment for their emotional condition within the previous 60 days or have never received any medical treatment for their mental condition. Either way, without a recent medical evaluation to tell Social Security about your current mental condition, disability examiners cannot close your case (deny you benefits), so they will schedule you for a psychological consultative exam to have some up-to-date details about your mental condition.

When is a Psychological Evaluation Performed?

Evaluations will be ordered for those who have a cognitive disorder, a learning disability, stroke, head injury, organic brain disorder, or mental retardation. A psychological examination will be scheduled if a person is believed to have a diminished IQ or borderline intellectual abilities. Those with memory problems, whether from head trauma, an organic brain disorder, or other reason, will often be scheduled for testing as well. Both adults and children could be ordered to undergo psychological testing.

What Happens at the Mental Evaluation Exam?

Consultative examinations are a visit with a psychiatrist or a psychologist, paid by Social Security to carry out an examination that contains the fundamentals of a standard mental evaluation. Claims examiners use potential health issues to be addressed by one of three mental evaluations. In case you have alleged learning disabilities, the inability to read or write, a decline in mental functioning because of stroke, organic brain disorders, or accident, or you suffer from mental retardation, you may be sent to a mental consultative examination that may involve intelligence quotient (IQ) or memory testing.

After a Mental Evaluation Exam

The doctor or psychologist who performs a mental examination for disability will send a written report to your state Disability Determination Services (DDS) Bureau (in which Social Security disability decisions are made) within 10 days, so the disability examiner can form a medical opinion on your current state of health on a record before deciding.

The report will include your ability to manage coworkers and an opinion about your capacity to remember and comprehend instructions, and your capacity to take care of the stresses of work, and much more.

What to Expect at Exam for Impairment Case

Mental evaluation exams go one of 2 ways. You will find SSA exams that test for IQ, memory, and mental status. There are SSA psychiatric exams. Psychiatric exams are given by M.D.s who are psychiatrists and mental evaluation exams are frequently given by master’s level psychologists.

What Types of Psychological Tests are There?

The IQ test administered in mental evaluations is the Weschler Adult Intelligence Scale, designed to measure intellectual functioning. This test, now in its fourth edition, is thus abbreviated as the WAIS-IV. The WAIS-IV yields four separate index scores in the following areas.

Verbal Comprehension: Your score in this area reflects your verbal communication and reasoning abilities, and your level of knowledge about society and culture.

Reasoning: This place tests your ability to solve puzzles.

Processing Rate: This score indicates your abilities in visual-motor coordination and your level of speed and motor speed.

Working Memory: This deals with your ability to maintain attention, concentration, and focus when solving math problems and working with numbers.

In addition to the scores, a full-fledged IQ score will also be given. The median full-scale IQ score is 100, with a standard deviation of 15. The full-scale score is not the average of the four index scores, but it is advised by your performance in these areas. Scores of standard deviations below the median are considered low functioning.

Do the Social Security Psychological Exam’s Outcomes Have Any Bearing on Being Approved?

The results of a consultative mental examination (a social security medical exam) in nature will have a far better chance of having a positive effect on the outcome of a Social Security Disability claim or SSI disability claim. I say this from my perspective of being a former disability examiner in DDS (disability determination services) in which claims are decided by the social security administration.

Typically, the given exams are very brief and are cursory in nature. The physician, who knows nearly nothing about the medical history or the claimant will provide a brief examination that results in him or her documenting a person’s muscle strength, and vitals.

As you would expect, based on this description of a physical CE (consultative examination), not a lot of cases can be expected to be won based on the findings of this exam.

In cases where a person is qualified for disability following a CE has been done, it is likely that the disability examiner really had enough favorable medical evidence in the record to approve the case, but wanted some “recent” medical documentation (recent being defined as within the past 90 days) to be allowed to close the case.

For those who are unaware, social security demands record before a case can be approved since they are currently certifying the individual forward.

The Importance of Doing Your Best During Testing

You should resist the temptation to give less than your very best effort on any sort of testing or to exaggerate the severity of your condition. This is called “malingering” (faking), and consultative examiners are trained to spot it. You will lose credibility with Social Security if is determined that you’re overstating the extent of your impairments and you may lose your disability claim.

Some disability claimants are tempted from the contrary direction; that is, they attempt to minimize their psychological or emotional problems from humiliation or fear. It is critically important to be entirely honest with the examiner about your problems. Failure to do so could result in the denial of a claim.

Read More: Disability Problems and Knowing the Different Common Conditions