Determining Psychological Disability for the Social Security Administration
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Determining Psychological Disability for the Social Security Administration Thomas L. Kuhlman
# National Register of Health Service Psychologists 2020
Abstract The Social Security Administration (SSA) provides long-term disability benefits for workers who have been rendered disabled by physical and/or mental impairments. This article provides an overview of SSA’s disability determination process and descriptions of the of three mutually exclusive roles that psychologists may play in this process. These include (1) performing formal psychological evaluations of applicants, which are oriented to SSA’s disability program and (2) performing in-house reviews of applicants’ medical records, which will steer the disability decisions made about them. The third role is an incidental one: a psychologist had been providing mental health services to someone who subsequently applies for disability and lists the psychologist as a treating source on the disability. The article concludes with a suggested format for treatment providers to use when conveying clinical information to SSA about their clients. Keywords Disability determination . Social security benefits . Functionsnecessary for work . Functional disability . Psychological disability
Clinical Vignette Don, a 34-year-old White male, was referred to you by his disability case manager for a psychological evaluation. He resides in a group facility for individuals who suffer from mental illness and chemical dependency following a twoweek stay in a psychiatric hospital. Don tells you he was diagnosed with ADHD as a child and with bipolar disorder at age 24 (both confirmed by others). He reports emotional and physical abuse from both parents, and claims his father beat him so badly one time that he suffered an ankle injury from which he never fully recovered. This continues to limit his physical mobility. He reports getting mostly Bs in high school and being into gaming as he could not do sports. He denies ever having had an intimate relationship with anyone. He believes his first manic episode occurred at age 28. Much of that episode is now a “blur” to him, except for having been arrested and convicted of aggravated robbery. He received both chemical dependency treatment and psychiatric care while in prison. He says that he has since been compliant with taking the “mood pills” prescribed for him in prison but also admits to having missed some psychiatric appointments since his release. He has used illicit substances “once or twice” since that release, and one such occasion had been a factor in his recent psychiatric hospitalization. He reports being frustrated by life, unconnected to others, and lacking in direction. He
says he wants to live a normal life—but is uncertain whether he could maintain a regular job. Given Don’s mental health history and 16 years of relatively unsuccessful living, the case manager wants to know whether the extent of his mental impairment qualifies Don for long-term disability benefits or not. Do you feel prepared to address this referral questi
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