If you’re applying for Social Security disability based on a mental, psychological, or emotional condition, the Social Security Administration (SSA) will often schedule you for an independent psychological evaluation with a psychologist or other mental health professional. These evaluations, referred to as consultative examinations by SSA, are paid for by SSA and are especially common in cases where a person has received no mental health treatment or little. That’s because disability examiners working at state Disability Determination Services (DDS) agencies (the employees who initially decide your claim) are required to base their decisions on update-to-date medical information.
In DDS offices consultative exams are scheduled for almost all claimants who allege mental health issues. Sometimes mental examinations are even ordered for applicants who don’t actually allege mental health issues, but if there is some indication in the file (for example, on a form completed by a third-party) that mental health issues might be present.
Mental Status Exams and Psychiatric Exams
There are several different types of examinations that SSA can order in a specific case. For those with issues like depression, anxiety, or bipolar disorder, SSA will often schedule a mental status exam (MSE), which is meant to provide a snapshot of your current mental condition. In the typical MSE, you will be asked, as an instance, to name the current president, to count backward by sevens from 100, to recall items from a list after several minutes, to explain a well-known proverb, and to talk about your family and your childhood.
A psychiatric exam will often be scheduled for people with schizophrenia, schizoaffective disorder, or psychosis, and occasionally for those who have mood disorders like anxiety and depression.
Why Are Social Security Exams Required?
Since there is no recent information in a patient’s file, exams are usually ordered. Both Social Security disability (SSD) and Supplemental Security Income (SSI) Programs require that medical advice for the applicant be on file before a disability decision can be rendered.
Quite frequently, disability applicants will list ongoing mental symptoms such as depression, anxiety, memory loss, or insomnia on their application, but either has not received medical treatment for their mental condition within the past 60 days or have never received any medical treatment for their mental condition. Either way, without a recent psychological evaluation to tell Social Security about your current mental state, disability examiners cannot close your situation (deny you benefits), so they will schedule you for a psychological consultative exam to get some up-to-date information about your mental state.
Social Security may require you to attend a mental exam even if you have recently seen your psychiatrist or psychologist. It only depends on a specific situation. Some disability examiners (or their unit supervisors) just prefer to have the input of a consulting doctor prior to making a decision.
When Is a Psychological Evaluation Performed?
A psychological evaluation will be arranged for those with an organic brain disorder, stroke, head injury, a learning disability, or mental retardation. A psychological examination will be scheduled if a person is believed to have an IQ which has sharply decreased or borderline low abilities. Those with memory problems, whether from head trauma, an organic brain disorder, or another reason, will often be scheduled for psychological testing too. Both children and adults may be ordered to undergo psychological testing.
What Kinds of Psychological Tests Are There?
The normal IQ test administered in psychological evaluation is the Weschler Adult Intelligence Scale, designed to measure intellectual functioning in adults. 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 level of knowledge about culture and society and reasoning abilities and your verbal communication.
Perceptual Reasoning: This area tests your ability to solve spatial and visual puzzles.
Processing Speed: This score indicates your skills in visual-motor coordination and your level of motor speed and speed.
Working Memory: This deals with your ability to maintain concentration, attention, and focus, particularly when solving math problems and working with numbers.
In addition to the scores, a full-scale IQ score will also be given. The median full-scale IQ score is 100, with a standard deviation of 15. The score is not merely the average of the four index scores, but your performance in those areas informs it. Scores of two-and-a-half to three standard deviations below the median are considered low intellectual functioning.
The Importance of Doing Your Best During Testing
You should resist the temptation to exaggerate the severity of your condition or to give less than your best effort on any sort of psychological testing. This is called “malingering” (faking), and consultative examiners are trained to spot it. If it is determined that you are overstating the extent of your impairments, you and you will lose credibility and your disability claim, respectively consequently.
Some disability claimants are tempted in the opposite direction; that is, they try to minimize their psychological or emotional problems, perhaps out of fear or embarrassment. It’s critically important, however, to be entirely honest with the examiner about your problems. Failure to do so could result in the denial of a claim.
Disability mental exam what to expect
In all consultative medical examinations scheduled by Social Security (sometimes by a judge but more often by a disability examiner), they are looking for evidence of functional limitations so that they can assess what you can still do and what you could not do. A person filing for disability must be found to have a medically determinable severe disability.
Mental exams are different from physical consultative exams. They are long for one thing. A CE can last as little as 15 minutes. Also, in many cases have stated that the doctor was rude or condescending.
Why is this? We can only speculate. Doctors who perform exams for Social Security do since CE compensation rates are not high it’s often true that the physicians who do CEs are those who do not have thriving clinics, and so to supplement their income. At the very least, it is safe to say they do not have many patients they wouldn’t be doing CEs for the Social Security Administration. Perhaps this is partially due to their skills and demeanor.
Mental assessments offer less opportunity for the psychologist or psychiatrist to descend to the level of rudeness or curtness. Why? Because this, naturally, can impact the mental affective state of the individual. This is not to say that it does not happen, but it probably occurs.
Also, when it comes to physical assessments, the examining doctor might know nothing about the claimant’s medical condition. It is not uncommon for claimants who have severe degenerative spine conditions to report that they have been examined by a gynecologist. When it comes to psychological evaluation, the professional will either be a licensed psychiatrist or licensed psychologist.