SOCIAL SECURITY MENTAL EVALUATION EXAM - WHAT TO EXPECT



What can I expect from a Social Security Mental Examination or Evaluation?



 
I received a letter that I have to see a Psychologist for depression evaluation. My doctor has me on medication for the depression so what can I expect from this appointment? What are they looking for? Thank you for your help.



What to expect from a Social Security Mental Examination? Mental exams are different from physical consultative exams. They are longer for one thing. A physical CE can last as little as 15 minutes. Also, in many instances, claimants who have gone to CEs have stated that the physican performing the CE was rude or condescending.

Why is this? We can only speculate. Medical doctors who perform exams for Social Security do so to supplement their income, and since CE compensation rates are not high it is often true that the only doctors who do CEs are those who do not have especially thriving medical practices. At the very least, it is safe to say they don't have too many patients; otherwise, they would not be doing CEs for the Social Security Administration. Perhaps this is partially due to their skills and demeanor.

Mental exams, on the other hand, offer less opportunity for the psychologist or psychiatrist to descend to the level of rudeness or curtness. Why? Because this, obviously, can impact the mental affective state of the person being examined. This is not to say that it does not happen, but it probably happens less often.



Also, when it comes to physical exams, the examining doctor may literally know nothing about the claimant's medical condition. It is not uncommon for claimants who have severe degenerative spine conditions to report that they were examined by a gynecologist. When it comes to mental examinations, the examining professional will either be a licensed psychiatrist or licensed psychologist.

Mental exams go one of two ways. There are SSA psychological exams that test for memory, mental status, and for IQ. There are also SSA psychiatric exams. Psychiatric exams are given by M.D.s who are psychiatrists and psychological exams are often given by master's level psychologists.

What they are looking to capture on an IQ test is fairly obvious. The mental status exam is designed to get the mental examiners observations on the following type of information:
  • Manner and approach to evaluation;
  • Dress, grooming, hygiene and presentation;
  • Mood and affect;
  • Eye contact;
  • Expressive/receptive language;
  • Recall/memory, including working, recent and remote;
  • Orientation in all 4 spheres;
  • Concentration and attention;
  • Thought processes and content;
  • Perceptual abnormalities;
  • Suicidal/homicidal ideation;
  • Judgment/insight;
  • Estimated level of intelligence.
In a broader sense, Social Security is also looking for this type of information when a person is filing on the basis of a mental impairment because these specific areas speak directly to what is required for a person to maintain the ability to work and earn a substantial and gainful income.

The ability to:
  • Understand, carry out, and remember instructions (both complex and one-two step);
  • Sustain concentration and persist in work-related activity at reasonable pace;
  • Maintain effective social interaction on a consistent and independent basis, with supervisors, co-workers, and the public; and
  • Deal with normal pressures in a competitive work setting.
Good luck with your case.

Note: 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 cannot do. A person filing for disability must be found to have a medically determinable impairment that is severe.




About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.







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