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Social Security Disability and Getting a Different Diagnosis on a Mental Condition



 
Someone wrote in and stated that she had received different labeling of her condition (different diagnoses) after being seen by a number of different psychologists and, perhaps, M.D.s as well. Her questions were A) why does this occur and B) do disability examiners notice this in the medical records they read and, if so, how does it affect their evaluation of a case.

Related:

1. What kind of Mental Problems Qualify for Disability?.
2. How to prove and win disability with a mental condition.

As to why it happens, I think that's really part and parcel of the mental diagnostic process and the fact that mental conditions are subjective, both for the individuals who suffer with their conditions and for those who must attempt to properly categorize their condition for the purpose of delivering proper and effective treatment.



In my own experiences in assisting others in mental health settings (this would not be in the capacity of an examiner), I've found that it is fairly common to received different--and sometimes even dissimilar diagnoses--from different psychiatrists and psychologists. For example, patient A could receive treatment from Doctor A and then, for whatever reason, switch to Doctor B. Doctor B, after performing his or her own evaluation of the patient may determine the prior diagnosis was incorrect, or perhaps that the patient's condition has changed in some way that affects the current diagnosis. Sometimes, this means dropping the old diagnosis in favor of a different one, or adding a new diagnosis to the current list of diagnosed conditions.

This is fairly routine and normal, based on my experience as an examiner, but also from my own personal observations taken within the mental health system.

However, it does lend some insight as to why mental health disability claims sometimes have an uphill battle.

As I've said many times, the process of making a decision on a disability claim is highly subjective. If that wasn't true, then certainly would not have so many individuals being denied at the first appeal level (request for reconsideration), with such a high percentage of those denials effectively being overturned by federal judges at Social Security Disability hearings.

Also, there is the fact that (and I base this on my own direct experience as an examiner) a case could be taken to several different processing units at a disability determination services agency (where disability claims get worked on for the social security administration) and you could literally get back more than one type of decision. Meaning the system is subjective and not so objective as many would pretend is the case. And it becomes more subjective with mental claims, particularly when you consider the fact that, so often, treating mental health professionals cannot even agree on a diagnosis.

As to the second question: how do disability examiners deal with this phenomenon? Actually, quite easily. Because, as I've said many times on this blog and on www.ssdrc.com, it is not the diagnosis, not the name of the condition that everything rests on. All Social Security Disability and SSI cases are decided according to the functional limitations that are demonstrated by the claimant's medical records. And cases are approved if those records indicate the claimant cannot return to their past relevant work or perform some type of other work while earning a substantial and gainful income. To a large degree in most cases, the name of the condition itself is barely relevant.








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For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.