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How to file for disability, Filing for SSI
Disability Requirements, Disability Status
How long is the wait?, Disability Application
The Social Security List of Impairments
Qualifying for Disability, Mental Disability
Disability Lawyer Info, Disability Back Pay

Social Security Disability and SSI Mental Claims and Criteria



 
Continued from: The Social Security Disability and SSI Process for Mental Claims based on Mental Disorders

Disability examiners working on Social Security Disability and SSI claims review medical records looking for signs of limitations in these basic areas. When limitations are found, they are recorded in the examiner's informal writeup of the case, which may then be used to complete a mental residual functional limitation form, which is the next step in the evaluation process.

3. The disability examiner will complete a form known as a MRFC, or mental residual functional capacity form. This form will be based on the mental evidence that has been received and read by the disability examiner and it will indicate the claimant's abilities and limitations in a wide variety of functional areas. The MRFC form assesses the claimant's ability to A) understand and remember, B) sustain concentration and persistence, C) Interact socially (with the general public, supervisors, and coworkers) and D) Adapt (including the ability to adapt to changes in the work environment).



After the disability examiner completes his or her write-up of the case and completes an MRFC form, the examiner will meet with the mental consultant who is part of the examiner's case processing unit. This individual is usually a psychologist who holds a Ph.D., though sometimes it will be an M.D. physician who has practiced as a psychiatrist.

4. The examiner's unit mental consultant will also complete an MRFC form and in addition to this will compete a PRTF, a psychiatric review technique form. The PRTF is used to evaluate by the mental consultant to evaluate the severity of a mental impairment for a Social Security Disability or SSI claim. The form rates the following:

A) Whether or not the claimant has a medically determinable impairment.

B) Whether or not the claimant's condition is severe.

C) Whether or not the claimant's condition is severe but unlikely to last 12 months or longer (the one-year duration is the litmus test for whether or not a condition is disabling, in the eyes of the social security administration).

D) Whether or not the claimant's condition is severe enough to meet or equal a listing in the blue book, the Social Security Disability list of impairments.

The PRTF form is also used by the mental consultant to note the presence of, as demonstrated by the medical records, certain psychological or psychiatric characteristics displayed by the claimant such as memory impairment, changes in personality, mood disturbance, delusions, hallucinations, decreased energy, sleep disturbances, lowered IQ, obsessions, compulsions, changes in appetite, difficulty with concentration, and even suicidal thoughts.

5. The evaluation of the claimant's medical evidence will conclude with one of the following determinations:

A) The claimant is denied due to the fact that their condition is not severe.

B) The claimant is denied because their condition, while severe, will not last 12 months.

C) The claimant is denied because their condition, while severe, is not severe enough to prevent them from going back to one of their former jobs, or from doing some type of other work.

D) The claimant is approved because their condition is severe enough that they either meet or equal a mental listing in the Social Security Disability and SSI blue book (a list of impairments and their approval criteria; the book is published under the title "Disability Evaluation under Social Security").

E) The claimant is approved because their condition, while not meeting or equaling a blue book listing, is severe enough to make it impossible for them to perform any work activity (past work or other work) at a level that would allow them to earn a substantial and gainful income.

Whether a Social Security Disability or SSI claim is processed at the disability application level, or the reconsideration appeal level, this will be the process that is used to determine the claim.

If a claimant's Social Security Disability or SSI benefits case has progressed to the level of a disability hearing, the manner in which the medical evidence will be viewed will be the same; however, neither a disability examiner nor a medical consultant will be involved. At a disability hearing, the case is presented by a claimant, or his or her disability attorney, to a federal administrative law judge who has been trained to adjudicate disability claims.

While disability representation at the hearing level is important for all types of claims, at the hearing level it may be particularly important due to the sensitive nature of mental treatment records and the sheer importance of obtaining supporting statements from a claimant's mental health treatment provider.

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








Essential Questions

What is the Social Security Disability SSI list of impairments?

Can you work while getting or applying for Disability?

How Often Does Social Security Approve Disability The First Time You Apply?

Tips for getting Social Security Disability or SSI benefits approved

What medical conditions will get you approved for disability?

What kind of Mental Problems Qualify for Disability?

Receiving a Disability Award Letter

Conditions Social Security will recognize as a disability

Previously answered questions regarding SSD and SSI

Applying for disability in your state



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Related pages:

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Who is eligible for SSI Disability?
Disability Criteria - Eligibility For Social Security and SSI Disability
Can I Be Eligible For SSI And Social Security Disability At The Same Time?
Social Security Disability and SSI Mental Claims and Criteria
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Inability to Work and Eligibility for Social Security Disability and SSI Benefits
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Will I qualify for SSI disability in Missouri?
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These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?

What happens if I file a disability application and it is denied by a disability examiner or Judge?









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.