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Ask the Doctor

by Leslie Greenspan, MD

Source: The Iris  June/July 2004

 

What criteria are required to be eligible for social security benefits?

 

Wilbur Cohen, the first professional employee of Social Security, described its vision, “a consciousness of community that provides a program to assist those members of the community who are in medical and financial need due to an illness or injury that prevents their being wage earners.”

 

Most of the mental illnesses described in the DSM, the primary psychiatric diagnostic manual, meet medical disability criteria. In screening an applicant for eligibility, the following symptoms are addressed:

 

·        oddities of thought, speech, or behavior

·        perceptual disturbances

·        catatonia

·        delusions

·        hallucinations

·        paranoia

·        memory impairment

·        disorientation

·        mania

·        generalized anxiety

·        internal agitation

·        intrusive recollections of a traumatic experience

·        depression

·        decreased energy

·        pervasive loss of interests

·        irritability

·        poor concentration

·        social withdrawal

·        feelings of guilt/worthlessness

·        suicide attempts

 

To meet eligibility criteria, the symptoms must interfere with the ability to work productively. Common ways that psychiatric symptoms hinder people include:

 

Attendance

  • irregular attendance because of illness
  • tardiness

 

Distraction

  • inability to maintain attention for at least two hours
  • being distracted when working near or with others’
  • interruptions from psychiatric symptoms during a typical workday
  • inability to perform at a consistent pace without an unreasonable number of rest periods
  • inability to deal with normal work stress

 

Disruptive Symptoms

  • inability to tolerate constructive criticism from supervisors
  • inability to get along with co-workers or peers without disruption or behavioral extremes
  • difficulty interacting with the general public
  •  socially unacceptable hygiene or behavior

 

Inability to Perform the Job

  • inability to understand instructions
  • inability to remember procedures
  • difficulty making decisions, setting goals, or making plans
  • inability to request assistance when needed
  • difficulty sustaining an ordinary routine without special supervision

 

Evaluators for Social Security benefits require verification from a medical professional regarding the applicant’s psychiatric symptoms and the specific impairments that result from them. This information is obtained from medical records, from the treating psychiatrist or psychologist, or from an evaluation by an independent medical expert.

 

The Social Security Administration just initiated an effort to recruit and involve doctors in helping advocate for their clients directly, thus obviating the need for additional psychiatric evaluations and lengthy and costly reviews and appeals. This is one change being implemented because of concerns about the lengthy, inefficient process of applying for disability benefits.

 

For more information, contact

 

The National Alliance on Mental Illness

NAMI of Greater Chicago

1536 West Chicago Avenue

Chicago, IL  60642

(312) 563-0445

Fax:  312-563-0467

namigc@aol.com

www.namigc.org