Why is it hard to get approved for disability in Illinois with a mental condition?
Disability cases filed with the social security administration in Illinois, primarily on the basis of a mental condition, can often be difficult to win. And a large part of the problem has to do with the competency of DDS (in most states, the agency that evaluates Social Security Disability and SSI claims is called DDS, or disability determination services) itself. What do I mean by this? Here's a short list.
1. Disability examiners (the case specialists who actually make decisions on disability applications and reconsideration appeals) get very little training for the purpose of evaluating mental ( psychological and psychiatric ) impairments. And this renders their insight into mental conditions to practically nil. It also severely inhibits their ability to interpret medical evidence that is mental in nature.
Yes, they can read and synopsize the records and they can then take this write-up to a unit psychological consultant for review (examiners have psychologist and physician consultants, who are attached to their unit, sign off on their cases). But their ability to abstract and interpret is very limited. In the end, they are no more qualified to evaluate mental medical records than an xray technician might be---which is to say not at all.
2. The Ph.D.s who serve as unit psychological consultants for disability examiners who work at the various state agencies...tend to be of very poor quality. I will admit that this is a subjective assessment to some extent. But I have seen many of them deliver mental residual functional capacity assessments that were completely ridiculous. And, as a consequence, a great many individuals whose mental condition precluded the ability to hold a job were denied benefits.
3. The social security administration, in its evaluation of disability claims involving mental conditions, does not seem to adequately take into consideration the fact that certain conditions have the characteristic of "exacerbation and remission".
That is, some conditions tend to slide back and forth on a regular basis. Bipolar disorder is a great example of this. A person with bipolar disorder will, by the definition of the disorder, experience depression, manic states, and often will experience mixed states.
How does social security evaluate a claim based on bipolar disorder? Very often, the claim is denied with the reasoning that the condition will resolve to a non-severe state within the twelve month timeframe needed to substantiate a state of disability (the social security administration's definition of disability states that, to qualify for benefits, a condition must be disabling for a period of not less than 12 months, though this can be actual or projected).
In later posts, I'll discuss what claimants with mental conditions may wish to consider when they file a claim for Social Security Disability or SSI benefits.
Resources:
1. How long does it take to get a disability hearing scheduled?
2. How long does it take to get a disability hearing?
3. How long does it take to get a decision after a disability hearing?
4. How to get a disability hearing scheduled faster?
5. Getting a faster disability hearing scheduled
6. Can an attorney get you a faster disability hearing?
7. Disability hearing decision timeframe
8. ALJ disability hearing decisions
9. What to expect at a disability hearing
10. What happens when you go to a disability hearing?
11. After a disability hearing, what happens?
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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