Social Security: Mental Disorders
Mental Disorders and Social Security
There are situations that we find ourselves in that sometimes we can not support ourselves in the traditional way. Finding a job or working full time may ( like in my situation ) may be permanently or temporarily impossible. Due to a child's or your own disability you may be unable to work and it's necessary to support ourselves in some way. Some do so in illegal ways and some may live off child support. Many don't realize that even mental disorder's may qualify you with Social Security benefits.
Mental Disorder's have to be evaluated in a few different ways. One requires documentation of what is termed in the September 2008 guide to Social Security benefits as "a medically determinable impairment(s); with the degree of the individuals ability to perform on a job considered and whether the limits posed on the individual by the disability will last or may last, at least 12 months or longer.
These mental disorders are listed in nine diagnostic categories:
- (12.02) organic mental disorders
- (12.03) paranoid schizophrenia and other psychotic disorders
- (12.04) affective (such as schizo affective) disorders
- (12.05) mental retardation
- (12.06) anxiety related disorders
- (12.07) somatoform disorders
- (12.08) personality disorder's
- (12.09) substance addiction disorder's
- (12.10) autistic disorders and other pervasive developmental disorders
Requirements
Aside from mental retardation and substance addiction disorders; each category consists of statements that describe the disorder, a set of medical findings, and a set of impairment related functional limitations. Additional functional criteria is needed for schizophrenia, affective disorders, organic mental disorders, and somotoform disorders. That is only if the set of impairment related functional limitations criteria is not satisfied in assessment.
Set of medical findings: This is meant to substantiate medically the mental disorder such as:
- specific symptoms
- signs
- lab findings
Impairments are analyzed or reviewed under a mental category that are indicated by the medical findings.
Symptoms can include the description in your own words of your mental or physical problem/disorder.
Psychiatric signs is a medical demonstrable phenomena that will show a specific psychological problem such as: abnormality in behavior, moods, thoughts, memory's, their orientation/development or perception, that will be described by a reliable medical sources.
Symptoms and Signs tend to be inter-related and are recognizable and may be either intermittent or continuous depending on the nature of the mental disorder.
Other mental impairments may be considered under physical body listings as well; the concept used is medical equivalence when the mental disorder results in a physical dysfunction such as anorexia and other eating disorders.
Set of impairment related functional limitations and additional criteria: This is when "impairment related functional limitations" are incompatible with the ability to do an activity and they have to be in result to a mental disorder.
Assessment of the Severity
They measure the severity of the individuals disorder according to the functional limitation that is imposed by "your medically determinable mental impairment". The social security administration assesses functional limitations using four different criteria.
- Activity in daily living
- social functioning
- concentration
- persistence or pace and episodes of decomposition
When looking at the "marked degree" they are saying more then moderate and less then severe.
Such limitations mentioned as "marked" may arise when several activities, or functions are affected or impaired. The degree of that limitation needs to interfere seriously with the ability of the person to function independently, appropriately, effectively and on a sustained basis.
Daily Living
Adaptive activities: cleaning, shopping, cooking, taking public transportation, paying bills, maintaining a residence, caring appropriately for your grooming and hygiene, using a telephone, a post office or directory. The SS Administration looks at the context of the entire situation for the individual and assesses the quality of those above activities by their independence, appropriateness, effectiveness, and sustainability. They will look at how the person can participate in an activity that doesn't require the person to have help, supervision, direction.
Social Functioning
Defined by how you are able to interact on your own in an appropriate manner. Effectively and also on a sustained basis with other people. It can include your ability to get along with others; your family, your friends, neighbors, grocery clerks, landlords, public transportation operators, teachers etc. An example of an impairment in this category could be a history of verbal altercations, evictions from your residence, getting fired from your jobs, fears of strangers, avoiding interpersonal relationships, or isolating yourself socially.
A persona example I am willing to share with you to help clarify: I have not maintained employment for more then one year and towards the end have many issues relating to my employees and my boss. I will walk out of my job, quit without warning over night, be on the verge of being fired so I quit, etc. I will allow myself to be put in situations that I know I can control but also know I will be evicted but let it happen. I have been evicted on two occasions that I could control but didn't. I have a very social persona but I am terrified of people I do not know. I will not ask for directions, I will not ask where the tampons are in the supermarket. I can't call and talk to a bill collector or call and initiate someone to come fix something or call and let my landlord know I will be late with rent or whatever. I don't avoid relationships but I seem to on purpose screw them up. I haven't maintained a female friendship for longer than one year without many altercations. I can't have a good relationship with my mother and my sister so I don't have one at all. I fear a relationship with my father or talking to him or if I do I will start problems or arguments. I have no remaining friends or neighbors from my last residence and find when I get close to new ones I will be inappropriate in my interactions for no purpose and it ends up screwing up my relationship with them. I currently have two close friends but they are new ones. I can only seem to sustain relationships from a distance with limited contact. The only public transportation I will use is an airplane but I avoid the airport if possible. I have problems flying on my own with my children though I have; even internationally and have the experience flying my entire life. I will explode on clerks at a whim if I don't like what they say or do or my mood shifts in the wrong direction or I will over talk and overwhelm people. I go from being surrounded all the time by people then isolate myself from the world and won't even check my email which is currently the case. I never check my voicemail and have currently over twenty to listen to in two days. I will never use a bus or cab/taxi; I will walk.
They also keep in mind cooperative behaviors. These are things like consideration of other's feelings ( I don't care until after I make them cry and never say I am sorry though I didn't mean to do or say things the way they come out). Response's perhaps with authority ( the military police here at Fort Stewart threatened to arrest me several times for my complete disrespect and inappropriate reactions and behaviors to their authority making my situations worse even if it wasn't against me to start). Just because say the school of my children's staff loves me but yet I am known to be highly antagonistic (which I am), uncooperative (I find fun in it sometimes) and hostile (more often than I mean to be and for no real reason) you may still be found to be having marked limitations by the SS Administration in their assessments. The reason being you are showing socially inappropriate and unacceptable behavior in social contexts.
Concentration, Persistence, Pace
Your ability to remain focused in both concentration and attention for enough time to do things timely and complete things in an appropriate manner; such as but not limited to, work settings where it is the best way to assess your limitations if any. It can be manifested in other situations however. This is often shown through clinical observations or psychiatric testing. Concentration can be assessed by ( example provided by the SSA guide ) by tasks such as having you subtract serial sevens or serial threes from 100. I just tried it and I get not even into the eighties before I have to start over because I forgot what I was on. I have issues with trying to keep mental track of my spending in the grocery store and I forget to punch in the digits when I use a calculator and never can get through a store with food shopping and be accurate in any way to my spending. Lists don't even help me its just frustrating. In psychological testing the guide uses the example of testing your short term memory ( I don't have one it seems ) or tasks giving you time limits and I never finish mine.
Decomposition
Episodes, exacerbation's, or a temporary increase in symptoms or signs. It will also have a loss of adaptive functioning. This will be manifested by a difficulty in performing in daily living or activity, maintaining your social relationships, concentration, persistence and/or pace. They will normally require (and for me it is true) increased treatment (adding xanax to my medication for a short time or adding psychologist referral) or less stressful situations or both. ( For me that never seems to be something that happens but in the past in my first marriage I would have to pass on all my responsibility to my husband, require him to come help me discipline my children or attend meetings with their teachers, take them to the doctor etc or I would get way to overwhelmed and affect me even more so.)
A good reason to keep your medical records and pharmacy records current and have copies is because it will show the administration that their is a drastic difference. Example would be like when my second husband walked out saying he wanted a divorce. My medication jumped from 20mg Paxil to 40mg. Then add in my school starting and I ended up doubling my Adderall to fifty mg a day and then Christmas and being financially cut off you see them add Xanax. I am only off Xanax currently and about to have them add it back in as well as a possible mood stabilizing medication. Even still I have recorded with military police reports or calls of my inappropriate reactions despite the drastic change in medications. Once I was on Provigil and after doubling it in two weeks they took me off and you see a huge change to adderall and almost eighty mg while my meds were paxil CR, xanax, adderall, and a sleep aide. I still went through three jobs in nine months.
