Skip to main content
SpringerLink
Log in

An Approach to the Patient Seeking Psychiatric Disability Benefits

  • Research Article
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Psychiatric disability determination is a complicated task for the psychiatrist. With filings for disability benefits increasing, the task is becoming unavoidable. The increasing social cost of disability requires that psychiatrists learn how to respond appropriately to petitions for psychiatric disability benefits. However, there is a significant dearth of education on psychiatric disability assessment. The various disability programs are reviewed; criteria of disability determination and difficulties involved in making an assessment are examined. Characteristics of disability petitioners are reviewed, and practical suggestions are provided for psychiatrists on how to approach a psychiatric disability evaluation. Finally, recommendations for the inclusion of psychiatric disability assessment training in residency programs are outlined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reich J: DSM-III diagnoses in Social Security disability applicants referred for psychiatric evaluation. J Clin Psychiatry 1986; 47: 81–82

    CAS  PubMed  Google Scholar 

  2. Wallace C: Psychiatric rehabilitation. Psychopharmacol Bull 1993; 29: 537–548

    CAS  PubMed  Google Scholar 

  3. Nussbaum K, Schneidmuhl A, Shaffer J: Psychiatric assessment in the Social Security program of disability insurance. Am J Psychiatry 1969; 126: 897–899

    CAS  PubMed  Google Scholar 

  4. Heiman E, Shanfield S: Psychiatric disability assessment: clarification of problems. Compr Psychiatry 1978; 19: 449–454

    Article  CAS  PubMed  Google Scholar 

  5. Enelow A: Psychiatric disorders and work function. Psychiatric Annals 1991; 21: 27–35

    Google Scholar 

  6. Schouten R: Approach to the patient seeking disability, in MGH Guide to Psychiatry in Primary Care, edited by Stern T, Herman J, Slavin P. New York, McGraw-Hill, 1998, pp. 121–126

    Google Scholar 

  7. Fontana A, Rosenheck R: Effects of compensation-seeking on treatment outcomes among veterans with posttraumatic stress disorder. J Nerv Ment Dis 1998; 186: 223–230

    Article  CAS  PubMed  Google Scholar 

  8. Social Security Administration: Understanding Social Security, 1994

  9. Folsom J, Lipsett M, Raskin D, et al: Guidelines for psychiatric evaluation of Social Security disability claimants. Hospital and Community Psychiatry 1983; 34: 1044–1051

    Google Scholar 

  10. Social Security Administration: Social Security disability benefits, 1996

  11. Social Security Administration: SSI: Supplemental Security Income, 1994

  12. Social Security Administration: Medicare, 1996

  13. Pincus H, Kennedy C, Simmens S, et al: Determining disability due to mental impairment: APA’s evaluation of Social Security Administration guidelines. Am J Psychiatry 1991; 148: 1037–1043

    CAS  PubMed  Google Scholar 

  14. Okpaku S: A profile of clients referred for psychiatric evaluation for Social Security Disability Income and Supplemental Security Income: implications for psychiatry. Am J Psychiatry 1985; 142: 1037–1043

    CAS  PubMed  Google Scholar 

  15. Shaner A, Eckman T, Roberts L, et al: Disability income, cocaine use, and repeated hospitalization among schizophrenic cocaine abusers. N Engl J Med 1995; 333: 777–783.

    Article  CAS  PubMed  Google Scholar 

  16. McLellan AT, Ball JC, Rosen L, et al: Pretreatment source of income and response to methadone maintenance: a follow-up study. Am J Psychiatry 1981; 138: 785–789

    CAS  PubMed  Google Scholar 

  17. Rosenheck R: Disability payments and chemical dependence: conflicting values and uncertain effects. Psychiatr Serv 1997; 48: 789–791

    CAS  PubMed  Google Scholar 

  18. Frisman LK, Rosenheck RH: The relationship of public support payments to substance abuse among homeless veterans with mental illness. Psychiatr Serv 1997; 48: 792–795

    CAS  PubMed  Google Scholar 

  19. Satel SS, Reuter P, Hartley D, et al: Influence of retroactive disability payments on recipients’ compliance with substance abuse treatment. Psychiatr Serv 1997; 48: 796–799

    CAS  PubMed  Google Scholar 

  20. Rosenheck R, Lam J, Randolph F: Impact of representative payees on substance use by homeless persons with serious mental illness. Psychiatr Serv 1997; 48: 800–806

    CAS  PubMed  Google Scholar 

  21. Shaner A, Roberts LJ, Eckman TA, et al: Monetary reinforcement of abstinence from cocaine among mentally ill patients with cocaine dependence. Psychiatr Serv 1997; 48: 807–810

    CAS  PubMed  Google Scholar 

  22. Brewin C, Veltro F, Wing J, et al: The assessment of psychiatric disability in the community: a comparison of clinical, staff, and family interviews. Br J Psychiatry 1990; 157: 671674

    Article  Google Scholar 

  23. Massel H, Liberman R, Mintz J, et al: Evaluating the capacity to work of the mentally ill. Psychiatry 1990; 53: 31–41

    CAS  PubMed  Google Scholar 

  24. Aylward M, Locasio J: Problems in the assessment of psychosomatic conditions in Social Security benefits and related commercial schemes. J Psychosom Res 1995; 39: 755–765

    Article  CAS  PubMed  Google Scholar 

  25. Bohr T: Fibromyalgia syndrome and myofascial pain syndrome: do they exist? Neurol Clin 1995; 13: 365–384

    CAS  PubMed  Google Scholar 

  26. Atkinson R, Henderson R, Sparr L, et al: Assessment of Viet Nam veterans for posttraumatic stress disorder in Veterans Administration disability claims. Am J Psychiatry 1982; 139: 1118–1121

    CAS  PubMed  Google Scholar 

  27. Farb H, Hinckley L, Hoerner E: How to write a psychiatric disability report. Journal of the Medical Society of New Jersey 1965; 62: 517–519

    CAS  PubMed  Google Scholar 

  28. Gordon R, Eisler R, Gutman E, et al: Predicting prognosis by means of the DSM-III multiaxial diagnoses. Can J Psychiatry 1991; 36: 218–221

    CAS  PubMed  Google Scholar 

  29. Perl J, Kahn M: The effects of compensation on psychiatric disability. Soc Sci Med 1983; 17: 439–443

    Article  CAS  PubMed  Google Scholar 

  30. Loyd D, Tsuang M: Disability and welfare—who wants it? J Clin Psychiatry 1985; 46: 273–275

    CAS  PubMed  Google Scholar 

  31. Forrester R: Locus of control among psychiatric disability petitioners. J Clin Psychol 1982; 38: 221–225

    CAS  PubMed  Google Scholar 

  32. Strasburger LH, Gutheil TG, Brodsky A: On wearing two hats: role conflict in serving as both psychotherapist and expert witness. Am J Psychiatry 1997; 154: 448–456

    CAS  PubMed  Google Scholar 

  33. Rosenheck R, Frisman L, Sindelar J: Disability compensation and work among veterans with psychiatric and nonpsychiatric impairments. Psychiatr Serv 1995; 46: 359–365

    CAS  PubMed  Google Scholar 

  34. Rosenheck R, Seibyl CL: Homelessness: health service use and related costs. Med Care 1998; 36: 1256–1264

    Article  CAS  PubMed  Google Scholar 

  35. Satel S: When disability benefits make patients sicker. N Engl J Med 1995; 333: 794–796

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital (MGH), WAC 812, 15 Parkman Street, Boston, Massachusetts, 02114, USA

    David Mischoulon M.D., Ph.D. (Instructor in Psychiatry)

Authors
  1. David Mischoulon M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Mischoulon M.D., Ph.D..

Additional information

The author thanks Dr. Theodore Stern, of the Massachusetts General Hospital’s Psychiatric Consultation-Liaison Service, for his critical reading of this manuscript, and his many helpful suggestions and encouragement.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mischoulon, D. An Approach to the Patient Seeking Psychiatric Disability Benefits. Acad Psychiatry 23, 128–136 (1999). https://doi.org/10.1007/BF03340040

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03340040

Keywords

Search

Navigation