Social Security Disability Insurance (SSDI): Mental Impairment Evaluations

In the many years that I have been a consultative examiner for the Social Security Administration’s Disability Determinations Services (DDS), I have conducted close to 10,000 psychological disability evaluations. I am regarded by their administrative law judges as a thorough and accurate psychologist who provides quality comprehensive narrative reports and medical source statements with regard to functional impairment in this important process.

Disability evaluations assist individuals, attorneys, and other parties in determining the extent of functional limitations and eligibility for Social Security Disability Insurance (SSDI). These evaluations are conducted to assess such factors as the extent of malingering, emotional or psychological difficulty, cognitive limitation, or learning difficulty. An assessment of functional abilities is an important component in these evaluations because not all individuals who experience mental, emotional, and/or cognitive difficulties are unable to work.

For those individuals who are experiencing functional limitations due to ongoing behavioral health symptoms, SSDI is crucial for their financial welfare, given that their mental health symptoms are preventing them from engaging in full-time competitive employment.

There are various types of psychological disability evaluations, which are generally as follows:

General Clinical Evaluation With Mental Status Examination

This type of evaluation is conducted on all claimants and consists of a thorough review of their mental health history, current and past symptoms, and medical records. The mental status portion of this evaluation includes Dr. Jalazo’s clinical observations and impressions of the claimant at the time of the evaluation.

Objective Psychological Testing

In addition to the General Clinical Evaluation With Mental Status Examination, Dr. Jalazo conducts objective psychological testing to provide support for any current diagnoses and their severity.

Clinical & Personality Disorder Testing: Assessment of Emotional, Behavioral, and Interpersonal Functioning

Dr. Jalazo uses the Minnesota Multiphasic Personality Inventory, Third Edition (MMPI-3), to assess for current clinical and personality disorders that may be affecting the claimant. The MMPI-3 is the most widely used and researched clinical assessment tool used by mental health professionals to help diagnose mental health disorders and to provide objective clinical data to support these diagnoses. It is considered the gold-standard in the industry, the most highly-powered lens that we have.

Cognitive Testing

Each claimant receives cognitive testing. For persons with significant cognitive and/or intellectual limitations, Dr. Jalazo uses the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV) or the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V), depending upon the age of the claimant. Additionally, for those persons who are believed to have a learning disability, the Wechsler Individual Achievement Test, Fourth Edition (WIAT-4) is administered. All of these tests are approved by the DDS for consideration in the SSDI claim process. For persons who are not suspected of having a severe cognitive-intellectual disorder (i.e., intellectual disability, learning disability, traumatic brain injury), an objective cognitive screening measure is utilized to determine if the claimant’s current mental health symptoms are likely impacting his or her abilities for attention, concentration, and/or task persistence.

Medical Source Statement

In addition to providing a typed narrative psychological evaluation utilizing DSM-5 diagnoses, Dr. Jalazo will fill-out a medical source statement (sometimes called a Mental Health Impairment Questionnaire) that is usually provided by the hiring attorney. This medical source statement is important to those making the determination for a disability award because it consists of the psychologist’s professional opinion regarding the claimant’s functionality. All administrative law judges require this document.

Substance Material to Disability Statement

Sometimes, a claimant applying for disability either has used substances or is currently using substances. Psychologists should make a decision regarding the claimant’s substance use with regard to how it may or may not “contribute” to the individual’s impairment. The DDS no longer considers “drug addiction and alcoholism” to be a disability in-and-of-itself. However, in some cases, the claimant’s drug use is not considered material to their disability. Stated another way, the claimant may be impaired independent of such drug use. Moreover, if the psychologist does not make a statement regarding this aspect of the claimant’s psychological condition, then the judge may automatically opine that the claimant’s drug/alcohol use is responsible for the claimant’s mental impairment and thus decline disability.

In cases where the claimant has self-reported previous or current substance use, Dr. Jalazo will provide a signed document speaking to whether the claimant’s substance use is material to their disability.

The outcomes for person’s whose substance use is not material to their disability (i.e., is not the cause of their disability) are generally as follows:

  • The claimant is reportedly not currently using drugs and/or alcohol and remains disabled.
  • The claimant’s self-reported use of drugs and/or alcohol is insignificant and has no impact on his or her disability.
  • The claimant’s self-reported use of drugs and/or alcohol is a symptom of his or her condition, and/or is a form of self-medication. The disability is independent of any use.
  • It is impossible for me to separate the claimant’s use of drugs and/or alcohol from the disability.
  • The claimant’s use of drugs and/or alcohol has led to an organic condition that is irreversible regardless of whether the claimant continued to use or abstained from drug and/or alcohol use.