The month of May was Mental Health Month. Since 1949, Mental Health America and their affiliates across the country have led the observance of May is Mental Health Month by reaching millions of people through the media, local events and screenings. Increased awareness of the need for mental health is now well established in our society. Most jobs today do not just have physical qualifications. There are mental qualifications as well. So, it is not surprising that almost a third of Social Security Disability recipients have a mental disability or a combination of several mental disabilities.
Generally, a “disability” is a permanent condition which substantially impairs at least one important daily function, even if the patient is taking medicine or undergoing other forms of treatment. Frequently, often depending on the nature of the condition and the patient’s individual makeup, medical interventions only take the edge off mental disabilities. They often do not come close to effectively eliminating the disability and usually require ongoing treatment.
At Heermans Social Security Disability Law Firm, our disability lawyers serving Memphis and the greater Mid-South also focus on mental disability claims. We understand how frustrating these disabilities can be. We also understand the unique nature of these claims. So, we present the compelling evidence that captures the attention of Administrative Law Judges. Because of our experience in this area, we are often able to help you achieve a favorable decision.
In both physical and mental disability claims, the focus is on the claimant’s functional capacity, as opposed to the claimant’s job skills. There is a presumption that if claimants cannot function well in their everyday environments, they probably cannot function well at work either. This presumption is easier to apply if the claimant has a listed condition. More on that in a moment.
To better understand this concept, think about the things you do on a daily basis. These items include things like:
- Paying Bills: This seemingly simple task is almost impossible for many with a mental disability. They do not understand what the expense is for or cannot transfer information from a paper bill to a computer payment screen. In other words, through no fault of their own, they cannot follow directions well. People who cannot do that usually cannot work.
- Cooking: This everyday activity requires people to not only follow directions, but also use the creative sides of their brains. Many people have disabilities which impair the connection between the left and right brains. As a result, they cannot understand the sequence and order of cooking and preparing the dish or visualize what the dish looks like or anticipate what it will taste like.
- Personal Hygiene: Most people know to wash their faces, comb their hair (assuming that, unlike me, they have hair), brush their teeth, wear matching clothes, and so on. People with brain injuries often lack the physical coordination necessary to perform these activities. Alternatively, many brain injury victims are very forgetful. They simply don’t remember to do these things, especially if they are preoccupied with anything else.
These impairments affect social interaction. People who forget to shower and shave do not blend in very well, and those who lack basic processing ability cannot keep up with normal conversations. As a result, these people feel isolated, and their symptoms get worse due to eventual real-time isolation.
The SSA publishes a list of Blue Book presumptive mental conditions. These conditions are widely known to most Claims Examiners, so it is easier for them to assess the victim’s functionality level. These listed conditions include:
- Pervasive developmental disorders,
- Substance abuse disorders,
- Depression and other affective disorders,
- Intellectual disorder (f/k/a mental retardation),
- Schizophrenia, and
- Neurocognitive disorders, such as brain injuries.
A medical diagnosis of a listed condition is not a Golden Ticket to claim approval. A Social Security disability lawyer with Heermans Law Firm must still establish that the condition causes one or more severe functional limitations. These issues are often complex, and depression is a good example.
Initially, there’s a difference between situational depression, perhaps over the loss of a loved one, and clinical depression, which is a chemical imbalance in the brain. The difference is not necessarily the length of the symptoms. When Oliver Hardy died in 1957, Stan Laurel never got over his depression. He never performed again and often refused to come out of his room for weeks or months. Although Laurel’s depression was clearly disabling, he wouldn’t have been eligible for Social Security benefits. His depression was situational as opposed to a bio-chemical imbalance.
Furthermore, there are a number of effective treatments available for clinical depression, mostly medication. However, as mentioned, not all people respond to medication and not everyone responds to the recommended dosage as directed and may need a longer amount of time to find the dosage or particular drug that works best for their body.
That’s especially common if the claimant has coexisting disorders. Assume Cecil suffers from moderate clinical depression and moderate anxiety. His doctor believes medicine would completely control his symptoms. But Cecil hears about the potential side-effects of antidepressants like Zoloft, and he is afraid to take them.
The combination of anxiety and depression could be disabling in Cecil’s case. The Heermans SSA law firm must examine all the evidence to determine if Cecil has a claim worth pursuing. More on the evidence in these cases below.
Substance Abuse, Mental Disabilities, and Disability Lawyers
Many people with mental disabilities, especially Post Traumatic Stress Disorder and other brain injury victims, self-medicate to ease their symptoms. This approach might work in the short term, but it’s obviously not sustainable in the long term. If substance abuse substantially contributes to the victim’s lack of capacity, the SSA might deny a disability claim.
Wait a minute, you’re probably thinking. Didn’t you just say that substance abuse disorders could be disabling? Yes we did. So, let’s break it down.
To determine if substance abuse is a contributing factor as opposed to an underlying cause, most Claims Examiners look at the onset date and the claimant’s family history.
Let’s go back to our friend Cecil. Assume Cecil, who has no family history of substance abuse, takes prescription pain pills after he breaks his leg. He finds that the pills ease his physical pain and his anxiety. After the doctor cuts off his Oxycontin, Cecil moves onto heroin.
A Claims Examiner would probably conclude that Cecil’s drug use contributed to his symptoms. He started taking heroin after his anxiety developed. And, he had no genetic predisposition toward substance abuse.
There is obviously a very fine line here. An attorney usually requests medical evidence regarding the necessary evidence on this point.
In addition to medical expert reports, the MRFC (mental residual functional capacity assessment) is often critical in these situations. This assessment, which an SSA doctor usually completes, measures things like understanding and following directions, staying on task and completing tasks on time, and interacting with co-workers.
If a substance abuse issue substantially contributes to a mental health impairment, this can lead to denial. If mental health impairments are separate from substance abuse, an approval may still be possible.
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