As a practicing psychiatrist in Pittsburgh, I have become all too aware of a disturbing and potentially dangerous way in which Social Security Disability is now being deployed for psychiatric patients.
In years past, a person who applied for SSI/Disability would have his or her psychiatric records requisitioned from a treating psychiatrist. The applicant would then also be evaluated by a second psychiatrist contracted to the Social Security Administration and not linked to the patient. In addition, the applicant was required to be seen by a contracted psychiatrist annually to ensure that he or she indeed remained disabled and qualified for the subsidy.
In recent years, however, I am finding patient after patient placed on disability, often after an initial evaluation with me, without any attempt made to check if that individual remains disabled, even years after the initial determination.
For instance, I queried a middle-aged patient I've treated for four years as to how he is now supporting himself. "Well, I am on Social Security Disability," he replied.
I asked him why he remains on disability. "I have depression." But you are no longer depressed, I countered. Indeed, he has been free of symptoms since a few months after beginning treatment three years ago. ...
Here is a typical scenario: A patient makes an appointment with me for what are often, though not always, legitimate psychiatric symptoms. Then, within a week or two of my evaluation, I receive a request from Social Security for a copy of my report (the patient has signed a release for this information).
The patient has often applied for disability prior to seeing me, and hardly ever volunteers that he or she has done so. The patient is awarded the disability before our next visit! By the third visit, often within two months of the initial evaluation, the patient has fully recovered from the initial "disabling" symptoms.
Here are a few comments on this piece:
- Social Security already does continuing disability reviews. The agency would do more of them and do them more intensively if the agency had decent administrative funding. Take your complaint up with Republicans in the Congress.
- There was never a time where all persons disabled by psychiatric problems were automatically sent to a second psychiatrist when they applied for Social Security disability benefits nor was there ever a time where all individuals drawing Social Security disability benefits by reason of mental illness were automatically reviewed every year. I'll be kind and say this man's memory is playing tricks on him.
- I'm getting schizophrenics denied in North Carolina even though they've been in psychiatric treatment for years and have had involuntary commitments but one visit to a psychiatrist can get you on Social Security disability benefits in Pennsylvania?
5 comments:
Disregarding your knock against the Republicans,you are completely correct on all other points. This guy has no idea what he is talking about. I have seen exactly the same types of things as you have. You frequently have to be so severely impaired to the point of multiple institutionalizations to be allowed at an initial claim level, or have a really long history of mental illness. His allegations hold no water.
He's right about claimants going for one visit, then asking for paperwork. Typically, I see it once the claimant hires an attorney. The attorney, knowing that the claimant's allegations of "depression" won't hold water in front of an ALJ, tells the claimant to go get treatment. The claimant goes to a psych intake, making claims of depressive symptoms. The psych "diagnoses" depression and now it's a severe impairment. Once benefits are awarded, the claimant never goes back and in a lot of cases, never even goes back after the initial assessment.
The guy is also right about the recovery. Many claimant's "depression" is actually situational, due to financial and job (lack thereof) stresses. Instead of clinical depression.
really the thing is your are so wrong. where do i begin. there are very long wait times between getting ssd or ssi that i dont see how they are approved that soon if so i want to know what state cause in Indiana it doesnt happen.
The bigger problem is the gullibility of most mental health professionals, who are willing to believe everything they are told. They let their patients diagnose themselves and then act like that diagnosis is legitimate in the absence of any objective evidence. Any the CE mental health professionals are often no better than the treating providers. We have a psychologist in Illinois who is often used for CEs but who was so notorious for giving very low GAF scores to every person she examined that DDS finally told her she was no longer allowed to include a GAF score in her reports (if DDS was smart, they would quit using her entirely).
Your link to this story isn't any good, but I was able to find it by searching for the first paragraph.
http://www.post-gazette.com/stories/opinion/perspectives/patients-are-gaming-the-disability-system-at-high-cost-to-themselves-and-society-647898/
As for the clown who wrote this piece; there is such a thing as telling a target audience exactly what they want to hear, and calling it journalism.
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