From
Ritchie King at Quartz (whatever that is):
A recent German study
shows that a middle-aged worker who develops arthritis is much more
likely to take a disability pension and retire early if she is feeling
depressed than if she is struggling physically to perform her job but
isn’t suffering mentally. Overall, musculoskeletal disorders such as
arthritis are the most common cause (pdf) of early retirement in Europe.
There are those who theorize about disability without having any real experience with the medical records of those who file disability claims. One of the most important things that these people miss is the complex interplay between physical illness and mental illness. Significant physical illness almost inevitably leads to depression of varying degrees. The depression tends to make the perception of pain and other symptoms worse -- and there is no meaningful difference between pain and its perception. Pain cannot exist without a person perceiving it. It shouldn't be hard to understand how this could produce a negative spiral. On the other hand, serious mental illness is
associated with physical illness and early mortality. Again, it shouldn't be hard to understand that it can be impossible to separate out the strands of physical and mental illness in one individual. Dealing with this complexity is, for me anyway, one of the most interesting things about Social Security disability claims.
4 comments:
...and Europe is in great shape!
I agree Chuck. My observation has been that depression can significantly worsen when clients learn that severe pain, or some other serious symptom, is permanent and will likely not improve. Add financial stress (loss of home, savings), inability to adequately care for dependents for a person who was a provider for a family, and the downward spiral can get steeper. The studies of the objective physiological effect of such stress on the brain and body are interesting and helpful to understanding how impairments can combine to cause disability. Looking at the mental and physical impairments separately with blinders on is a common error.
How do you measure this? I would think most people who have a physical disabilities also "feel depressed" because they can't do some of the same things they could before. Perception may be reality for these claimants, but how can percieved pain be used to award disability?
Ah, but that's not the standard, at least in the 4th circuit. There does have to an impairment that could reasonable cause the type of symptom alleged (pain), but the Administration has recognized there is no pain meter. Once an underlying condition is established, other factors are evaluated - daily activities, treatment regime, etc. I know this is about Europe, but I think the above still applies.
Justin
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