From Correlation Patterns between Primary and Secondary Diagnosis Codes in the Social Security Disability Programs, Social Security Administration, Office of Retirement and Disability Policy, ORES Working paper 113:
... [D]isorders of the back and affective/mood disorders are by far the two most common impairments overall, together accounting for a disproportionately high share of the diagnoses (32.4% combined ... [T]he estimated correlation between the two diagnoses is small, but it is both negative and statistically significant (a −0.062 posterior mean with a t-statistic of −10.5). This finding appears to conflict with a popular perception: that affective/mood impairments and disorders of the back are two relatively “subjective” medical diagnoses with a “suspiciously” high degree of association. ...
3 comments:
If there were a spot for tertiary diagnoses, you'd see the trifecta completed... back impairment, depression, and obesity. Though rarely listed as a primary or secondary impairment, obesity has to be the most common severe impairment by far.
The graph of the age distributions shows you what you need to know. Affective/mood disorders such as bipolar and schizophrenia tend to hit hard and fairly quickly in the late teens. Treatment can be difficult and uneven. Bipolar and schizophrenia are well known for their effects and SSA is more likely than not to approve. Depression isn't taken as serious by the public and approval rates are much lower. Depression is also the one most likely to accompany chronic pain. Back pain, in contrast to mood disorders, tends to develop over time and effects older workers. People take back pain seriously when it requires surgery. SSA is very reluctant to pay anyone under 50 with back pain under the assumption that "everybody's back hurts." The people who think this way have NO IDEA. I have Ankylosing Spondylitis, which is basically arthritis of the back, but it can effect your organs, ribs, shoulders, etc. It is rare enough (1 in 1000) that I don't think most doctors are familiar with it. It took 11 years for it to be diagnosed, which is not atypical.
It seems, to me, that any time a claimant mentions a mental health problem it is given either primary or secondary listing on their case, even if the mental health problem is fairly minor. Most disabled persons, in my experience, are depressed and/or anxious and many are treated for these problems by doctors who can provide medication for it when they cannot do much for a much more severe physical problem. Result: It is going to be listed and SSA picks it up as a primary or secondary problem when it may, in fact, be the 4th or 5th most serious issues.
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