From The Spectator:
The Social Security office in Detroit is a dispiriting place done up in industrial grays. It is filled with the long, glum faces of those who molder in the bowels of the federal bureaucracy waiting for some faceless bureaucrat to help them. ...
Into this purgatory enters Gus Malone, a raggedy 52-year-old homeless man, along with his invisible dog Timmy. Gus parades Timmy up and down the gray carpet of the waiting room as if it were the competition floor of the Westminster Kennel Club. ...
Here, Gus casts a sideways glance up at the government clerk who is sitting behind the bulletproof glass, wanting to be sure she is taking all this in. But it appears that imaginary dogs are as common at the Social Security office as daffodils in spring. The bureaucrat bats not an eyelash at the dog who is not there.
Gus has come to the Detroit office to file a disability claim with the federal government, hoping to hit the jackpot of all jackpots — $771 a month, every month, for the rest of his natural-born days.
Gus then admits that there really is no Timmy. It is a ruse that he characterizes as ‘playing crazy’. The invisible-dog bit may be the dollop of perceived schizophrenia that will fast-track his application directly to the top of the ‘approved’ basket. ...
For all the electronic chatter about the comeback of Detroit, it is hard to see it here at the Social Security office, miles from the refurbished office towers of downtown where the artificial beach, deck chairs and outdoor cocktail stands have become something of a surrogate Puerto Vallarta for the skinny-jeaned millennials who work the cubicles there. ...
The Motor City is hardly alone. Nationwide, more than 8.5 million people of working age collect a federal disability check. The phenomenon has been dubbed the ‘disability-industrial complex’. Consider: more is paid for federal disability claims than for welfare and food stamps combined. It is into this army of have-nots that Gus hopes to enlist. ...A few thoughts:
- I guess Gus is real but I've seen a few contrived psychiatric disability claims but I don't think that I've ever seen one as ridiculously contrived as the one described here.
- It's actually quite difficult to get Social Security disability based upon psychiatric illness. It's almost impossible to get a claim approved if the claimant isn't receiving active treatment.
- What are the odds that Gus will be willing to see a psychiatrist for treatment even once, much less on a regular basis?
- What are the odds that Gus could fool a psychiatric professional for a minute? I'll answer that one since I may have some readers who have less than no knowledge of psychiatry. The answer is NO!
- Assuming Gus is real, he really may have serious psychiatric illness; just not the sort of thing he's acting out. There are "gild the lily" claimants who are quite ill but who add a layer of contrivance on top that makes it harder to get them approved. Factitious disorder is itself a real psychiatric illness.
- My experience is that the vast majority of homeless people have serious psychiatric problems. Sometimes, it's substance abuse that won't qualify for disability benefits but mostly it's other problems.
"What are the odds that Gus could fool a psychiatric professional for a minute?"
ReplyDeleteBased on my own experience, I'd say his odds aren't bad at all. Sure, there are plenty of sharp, perceptive psychiatrists and psychologists out there. But there are a whole lot of dim bulbs in that box, too. And psychologists in particular have a tendency to take patients' statements at face value without much objective evaluation or skepticism.
But believe whatever you want to believe. I guess your apparent naivety is harmless in this context, though I'd hate to see the consequences if you were in charge of evaluating defendants' insanity defenses.
Pain is much easier and depression, dude needs to do some research.
ReplyDeleteI live and have my office in the Detroit suburbs. I spend a fair amount of time in the city. The comeback is real, but has only gone to those at the top. The progress of shiny new stadiums, high rises, and hip new restaurants and bars can only be enjoyed by those who can afford to buy the new condos with views of Canada or those who drive back to their homes in the suburbs. Meanwhile, city services and schools for the residents continue to deteriorate. "Gus" from this article needs to give my office a call: I can help get him into a community mental health facility and give him a legitimate chance of winning that SSI claim.
ReplyDeleteThe article was almost like a stream of conscience. Not sure if it is showing the decline of Detroit or railing against the disability system. Maybe a little of both.
ReplyDelete@8:41
ReplyDelete1, I trust a trained psychiatrist or psychologist to evaluate a claimant's mental impairments far more than a layman. I'll counter your anecdotal response that Gus' odds are good, with my own. I could see one of the dozen CEs we deal with on a regular basis believing Gus. I can see none of the state agency's consultants believing that CE's report.
2, even assuming a psychologist were to give Gus a supportive opinion, a case is not built on a single examination pretty much ever, and unless his treaters also are naive, Gus won't win. Also, the article indicates Gus was bragging about his plan in the field office lobby. Assuming Gus is real, you really think that sort of behavior would not be documented in treatment records?
3, A rep taking a client's statements at face value violate's their duty both to their client and the Administration. If this sort of behavior was documented in a field office report (doubtful, since at least in our offices 99% of the time they are just left blank), our immediate response would be to verify this with treatment records.
Indigents thinking they're clever in duplicity is always a good laugh.
ReplyDeleteI bet Charlie LeDuff will be a District Court appointee soon.
ReplyDelete@10:09 AM
ReplyDeleteThen I'd say your faith in the state agency consultants is even more misguided than your faith in the "trained psychiatrist or psychologist." Idiots abound in every profession, my man- doctors, psychologists, judges and lawyers included. And the subjective nature of psychological illness makes it especially easy for the idiots in those professions to be duped, as does the speed with which SSA's state agency consultants and judges are expected to process claims.
To be clear, though: I don't think Gus is typical of most claimants. And I agree the Gus's of the world aren't likely to have much success on a typical day.
I've had more than my share of malingering invisible dogs and family member ghost appearances. Almost always the person eager to tell of these things has seen a psychiatrist who isn't buying what they are selling.
ReplyDeleteIt's the people denying the things in the record that ought to help their case that get your attention in a hurry.
@10:09
ReplyDeleteI don't have faith that our state agency will see through an overly favorable CE or a claimant who is exaggerating. I have faith that the state agency will deny, regardless of merit, as is the norm. In my experience, if a CE is supportive, the state agency rejects it. If it is not supportive, the state agency agrees. That results in denial, at which point it will proceed to an ALJ. I actually do have a degree of faith in ALJs to see through this sort of behavior.
As to psychological illness being subjective in nature which can more easily dupe professionals in the area; not really. Plenty of psychological testing is specifically designed to detect exaggeration. Ever wonder why such simple testing is used? Because failure supports either clear disability (in which case you need further investigation) or exaggeration.
Vast majority of homeless people probably can't even make it through the damn system. I've had many walk ins come in off the street to start a claim and then totally disappear. No paperwork returned much less make it to a consultative exam. We are cutting food help, now if we can just get that disability industrial complex horseshit going again maybe we can totally shred the safety net. Let them eat cake! At the rate we are going the middle class and upper middle and professional classes will be homeless themselves someday. After the next big financial crash we can probably get it down to about half a dozen billionaires owning and controlling everything in this country! Only phrase that applies is total bullshit!
ReplyDeleteIt's been many years since ALJs were permitted to develop validity testing for mental allegations.
ReplyDelete