- Client: I need to work but every time I try to go back to work I end up in a psychiatric hospital.
- Me: Maybe you shouldn't try to return to work until your psychiatric condition is better stabilized.
- Client: But I HAVE to work. I'll lose everything if I don't work.
The standard for involuntary psychiatric hospitalization is that the patient is dangerous to themselves or to others but for the most part even voluntary psychiatric hospitalizations don't happen unless the patient is dangerous. Thus, almost all psychiatric hospitalizations are a sign that a person has been at significant risk before the hospitalization.
I wasn't trying to talk the client out of returning to work because it would hurt the case if the client returns to work. No, just the opposite. Futile attempts to return to work followed by psychiatric hospitalizations make a case stronger. I don't want clients committing suicide. I've had clients commit suicide. That's terrible even for the attorney. I can't imagine what it's like for the family.
I don't think that most people get just how dangerous it is to one's health to suffer from chronic mental illness.
7 comments:
As stupid as this sounds, maybe there should be a special type of ALJ's for cases like this; that has had, or currently has a mental condition, that doesn't affect said ALJ's job, anymore. You're absolutely right! People don't understand unless they have been through it themselves. It's a devastating wait for SSA as it is, one can lose everything, and that certainly does not make the "self intent on passing away" any better, whatsoever, at all...notta. I know they have "experts" but they seem to just be there to help SSA's case, not the claimant. Not all of them, I am sure...dont' rip me a new one, ya'll. Just saying, SSA's "experts" are, uh... well, rather bias, is all.
I work for SSA and have suffered from metal I’ll ness since my early 20’s. It’s extremely difficult to hold it all together and there are multiple times each day I think about how I want to just let it all go because I just can’t handle it all anymore. Hopefully that day doesn’t actually come.
I can barely remember the last time I won a hearing for anyone with mental illness standing alone. When they come in I start quizzing them asap about areas of chronic pain and old physical injuries. Next step is I tell them to head to a free clinic if available to get physical treatment. Particularly, if substance problems are rain wrapped with the mental illness forget about it!
The reality for a good many years now is the only "mental only (non ID)" case the overwhelming majority of ALJs are paying has at least an inpatient stay or two and an ER visit even while on meds. "Mental only" cases are DOA with only outpatient treatment, really doesn't matter what the psychiatrist writes on the MSS/MSO form.
5:02 the fault lies not with ALJs, who pay far more cases than DDS or the Appeals Council. The fault lies in the special psychiatric review technique, which requires "marked" or "extreme" limitations to pay a mental-only case, and those can be challenging to establish from psychotherapy progress notes about a chaotic home life, or a low dose rx for Prozac. If SSA's policy branch loosened up the rules, on the other hand...
Mental only cases are the majority of cases for claimants under the age 18. Very rare to see a physical disability for a child. However, these SSI childhood benefits are rarely continued after age 18 or graduating high school.
On the other hand almost all DDS allowances and continuances for people under 50 are mental only.
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