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?
