If you're applying for Social Security disability based on a mental, psychological, or emotional condition, the Social Security Administration (SSA) will often schedule you for an independent evaluation with a psychologist or other mental health professional. These evaluations, referred to as consultative examinations by SSA, are paid for by SSA and are especially common in cases where a person has received little or no recent mental health treatment. That's because disability examiners working at state Disability Determination Services (DDS) agencies (the employees who initially decide your claim) are required to base their decisions on update-to-date medical information.
In many DDS offices, mental consultative exams are scheduled for almost all claimants who allege mental health problems, regardless of their treatment history. Sometimes mental examinations are even ordered for applicants who don't actually allege mental health issues, but if there is some indication in the file (for example, on a form completed by a third-party) that mental health problems may be present.
Mental Status Exams and Psychiatric Exams
There are several different types of mental examinations that SSA can order in a given case. For those with issues like depression, anxiety, or bipolar disorder, SSA will often schedule a mental status exam (MSE), which is meant to provide a snapshot of your current mental condition. In the typical MSE, you will be asked, for example, to name the current president, to count backwards by sevens from 100, to recall items from a list after several minutes, to explain a well-known proverb, and to talk about your family and your childhood.
A psychiatric exam will usually be scheduled for individuals with schizophrenia, schizoaffective disorder, or psychosis, and sometimes for those with mood disorders like anxiety and depression.
When Is a Psychological Evaluation Performed?
Psychological evaluations will be ordered for those with a learning disability, cognitive disorder, stroke, head injury, organic brain disorder, or mental retardation. If a person is believed to have borderline low intellectual abilities, or an IQ that has sharply decreased, a psychological examination will be scheduled. Those with significant memory problems, whether from organic brain disorder, head trauma, or another reason, will often be scheduled for psychological testing as well. Both children and adults may be ordered to undergo psychological testing.
What Kinds of Psychological Tests Are There?
The standard IQ test administered in psychological evaluations is the Weschler Adult Intelligence Scale, designed to measure intellectual functioning in adults. This test, now in its fourth edition, is thus abbreviated as the WAIS-IV. The WAIS-IV yields four separate index scores in the following areas.
- Verbal Comprehension: Your score in this area reflects your verbal communication and reasoning abilities, and your level of knowledge about society and culture.
- Perceptual Reasoning: This area tests your ability to solve visual and spatial puzzles.
- Processing Speed: This score indicates your level of mental speed and motor speed, and your abilities in visual-motor coordination.
- Working Memory: This deals with your ability to maintain attention, concentration, and mental focus, especially when solving math problems and working with numbers.
In addition to the above scores, a full-scale IQ score will also be given. The median full-scale IQ score is 100, with a standard deviation of 15. The full-scale score is not merely the average of the four index scores, but it is informed by your performance in those areas. Scores of two-and-a-half to three standard deviations below the median are considered borderline low intellectual functioning.
Because the WAIS-IV is valid only for those 16 and over, intelligence evaluation in children is performed using different tests. The Weschler Preschool and Primary Scale of Intelligence (WPPSI) is given to children from ages 2 1/2 to approximately age 7. The Weschler Intelligence Scale for Children (WISC) is valid for children ages 6 to 16.
Adults with memory problems will be given the Weschler Memory Scale (WMS), a test designed to evaluate a person's ability to perform several different tasks using his or her memory. The test results consist of five separate index scores to reflect the various areas tested: Visual Memory, Auditory Memory, Visual Working Memory, Delayed Memory, and Immediate Memory. The WMS is frequently given in conjunction with the WAIS-IV.
In addition to performing intelligence or memory testing, a psychologist performing an evaluation will interview the claimant about his or her life, family, background, thoughts, and feelings. The psychologist must issue a written report to Social Security within ten days of performing the exam.
The Importance of Doing Your Best During Testing
You should resist the temptation to exaggerate the severity of your condition or to give less than your best effort on any sort of psychological testing. This is called "malingering" (faking), and consultative examiners are trained to spot it. If if is determined that you're overstating the extent of your impairments, you will lose credibility with Social Security and you may lose your disability claim as a result.
Some disability claimants are tempted in the opposite direction; that is, they try to minimize their psychological or mental problems, perhaps out of fear or embarrassment. It is critically important, however, to be completely honest with the examiner about your problems. Failure to do so could result in the denial of a meritorious claim.