Psychological Evaluations for Social Security Disability

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 are called consultative examinations, and they're especially common in cases where an applicant has received little or no recent mental health treatment.

That's because disability examiners—the employees who initially decide your claim at state Disability Determination Service agencies, or "DDS"—are required to base their decisions on update-to-date medical information. Many DDS offices will schedule mental consultative exams for almost all claimants who allege mental health problems, regardless of their treatment history.

Mental exams are sometimes ordered even for claimants who don't actually mention any mental health issues on their application. This can happen when there is some indication in their disability file (for example, on a form completed by a third party) that mental health problems may be present.

Social Security Mental Status Exams and Psychiatric Exams

There are several different types of mental exams that the SSA can send an applicant to for a mental health evaluation and assessment. The specific exam depends on what kind of mental health disorder is indicated by the disability application.

For applicants with issues like depression, anxiety, or bipolar disorder, the SSA will often schedule a mental status exam. Mental status exams are meant to provide a snapshot of your current mental condition. Typical mental status exam questions include asking you to name the current president, count backward by sevens from 100, recall items from a list after several minutes, explain a well-known proverb, and talk about your family and your childhood.

The SSA will usually schedule a psychiatric examination for applicants with schizophrenia, schizoaffective disorder, or psychosis. Occasionally, psychiatric examinations will be scheduled for people with mood disorders (such as anxiety and depression).

When Is a Psychological Evaluation Performed?

Psychological evaluations are ordered for applicants who have a learning disability, cognitive disorder, stroke, head injury, organic brain disorder, or intellectual disability. If the applicant is believed to have borderline low intellectual abilities, or an IQ that has sharply decreased, the SSA will schedule a psychological examination.

People with significant memory problems— whether from organic brain disorder, head trauma, or another reason—are often scheduled for psychological testing as well. Both children and adults may be required to undergo a psychological evaluation.

What Kinds of Mental and Psychological Exams 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 abbreviated as the WAIS-IV. The WAIS-IV results in four separate index scores in the following areas:

• Verbal Comprehension. Your score in this area reflects your verbal communication and reasoning abilities, as well as 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, motor speed, and how well you can engage 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, the WAIS-IV assesses a full-scale IQ score. The median full-scale IQ score is 100, with a standard deviation of 15. The full-scale score isn't simply the average of the four index scores, but it is informed by your performance in those areas. Scores of 2 ½ to 3 standard deviations below the median are considered borderline intellectual functioning.

Because the WAIS-IV is valid only for ages 16 and older, 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 ½ to (approximately) age 7. The Weschler Intelligence Scale for Children (WISC) is valid for children ages 6 to 16.

Adults with memory problems are given the Weschler Memory Scale (WMS), a test designed to evaluate the ability to perform several different tasks requiring memory. The test results are composed of five separate index scores, each reflecting the various areas tested: visual memory, auditory memory, visual working memory, delayed memory, and immediate memory. The WMS is frequently given along with the WAIS-IV.

In addition to administering intelligence or memory testing, a psychologist performing an evaluation conducts an interview with the disability applicant. The psychologist may ask questions about the applicant's life, family, background, thoughts, and feelings. Afterwards, the psychologist must submit a written report to Social Security within ten days of performing the exam.

Putting Forth Your Best Effort During Your Mental Status Exam or Psychological Evaluation

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 it"), and consultative examiners are trained to spot signs of it. If the SSA determines that you're overstating the extent of your impairments, you'll lose credibility—and likely your disability claim—as a result.

Some disability claimants are tempted to do the opposite and try to minimize their psychological or mental health problems, perhaps out of fear or embarrassment. It's critically important, however, to be completely honest with the examiner about your problems. The examiner doesn't know what you're struggling with if you don't let them know, and if you downplay your mental health symptoms, the examiner is less likely to approve your disability claim.

What Happens After the SSA Mental Health Exam?

The examiner will send a report to Social Security and it becomes part of the applicant's disability file. The SSA doesn't send a copy directly to you, but you're allowed to request a copy of your file. If you're applying for (or appealing a denial of) Social Security benefits without an attorney, it's a smart idea to request your disability file so you can make sure that the SSA has all your medical records and see what the consultative examiner said about your limitations.

The mental health evaluation will typically include a mental residual functional capacity (RFC) assessment that tells Social Security what kinds of jobs tasks you can do and which you can't. If your mental RFC restricts you from performing even basic work duties full-time, Social Security will find that you're disabled and award you benefits.

For more information about getting disability benefits (SSDI or SSI) for mental disorders, see our article on mental illness and Social Security disability.

_{Updated March 28, 2024}