When the SSA is deciding whether or not you qualify for disability payments, they will look at your records from health care professionals. The medical records you have may not provide enough evidence to show that you have a mental or emotional illness that should prevent you from working. In these cases, the SSA may request additional psychological or psychiatric examinations or tests.
Anytime you list a mental disorder as an impairment on your disability application, and there is not enough medical evidence in your file to support that claim, the SSA may offer you what is called a “consultative examination” with a licensed mental health professional. You do not have to pay for consultative examinations.
Who Conducts a Mental Consultative Examination?
A mental consultative examination may be conducted by your treating doctor if you have a treating psychiatrist or psychologist. Many times, however, the consultative examination is conducted by an independent doctor or psychologist. These doctors do not work for the SSA and do not make a decision on whether or not you are disabled; instead, consultative examination doctors report to the SSA what their opinion is regarding what you can and cannot do, given your impairment.
What Happens at a Psychological Consultative Exam?
A psychological exam by a consultative doctor will probably be similar to other exams you have had with mental health professionals. A psychological consultative examination report given to the SSA will include the following.
- General observations, including how you arrived at the exam (Were you by yourself? How far did you come? Did you drive, walk, take public transportation or get to the exam some other way?) and your general appearance (What are you wearing? Are you well-groomed?). The doctor will also note your attitude and how cooperative you are.
- Your major complaint, including a detailed description of the history of your impairment. This will include the date of the onset of your impairment, the date you feel your impairment began interfering with your work, and the date you actually became unable to work because of your impairment. The doctor will also note any times you tried to return to work and what the outcomes of those attempts were.
- Any outpatient or hospitalization related to mental disorders, including the names of hospitals or treating sources, any medications you were or are currently taking, and your response to the treatment.
- Results of laboratory and other tests, such as psychological tests. Depending on your impairment, these may include the results of tests concerning your thought processes (Are you logical?), the content of your thoughts (Are you delusional?), any abnormal perceptions (Are you hallucinating?), your mood (Are you depressed? Manic?), and your cognitive functioning (How is your memory, concentration, and intelligence?).
- Your diagnosis using the most recent version of the Diagnostic and Statistical Manual of Mental Disorders and your prognosis.
- The doctor’s statement about the limitations you have because of your impairment. This should describe what effect your mental disorder has on your ability to do work-related activities, such as speaking, hearing, seeing, your ability to understand and follow directions, and your ability to respond to other people and work stresses. The doctor will also note any limitations in your activities of daily living. “Activities of daily living” include things like cleaning, shopping, cooking, taking public transportation, living independently, paying bills, keeping yourself appropriately groomed and clean, using telephones, post offices, and so on.
Additional Psychiatric Information
Psychiatrists will include additional information in mental examinations if you have certain specific mental impairments. If you are schizophrenic, delusional, or suffer from another psychotic disorder, the consultative examination report will include information on any periods of time you spent in structured settings, such as group homes or psychiatric facilities. The report will also include how frequent and long-lasting your episodes of illness are and any side effects of medication you are taking.
Additional Information for Organic Mental Disorders
If you have an organic mental disorder (such as Alzheimer’s disease or a traumatic brain injury), your consultative examination report will include information on the source of the disorder and whether the disorder is stable or progressive. The exam will also note any changes over time. A psychological examination report for an organic brain disorder should also include information about neurological testing (such as EEGs) that have been done.
If your impairment falls under the mental retardation category, your report should show documentation of your IQ using an acceptable test.
How to Act at a Mental Consultative Exam
When you are undergoing a psychological examination, do not lie. Answer truthfully but try to avoid being melodramatic and exaggerating your problems. At the same time, it is important to admit the difficulties your impairments have caused you. The examining doctor should hear about your limitations in full. While they may be difficult to talk about, the doctor will not be able to make honest and accurate statements about your limitations and disability unless you are honest.