Why does mental illness present special obstacles in getting a claim for Social Security disability benefits approved?
In sum, a lack of mental health treatment or treatment notes, not taking medication, and having an episodic illness are the most common reasons mental illness Social Security disability claims are denied. The following assessment goes into a little more detail on these issues that often cause a claim for Social Security Disability benefits for mental illness to be denied.
Poor Treatment Notes
One of the biggest problems we face in a disability claim for a mental health condition is the fact that many mental health providers (psychologists, psychiatrists, counselors, etc.) keep relatively poor notes. Sometimes the notes are too abbreviated to collect any useful information from them. At other times the notes will be illegible and impossible to read. Some doctors (or other mental health providers) will sometimes submit a summary of their notes to the claims examiner or the Administrative Law Judge because the notes from office visits provide little detail and are not helpful to evaluating the extent and severity of the underlying mental illness.
No Record of Treatment for Mental Illness
All too often we find disability claimants who have no record of mental health treatment for the condition(s) listed on the disability application. This is especially true in mental disability claims involving depression. This is most frequently due to the fact that the claimant’s family care physician has diagnosed depression and prescribed a common anti-depressant. However, the claimant may have never been referred to a mental health specialist like a psychologist or psychiatrist. In such instances, the claimant will often not have sufficient mental treatment records to support the claim for mental disability.
Noncompliance with the Recommended Course of Treatment or Prescribed Medications
In some cases, the mental health provider will recommend a course of treatment like counseling sessions or group therapy, and such recommendations are noted in the claimant’s medical records. However, the records will also note if the claimant refused to attend counseling or failed to show up for group therapy. Later treatment notes will document the fact that the claimant was “non-compliant” with the recommended treatment plan. Make sure you comply with your provider’s treatment plan to give yourself the best chance of being approved for benefits.
In other instances the medical records will show that a claimant has been diagnosed with a specific mental impairment and has been prescribed medication, but records may further note that the claimant has not taken the medication. This is a particularly large problem for mental disability claims because the Social Security Administration (SSA) focuses on what a claimant is still able to do despite the limitations of his or her condition. A claimant’s limitations cannot be accurately measured if the patient is not taking his or her medications as prescribed.
Why is medical non-compliance an issue for some disability claimants? Sometimes it is due to the cost of care or medication. Unfortunately, the Social Security Administration is not typically concerned with whether or not a claimant can afford care or medication. If you cannot afford recommended care or medications, inform the claims handler or Judge that this is the reason that you don’t take your medication. According to the Social Security rules and regulations, an excuse such as this should be an acceptable nonmedical excuse for failing to take medication. If the SSA can help you find free medication, however, this will no longer be a valid excuse. For more information, see our article on failing to follow the prescribed treatment plan.
Lack of Duration
Some Social Security Disability claims are denied on the basis of duration. This means that a disability examiner or ALJ has concluded that the applicant’s condition has not lasted for at least one year or is not expected to last for one year. This is especially problematic in a claim with a medical condition that has a tendency to “cycle” (where the condition switches between getting better and getting much worse with regularity). This is an issue in claims based on a mental condition (like bipolar disorder) and in claims involving a physical disorder (such as lupus).
Improve Your Chances of Being Approved by Working with a Disability Lawyer
Due to the challenges described above, many people choose to hire a disability lawyer to represent them in a mental disability claim with the Social Security Administration. If you are unable to work or your doctor has recommended that you file for disability benefits we can help. Nick A. Ortiz is a Board-Certified Social Security Disability attorney that represents the disabled nationwide.
We assist Social Security Disability claimants from the initial application through a hearing before an Administrative Law Judge (ALJ). We will make sure your application and any appeals are filed as quickly as possible. We will not only assist you in obtaining all of your medical evidence – we also prepare custom medical source statements that are specific to your mental health condition. If you would like to learn more about how an experienced disability attorney can help with your claim, we encourage you to contact us online or call (888) 321-8131 to schedule your free consultation.