Psychiatric Impairments and Disability

A different procedure is followed for evaluating Social Security disability claims alleging psychiatric or mental impairments than that which is followed for claims based on physical or exertional limitations. As with claims based on physical limitations, any disability evaluation will focus on whether the impairment precludes the claimant from engaging in meaningful work activity. For physical claims, this means that Social Security will analyze the claimant’s ability to sit, stand, walk, lift, carry, push, pull, and perform other similar exertional activities. For claims alleging disability based on psychiatric limitations, however, Social Security will evaluate the claimant’s ability to engage in simple or complex tasks, to follow and execute instructions adequately, to maintain concentration and pace for meaningful periods of time, to tolerate and behave appropriately with co-workers and the general public, and to keep regular and punctual attendance at the workplace.

Social Security will evaluate the severity of a claimant’s psychiatric limitations by determining the extent to which the psychiatric limitations inhibit the typical workplace requirements described above. For each requirement, Social Security will determine whether the psychiatric limitation causes a “mild,” “moderate,” “marked,” or “extreme” restriction on the ability to perform the activity. Social Security may also decide that the psychiatric limitation causes no restrictions whatsoever. Generally, “marked” or “extreme” limitations are the most persuasive to Social Security judges in finding disability.

Additional evaluations will be made of the claimant’s psychiatric limitations in larger areas of human life, such as in activities of daily living, in social functioning and interaction, in maintaining concentration and attention, and whether the claimant has experienced multiple psychiatric breakdowns or institutionalization. For instance, the Social Security judge might evaluate whether the psychiatric limitations interfere with the claimant’s ability to clean, shop, bathe, take public transportation, use the telephone, or pay bills. Additionally, judges will look to see whether the claimant is unable to interact appropriately with family members, neighbors, and landlords, and whether the claimant has a long history of interpersonal altercations, periods of social isolation, firings from jobs, and evictions. An evaluation of the claimant’s ability to concentrate and maintain attention will focus on whether the claimant has any hobbies, and especially whether they are able to spend many hours reading or using a computer. Furthermore, the claimant’s need to be sheltered in a highly structured living environment is strong evidence of a disabling psychiatric impairment.

Finally, it is imperative that any claimant alleging psychiatric limitations and disability be seeing a psychiatrist or other mental health professional on a regular basis. Records from these providers contain important diagnoses and will document the claimant’s psychiatric problems over a longitudinal time period. Most psychiatric records also contain “GAF” (or Global Assessment of Functioning) scores that provide a succinct evaluation of the severity of the claimant’s psychiatric condition, and which can be particularly helpful to attorneys, judges, and independent medical experts.