What's involved in a Social Security mental exam?

October 24, 2010 1:11 PM

What can we expect during a social security disability "mental" exam?

After more than ten years of suffering constant pain due to a compression at the base of her brain stem my wife is finally applying for social security disability. Everything looks good but we're wondering what to expect at her "mental" exam next week. Has anyone been through this who can give us a sense of what the examiner will be trying to rule out? My wife has seen a medical doctor who also sees counseling patients on and off for some years with no diagnosis save Dysthymia related to childhood abuse. Should she be prepared to discuss her complete psychological history?

posted by tangram1 to Health & Fitness (6 answers total)

Best answer: I guess it might change depending on which disorder they're looking at, but for me, there was some basic orientation stuff--do you know the date, where you are, the president--as well as a lot of math and logic questions, and some putting-pictures-into-narrative-order cards. Then lists of questions about basic functioning--can you do your own cooking, shopping, dressing. I didn't have to discuss anything...personal, really. Just symptoms and barriers to normal living. Of the whole application process, this was really the least stressful, after I stopped worrying there would be a "gotcha" question.
posted by mittens at 1:32 PM on October 24, 2010

Best answer: My husband went through a mental exam as part of the process for applying for social security disability. He said it was pretty tame, that the examiner was on his side basically and did not have any "gotcha" questions. He just wanted to know if my husband's impending blindness made him depressed (and, indeed, it did.)

The best advice we got during this process was from a disability attorney I called one day who said, "Don't hold back information." This meant in the application talking about how his illness affected everyday things (being anxious about going outside, difficulties shopping.) Tell your wife that during the mental exam, she should not strive to come off as normal. Rather, she should let the examiner know that ten years of constant pain has made her depressed, anxious, led to difficulties in her marriage, her friendships, etc., etc., whatever are the results of living with this pain on an emotional and relational level. This is not the time to be stoic and brush off the consequences of her disability.
posted by eleslie at 3:53 PM on October 24, 2010 [2 favorites]

Response by poster: This is a great help and is putting our minds at ease. Thank you both very much!
posted by tangram1 at 5:31 PM on October 24, 2010

Best answer: A close relation does this kind of testing for the state. He usually runs standardized tests that find the testee's mental age, intelligence, and general emotional state. He then writes a report to the state agency. Like someone said above, he is generally sympathetic to your need for support-- he's been doing this for years, and while he has often hinted that he has seen some sad situations, I can't recall him ever talking about someone trying to pull a fast one or defraud the state. I think that the reward for getting past the tests is probably not worth the effort to the sort of person who doesn't really need the support. Nobody is trying to trip you up, they just want to get you the help that you need.
posted by pickypicky at 7:58 PM on October 24, 2010

Best answer: I was just talking with someone about this this evening. She has MS, and had to be evaluated to receive disability benefits. A lot of it sounded like the kinds of baseline IQ/aptitude tests I remember being administered in elementary school: looking at an image for a period of time, then describing its contents once it was taken away; listening to a series of numbers and repeating them back; logic questions about what you can infer from a statement.

It was hard for her at times — turns out her logic skills are still excellent, but her memory is only operating at about 40% of the average person's — and she cried a bit out of frustration, realizing she was unable to think as well as she once could. Her examiner suggested that this might be a sign of related depression. Which it certainly could be, I suppose. Point being, the examiner was definitely on her side, sympathetic, and didn't seem at all to be trying to catch her malingering.

Obviously this is just one case, but taken with mittens and eleslie and pickypicky's comments, I think it suggests that the system isn't adversarial, and that if you're just natural and honest, it'll all work out as well as it can. Best of luck to you.
posted by mumkin at 8:36 PM on October 24, 2010

Response by poster: This is very reassuring for us both. MeFites are lovely people.
posted by tangram1 at 12:03 AM on October 25, 2010 [1 favorite]