Social Security considers evidence of mental disorders from the following five categories:
- Evidence from medical source;
- Evidence from the applicant and people who know the applicant;
- Evidence from school, vocational training, work, and work-related programs;
- Longitudinal evidence; and
- Evidence of functioning in unfamiliar situations or supportive situations.
Social Security requires evidence from an acceptable medical source to establish that an individual applicant has a medically determinable mental disorder. This evidence is necessary to assess the severity of a mental disorder and its effects on the person’s ability to function in a work setting. Social Security determines the extent and kinds of necessary evidence from medical and non-medical sources based on the facts of each individual disorder. Please see the last blog which discusses the first two categories of evidence that may establish a mental disorder.
*Evidence from school, vocational training, work, and work-related programs. An applicant may have recently attended or may still be attending school, and may have received or may still be receiving special education services. If so, Social Security will try to obtain information from school sources when it requires this data to assess how an applicant’s mental disorder affects his or her ability to function.
An applicant may have recently participated in or may still be participating in vocational training, work-related programs, or work activity. If so, Social Security will try to obtain information from the training program or employer upon the necessity to assess how an applicant’s mental disorder affects his or her ability to function.
*Need for longitudinal evidence. Longitudinal medical evidence assists Social Security in learning how an applicant functions over time and assists it in evaluating any variations in the level of functioning. Social Security will request longitudinal evidence of a mental disorder when medical providers have records concerning an applicant’s mental disorder over a period of months or even years.
Certain situations, such as chronic homelessness, may make it difficult for an applicant to provide longitudinal medical evidence to the Social Security Administration (SSA). If a mental disorder is severe, evidence will probably exist which indicates its effects on functioning over time, even if there is no ongoing current medical treatment. Many other individuals such as family members, friends, neighbors, former employers, social workers, case managers, community support staff, outreach workers, or government agencies may be familiar with an applicant’s mental health history. Again, an applicant must give the SSA permission to communicate with and gather information from third parties.
In the absence of longitudinal evidence, Social Security uses current objective medical evidence and all other relevant evidence available in an applicant’s case record to evaluate a mental disorder. It may purchase a consultative examination to document a disorder, in which case the record will include the results of this examination.
Social Security considers an applicant’s medical history, symptoms, clinical and laboratory findings, and medical source opinions. If an applicant does not have longitudinal evidence, the current evidence alone may be insufficient to show the presence of a mental disorder that meets the criteria of one of the mental disorders listings.
*Evidence of functioning in unfamiliar situations or supportive situations. Social Security recognizes that evidence about an applicant’s functioning in unfamiliar situations does not necessarily reflect functioning on a sustained basis in an employment setting. People are unpredictable. Applicants may function in one-time, time-limited, or other unfamiliar situations, differently than in familiar situations.
The ability to complete tasks in highly structured settings, or those that are less demanding or more supportive than typical work settings, are not necessarily demonstrative of an applicant’s ability to complete tasks in a regular employment situation during a normal work period.
Social Security must assess an applicant’s ability to complete tasks by evaluating all evidence of an applicant’s functioning, with a focus on how independently and effectively tasks are completed by the applicant on a sustained basis.
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