How Do You Pass a Social Security Mental Exam?

I was recently asked this question so I thought I would address it here. There is no pat answer to this question. Consultative mental examinations (CE appointments) are often used if an individual has no current mental health treatment notes or no record of mental health treatment at all. As you might imagine, these types of examinations are typically a poor substitute for a documented history from a mental health professional with whom you have a longitudinal history of treatment.

However, if you are asked to attend a consultative mental health examination (a mental CE), you should remember that it is unlikely that you can fool the mental health examiner who administers the examination.

I only mention this because it has been the case, now and then, (probably a somewhat rare occurrence), that an applicant for disability benefits has tried to answer questions in such a way that the outcome of an examination or testing might be affected. I remember one specific individual for whom, on three separate occasions, the psychologist indicated in the CE (consultative exam) report that the results of the intelligence testing could not be considered valid as the claimant clearly gave less than his best effort.

Why was the claimant given "three shots" at testing? Because the claimant's educational history and medical record documentation pointed to a lifelong history of impaired cognitive function---something that might have been adequately substantiated by testing had the claimant not tried to "game the system".

It is simply a good rule of thumb to be truthful and give any mental health testing (IQ testing, memory scales, etc) your best effort.

As a disability examiner, I saw the reports generated by consultative physicians and psychologists. These reports, at times, contained references that an individual had not given their best performance or were even malingering (faking).

If you genuinely have a mental health impairment that prevents you from working at a substantial gainful work activity level and you have a consultative examination, give your best effort with no consideration as to the outcome of the testing. Because if a consultative physician or mental health professional suspects that you are not giving an honest portrayal of the limitations caused by your mental condition, your claim stands a good likelihood of being denied. And once there is a notation of malingering in your disability case file, it will be hard to win your disability claim if you have to use the Social Security disability appeal process.

So in conclusion, there is no sure way to "pass a Social Security mental health examination" in this sense. Claimants would simply better serve their disability claim by appropriately answering any questions asked of them during their mental consultative examination.






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Social Security Disability Mental Exam Questions

Individuals who file for disability benefits for a mental condition are often required to attend a social security consultative exam (CE). Both social security disability (SSD) and supplemental security income (SSI) programs require that recent medical information for the applicant be on file before a decision can be rendered.

Quite often disability applicants will list ongoing symptoms such as depression, anxiety, insomnia, memory loss, etc., on their application, but either have not received recent medical treatment for their condition (within the past 60 days) or have never received any medical treatment for their condition.

Either way, without a recent medical evaluation to tell them about your current mental state, disability examiners and judges cannot close your case, and will schedule you for a psychological consultative exam.

Social security consultative exams are performed by private doctors hired by the social security administration (SSA) to examine disability claimants. These doctors include physicians, psychiatrists and psychologists, who perform one of the following mental exams during a CE:

1. Psychiatric exam; performed by a psychiatrist (MD) vs. a psychologist. Psychiatric exams are used to evaluate those with psychosis, affective disorders, and mood disorders.

2. Psychological exam. Psychological exams are used to evaluate symptoms that point to reduced cognitive function (low IQ) and for claimants with little education or a history of enrollment in special needs courses in public school.

3. Mental status exam (MSE). An MSE is a common exam used to evaluate one’s memory, language skills, and awareness regarding their surroundings. During an MSE you may be asked to recall items on a list after reading it, count by 5s, name the current President, tell the examiner about your childhood, interpret what is going on in a picture, etc.

4. Memory Scale exam. This exam is used specifically for those who report short-term memory loss. Examples of people who may be asked to participate in this exam are stroke victims, people with traumatic brain injury, Alzheimer’s, etc., although just about anyone could be sent for a memory scale if they listed severe short-term memory loss on their disability application.

The physician or psychologist who performs a mental examination for disability is then required to send a written report to your state disability determination services (DDS) agency (where social security disability decisions are made) within 10 days, so that the disability examiner has a medical opinion of your current state of health on file before making a decision.

It is important to note that SSA may require you to attend a CE even if you have recently seen your physician (s). It just depends on a particular case, i.e. what information is at hand and what the examiner believes should be obtained. For example, a claimant who has been seen by a doctor for knee pain and notes this on the disability application, but has not been xrayed, may be sent to an imaging CE, i.e. an appointment for an xray of the knee. Of course, some disability examiners (meaning their unit supervisors) just prefer to have the input of a social security doctor before making a decision.

If you are scheduled for a CE, you must attend, even if you just saw your own doctor yesterday—missing your exam can potentially mean a dismissal of your claim, though in most cases this will only occur after repeatedly missing rescheduled exam appointments (failure to cooperate).

Also, unlike CEs for physical conditions, mental CEs are more than mere formalities, as examiners tend to strongly consider evidence gained from a mental examination when deciding a claim for disability.






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Additional Pages

SS Disability Denied
Social Security Disability Denials
Denied for disability, should I try to work?

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