Mental Evaluation for Social Security Disability and SSI

Social Security disability examiners are required to address any evidence of mental health problems contained within your disability file, which consists of your application for benefits and your medical records. If an examiner doesn't think that your medical records have enough information to make a decision about your mental status—such as any limitations you might have with memory or concentration—they can send you to an independent doctor for a mental consultative examination.

Why Is Social Security Sending Me to a Disability Mental Evaluation?

Consultative exams are typically ordered when a disability applicant ("claimant") hasn't had any recent medical treatment. Whether you're applying for Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or both, you'll need to have documentation of a severe mental impairment before a disability examiner can make a decision.

For example, many claimants will list mental symptoms such as depression, anxiety, memory loss, or chronic insomnia on their disability application, but haven't gotten treatment for these symptoms within the past two months (if they've had treatment at all). Even people who've recently seen a psychiatrist or psychologist might need to go to a mental exam if the disability examiner needs an opinion from a doctor familiar with Social Security's rules.

Another reason why you might be sent to a mental evaluation is when you haven't listed a mental impairment on your application, but your medical records contain information that you might be struggling with your mental health. Social Security often finds references to potentially disabling mental conditions in doctor's notes for an unrelated physical issue or in activities of daily living questionnaires.

You may also be sent for a psychological evaluation if you applied for benefits due to a physical condition, but the doctor doesn't find physical evidence to support your claim.

Types of Social Security Disability Mental Exams

The type of exam you'll take depends on the reason why Social Security is sending you for a mental assessment. Somebody with borderline intellectual functioning, for example, will need a different kind of exam than somebody who experiences severe panic attacks.

Mental Status Exams

Mental status exams (MSEs) evaluate your current mental state by testing memory, language skills, awareness, and mood. During an MSE, you may be asked to recall items on a list after reading it, count backward by threes, name the current president, tell the examiner about your childhood, and interpret a set of pictures.

Psychiatric Exams

Generally used to evaluate people with affective or mood disorders like depression or schizophrenia, these mental exams are performed by a psychiatrist (a doctor with an M.D. degree) rather than a psychologist (a doctor with a Ph.D. degree).

Psychological Exams

These exams are used to evaluate mental symptoms that suggest reduced cognitive functioning, such as low IQ. Adults are often given a test called the WAIS-IV (Wechsler Adult Intelligence Scale, 4th revision), while children may be given a similar version of the test called the WISC or WPPSI.

Memory Exam

Also called the Wechsler Memory Scale, or WMS, the memory exam is used specifically for claimants reporting short-term memory loss, such as people who've had a stroke, a traumatic brain injury, or a diagnosis of Alzheimer's disease.

Mental status exams are the most often administered of the above types—it's very common for claimants to be sent for an MSE because their doctor made a single mention of a mental health disorder somewhere in their treatment notes. Disability examiners must investigate the potential approval of a claim based on a mental condition if there's even the slightest indication that a mental impairment exists.

What Happens at the Mental Exam?

Social Security is required to schedule and pay for the examination at no cost to you. (20 C.F.R. § 404.1519.) The agency schedules exams with the expectation that comprehensive psychiatric evaluations will take at least 40 minutes and psychological evaluations will take at least 60 minutes, but the actual duration of your mental exam can be longer or shorter.

Consultative examinations are one-time visits with a psychologist or psychiatrist. The doctor will ask you questions about your medical and social history in order to help fill in any gaps in your disability application and give Social Security a better sense of your mental limitations.

Mental status exams usually involve answering questions only, but for a psychological or psychiatric examination, you may be asked to solve simple puzzles or logic games as well. You can learn more in our article on how to prepare for a Social Security mental exam.

What Happens After a Mental Exam?

Within 10 days after the exam, the doctor who conducted your mental evaluation will send a written report to your state's Disability Determination Services (where Social Security disability decisions are made.) The report will contain the doctor's opinion about:

• the nature and extent of your mental disorder
• your ability to remember and understand instructions
• your ability to concentrate and finish work at a reasonable pace
• your ability to deal with supervisors and coworkers, and
• your ability to deal with the stresses of work.

A claims examiner will add the doctor's opinion to your disability file and determine what, if any, restrictions from the opinion should be included in your residual functional capacity (RFC). Social Security uses your RFC to determine whether you're able to work.

For example, if the doctor who evaluated you doesn't think that your mental health keeps you from working full-time (and you don't have helpful medical records), you're probably going to need to appeal a denial. But if the doctor who evaluated you wrote that you can't perform even simple job tasks—and the rest of your medical records support that conclusion—the claims examiner will likely approve your application for disability.