Mental Health Disability: A Model for Assessment

Gold, Liza H.

doi:10.1007/978-1-4614-5447-2_1

Liza H. Gold³

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4 Citations

Abstract

Individuals who file claims for mental health disability benefits require medical documentation to support their claims. The level of training of the evaluating mental health professional and the relationship with the claimant vary depending on the type of disability evaluation and the orientation of the mental health clinician’s practice. Regardless, mental health disability evaluators should consider developing a narrative case formulation to assist them in answering the frequently asked questions associated with any type of mental health disability evaluation. A claimant’s documentation requirements may not include the provision of a case formulation. Nevertheless, mental health professionals are better able to address the questions they are asked to answer if they can construct a case formulation that allows them to understand the process by which evaluees have come to identify themselves or be identified as occupationally disabled. This chapter offers a model for constructing case formulations in disability evaluations based on a work capacity analysis.

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Authors and Affiliations

Department of Psychiatry, Georgetown University School of Medicine, 2501 N. Glebe Rd., Arlington, VA, 22207, USA
Liza H. Gold

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Liza H. Gold
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Correspondence to Liza H. Gold .

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Editors and Affiliations

, Department of Psychiatry, Georgetown University School of Medicine, N. Glebe Rd. 2501, Washington, DC, 22207, Vermont, USA
Liza H. Gold
PRMS, Inc., Risk Management, Wilson Blvd #700 1401, Arlington, 22209, Virginia, USA
Donna L. Vanderpool

Appendices

Appendix I: Possible Sources of Collateral Information in Disability Evaluations

Written records

1.
Employment Records
1. a.
  Job description
2. b.
  Performance Reviews
3. c.
  Personnel records, such as letters of commendation, complaints, awards, disciplinary actions
2.
Mental health records
1. a.
  Outpatient counseling and/or psychopharmacology records
2. b.
  Inpatient mental health records
3. c.
  Substance use treatment records
4. d.
  Psychological or neuropsychological testing
3.
Medical records
1. a.
  Primary care records
2. b.
  Specialist records
3. c.
  Laboratory testing results
4. d.
  Neuroimaging reports
4.
Pharmacy records
5.
Disability records
1. a.
  Insurance and medical documentation submitted to support current claim
2. b.
  Insurance and medical documentation submitted to support prior claims
3. c.
  Other experts’ evaluations in current or prior claims
  1. i.
    Mental health
  2. ii.
    Medical, including neurological
  3. iii.
    Vocational/Occupational

Third-party information

1.
Verbal contacts:
1. a.
  Family members and friends
2. b.
  Coworkers and/or supervisors
3. c.
  Mental health and medical treatment providers
2.
Written statements, including depositions or affidavits

Appendix II: Suggested Disability Report Format

There is no single, standard style or format for writing a disability evaluation report. A variety of report formats have been suggested (Buchanan and Norko 2011; Gold et al. 2008; Melton et al. 2007; Piechowski 2011; Silva et al. 2003). Reports will vary depending on the type of disability evaluation. Mental health evaluators will not be asked to document all elements listed here in every disability evaluation. If the referral source asks specific questions, mental health evaluators should answer these questions and limit themselves to providing opinions responsive only to these questions, unless they feel some significant aspect of the case is being overlooked. Generally, however, all disability reports should contain the following elements, unless the referral source indicates otherwise.

1.
Evaluee’s identifying information
2.
Identification of referral source
3.
Referral issue: What are the questions being asked by the referral source?
4.
Documentation of Informed Consent (see Chap. 2)
5.
All sources of information:
1. a.
  Records reviewed, with summary of relevant information, including imaging, diagnostic, and psychological tests findings
2. b.
  Dates and duration of interviews of the evaluee
3. c.
  Collateral sources (may include dates, duration, manner, and nature of contact)
4. d.
  Any psychological tests or evaluation instruments used
6.
History of Current Mental Health Problems
1. a.
  Onset and course of current symptoms
2. b.
  Claimed impairments
3. c.
  Observed impairments
4. d.
  Recent occupational status and relationship to impairments
5. e.
  Treatment and response to treatment
6. f.
  Present psychiatric medication
7.
Past Mental Health History
1. a.
  Onset of symptoms
2. b.
  Treatment, including medications used in past
8.
Substance Use History
9.
List of all medications taken currently
10.
Occupational history
1. a.
  Job history, including reasons for leaving a job
2. b.
  Grievances
3. c.
  Workers’ compensation claims for work-related illnesses and injuries
4. d.
  Any previous public or private disability insurance claims
5. e.
  Any previous employment related litigation
11.
Psychosocial history
1. a.
  Childhood and Adolescence
2. b.
  Educational history, including highest level of education attained
3. c.
  Social, including relationships, current living situation, financial problems
4. d.
  Family history (if relevant; see Chap. 2).
5. e.
  Criminal history
6. f.
  Military history
12.
Mental status examination
13.
Discussion with case formulation if requested or indicated
14.
Opinions:
1. a.
  When referral sources ask specific questions, opinions should be organized as responses to each question, which should be listed before the response
2. b.
  If no questions have been provided, include findings and opinions relevant to the disability issues in the case. These may include (but are not limited to):
  1. (1)
    Multiaxial diagnosis, including GAF score
  2. (2)
    Impairments in work function and the relationship to psychiatric symptoms
  3. (3)
    Adequacy of and response to past treatment
  4. (4)
    Treatment recommendations
  5. (5)
    Prognosis, including the expected course of the evaluee’s disorder(s), likelihood of chronicity, and expected duration of the impairment
  6. (6)
    Restrictions or limitations if requested, and projected length of time restrictions will be present

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Gold, L.H. (2013). Mental Health Disability: A Model for Assessment. In: Gold, L., Vanderpool, D. (eds) Clinical Guide to Mental Disability Evaluations. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5447-2_1

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DOI: https://doi.org/10.1007/978-1-4614-5447-2_1
Published: 11 January 2013
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-5446-5
Online ISBN: 978-1-4614-5447-2
eBook Packages: Behavioral ScienceBehavioral Science and Psychology (R0)

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