Personality Disorder & Social Security
For people with personality disorders, interacting with others can be very difficult, if not impossible. Depending on the nature and severity of the personality disorder, interacting with others or “social functioning”, in the Social Security lingo, can be so seriously impaired. So much so, it may render the individual disabled. Read on for a few tips when considering the complexities of personality disorder & social security.
Personality Disorder Clusters
Personality disorders are grouped into “clusters” or types (A) odd or eccentric; (B) dramatic or erratic; and (C) anxious or fearful. Like autism, personality disorders are on a “spectrum” (think of a thermometer with levels of severity: e.g. mild, moderate, marked or extreme.)
- Common “cluster A” disorders include the paranoid, schizoid in schizotypal personalities.
- Common “cluster B” disorders include the narcissistic, histrionic and borderline personalities.
- Common “cluster C” disorders include the avoidant, dependent and obsessive-compulsive disorders.
Sadly, it is often the case that people with personality disorders report that they’ve had trouble in school, alienated loved ones and friends, lost out on jobs, lost jobs, had run-ins with the law and have never understood why. Many people with personality disorders go undiagnosed for decades, going through life isolated and misunderstood. Thankfully, mental health care professionals can offer therapies and treatment.
With respect to Personality Disorder & Social Security, the substantial focus will be on “social functioning”. The Social Security administration defines social functioning as “your capacity to interact independently, appropriately, effectively and on a sustained basis with other individuals.” Examples of impaired function can be “a history of altercations, evictions, firings, fear of strangers, avoidance of interpersonal relationships, or social isolation.” The ability to maintain acceptable social functioning, may involve” interactions with the public, responding appropriately to persons in authority (e.g. Supervisors) or cooperative behavior involving coworkers.”
And while Social Security is supposed to look to your medical evidence (what your doctors have written or recorded in their notes) as well as your own descriptions of your limitations- as the primary sources of evidence, it is not uncommon for the Social Security Administration to take a skeptical stance when they review that evidence. Therefore, a mentally ill disability claimant needs a strong lawyer advocating for them.
Social Security judges (ALJs) are under heavy pressure to be efficient and productive. As a result, cases are analyzed systematically, with an eye towards looking for certain “red flags”. This is not a bad thing, on its own, but it can lead to bad outcomes for claimants.
As with any claim for disability benefits, the severity of your problem must be proven. Put another way, the judge must be convinced that the impairment is so severe that you can no longer reasonably be expected to work because of it. This is where one can enter the gray area between “objective and subjective.”
Objective and Subjective
Objective evidence is generally understood to be “specific symptoms, signs and laboratory findings” the ambiguity or gray area tends to revolve around the “symptoms” specifically, some judges take the position that reports or records chronicling your symptoms or their severity is not “objective evidence”. Some judges will even write “the doctor was just writing down what their patient told them…” reviewing courts have rejected such analysis, but it persists. On a commonsense level it begs the question, “how can one inform their doctor of their symptoms if they don’t tell them about their symptoms?
Incidentally, it is surprising how often some judges (ALJs)readily accept any mention of “feeling better” or “stable” at face value.
This becomes even more important in cases concerning mental impairments, such as personality disorders, where the afflicted individual may have good days and bad days… Because “a person who suffers from a mental illness will have better days and worse days so a snapshot of any single moment says little about the overall condition”
One should take some comfort in the fact that reviewing courts have concluded “it is well settled that treating physicians are in the best position to interpret their own clinical findings” and “ALJs must not succumb to the temptation to play doctor…”
The Attorney’s Job
Ultimately, it is the attorneys job to place the medical evidence in proper context for the ALJ. If the person has a partial or temporary response to medications it does not necessarily follow that they are cured and can go back to work because “there could be a great distance between a patient who responds to treatment and one who is able to enter the workforce “. Or if the individual says that they walk their dog, attends church or does some laundry it does not follow that they are able work as there are “critical differences between activities of daily living in activities in a full-time job”.
If you or a loved one have been struggling with a personality disorder or other mental illness please get treatment. If you are still unable to work despite treatment please contact us we can help you.
Did you appreciate these tips on personality disorder & social security? Consider reading our blog post, Fibromyalgia & Social Security.
For additional mental health resources consider Community Mental Health Center, Inc.