Note on Proposed Changes to Mental Illness Regulations

Advocacy groups for people living with mental illness are uniformly opposed to a new rule proposed in August by the Social Security Administration that would affect eligibility for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The rule would revise the definition of a key term used to determine if people with mental disorders qualify as disabled. It would also allow SSA adjudicators to consider the results of standardized testing in adults.
Mental health advocates oppose multi-step eligibility test for mental impairments
The first contentious issue in the proposal is the SSA’s revised definition of the term “marked impairment,” which is used to determine if a mental illness or disorder affects the applicant’s ability to work enough to qualify as a disability.
Within the nine mental disability categories in the SSA’s list of disabling conditions, each listing has three paragraphs — A, B and C — that determine eligibility. Currently, an applicant is generally eligible for benefits either if he meets both the A and B requirements or the C requirement.
To meet the paragraph B requirements, the applicant has to demonstrate a marked functional impairment, which is currently defined as “more than moderate but less than extreme.”
The SSA’s proposal would change that, defining a “marked impairment” as symptoms that “interfere seriously with your using that mental ability independently, appropriately, effectively, and on a sustained basis to function in a work setting.” Applicants would have to show a marked limitation in two specific abilities, or an extreme limitation of one specific ability. The specific abilities include the capacity to understand, remember, and apply information; interact with others; concentrate, persist, and maintain pace; and manage oneself.

The problem is that there are no scientifically valid standardized tests for mental illness or other mental disabilities in adults. Nevertheless, the SSA laid out a detailed set of rules on how the results of such tests would be used in determining an adult’s eligibility for Social Security disability.
“We recognize that the proposed rule did not require the use of test results alone when making determinations of disability,” explained Linda Rosenberg, president and CEO of the National Council for Community Behavioral Healthcare.

The proposal was so controversial that the SSA was forced to reopen the comment period in November. Source: Blog, Law Office of Jeffrey Rabin,