Today, we're going to talk about why it is so important when you're applying for SSD or SSI that you get treatment. Social Security bases their decision not only on your diagnosis, whether it's a mental disorder, such as a schizoaffective disorder or a major depressive disorder, or whether it's a physical disorder, such as a bad back, congestive heart failure, or Ankylosing Spondylitis.
Treatment for mental health issues
They also have to base it on your treatment, including what kind of treatment you are getting. Let's talk about treatment for mental health cases. If you're applying for SSD or SSI on mental health grounds, it is extremely important that you get treatment.
And what do I mean by treatment for that? It means that you're seeing a psychiatrist and a therapist and you are following their advice. Some people see a psychiatrist once a month. The psychiatrist is the doctor that prescribes the medication. Some people see their psychiatrist every other month, or sometimes even every three months.
My preference is that my clients see the psychiatrist at least once a month, as long as they're able to. That's because seeing your psychiatrist more often builds up more records as well as a stronger rapport with your psychiatrist. So it's very important to see a psychiatrist.
The importance of seeing a therapist as well
Equally as important is that an individual applying on mental health grounds see their therapist. The therapist could be a psychologist or a licensed clinical social worker. A psychologist is somebody who has a doctorate. They may not be a medical doctor, but they have their PsyD or their PhD. They are called a psychologist or an LCSW, a licensed clinical social worker.
A therapist is somebody where you sit down and spend a half hour, sometimes even an hour. It could be once a week. It could be every other week. I like my clients to see their therapist at least every other week. In a perfect world, it could be once a week, but every other week is fine. You get to sit down with them and spend that time to talk to a therapist about all the difficulties that you're having, whether it's significant depression, anxiety, paranoia, or hallucinations.
The difference between a psychiatrist and a therapist
Most psychiatrists just do what is called a med check. They might spend five or 10 minutes with you. If you're lucky, it may be15 minutes, unless it's a private psychiatrist that's not through Medicaid, and they basically ask a couple of questions and prescribe your medication. And that's it.
Whereas with a therapist, you can sit down with them and spend the necessary time telling them all the difficulties that you're having. In addition to the difficulties that I mentioned before, individuals might have difficulty concentrating, functioning socially, handling the public, or handling going on public transportation, and so on and so forth. This makes it a record. The more records you have when it comes to a mental health case, the better it is.
The second part of the equation, when it comes to why treatment is so important is for physical cases. What do I mean by physical cases? Lower back problems, congestive heart failure, Ankylosing Spondylitis, lupus, cardiomyopathy, or neurological impairment. These are problems that physically affect your body.
The need for a specialist
Usually, everybody starts with their primary care physician. If you have a major physical impairment that I just discussed, it's very important to see a specialist. If you have heart problems, you see a cardiologist. If you have an immune system disorder, usually you see a rheumatologist. If you have a neurological impairment, cognitively, or you have neuropathy, you usually see a neurologist. If you have bad knees, if you have a bad back, or bad hips, you see an orthopedic doctor or a pain management doctor.
So it is very important with physical problems to not only see your primary care physician, but to also see your specialist. In addition, for physical cases, it's very important to get what's called objective evidence. There are two types of evidence, subjective and objective.
Subjective and objective evidence
Subjective is what you're telling your doctor about: your pain, your level of pain, how long you can stand, how long you can walk, how often you get out of breath, how often you get headaches.
Objective evidence, which is very important as well includes MRIs, EMGs, EKGs, echocardiograms, which are radiology reports. If you have a bad back, and you have really bad back pain, you get what's called an MRI and determine the extent of the damage to your back.
And if you have neuropathy, or if you have radiculopathy, where the nerves are affected, and you have numbness, tingling, weakness in your hands or your feet, you can get what's called an EMG. This will determine the carpal tunnel, which will determine the extent of the nerve damage that you have.
And if you have heart problems, a nuclear stress test or an EKG, echocardiogram will determine how your heart is functioning. The echocardiogram and nuclear stress test will give you, what's called your ejection fraction, which will say, okay, at what percent is my heart pumping?
Why you MUST see your specialist
Things have gotten a lot tougher over the past two or three years. If you don't have this evidence and as much evidence as possible, it's very difficult to win your case. This is why it's so important, whether it's a mental health case or a physical case, to see your specialist.