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SSA - Will they send me to a counselor?

When do I see a counselor?


Many Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) applicants do not have medical care and they are struggling to provide medical evidence to the Social Security Administration (SSA) to prove they are disabled. In fact, many SSDI or SSI applicants may be very sick and disabled but simply lack the evidence to prove their condition is so severe they cannot work and continue to be denied time and time again. Recently, on our disability forum a claimant ask, “How likely is the SSA to send me to a counselor?” From the question, I gather that the claimant may be suffering from a mental health disorder but lacks the funds or resources to get continuous mental health treatment or a clear diagnosis and treatment plan from a mental health counselor.


What do I need to have to be approved for SSDI or SSI for a mental disorder?


It will be very difficult to win SSDI or SSI benefits for a mental health condition if you do not have a diagnosis, you have not seen a mental health doctor, and you have not followed their treatment plan for a period of months. Why? Because the SSA is likely to assume that if you are not seeing a doctor than you do not really know if you have the capacity to work. The SSA could argue with good medical treatment from a professional counselor your mental health disorder may be controlled and you could work or perform what they call substantial gainful activity.

What if you do not have medical records to support your mental disorder?

Many SSDI and SSI applicants are assuming that if they cannot get medical treatment or visit a counselor on their own that the SSA will provide this service. Maybe there is a group of doctors that the SSA sends claimants to for medical treatment and for a medical diagnosis.

Unfortunately, this is not exactly how the SSA system works. If you do not have the means to pay for good counseling the SSA does not send you to a counselor. They will, however, send you to what they call a consultative examiner (C.E.). If you have a mental health disorder your C.E. will be a mental health doctor, but they will not provide you with treatment or “counseling.”

The consultative examiner has forms, called residual capacity forms (RFC), that they will complete for the SSA. This form is sent back to the SSA for their review, and the SSA makes the disability determination. The consultative examiner is simply providing a cursory review of your condition; they are not providing a disability decision.

Should I go to my own counselor?

If you want to be approved for SSDI or SSI it is imperative that you get good medical treatment from a professional doctor, especially for a mental health disorder Because a mental health condition is not visible to the naked eye it will be much more difficult for a doctor who evaluates you for ten to fifteen minutes to determine if you have a serious mental disorder.

Sometimes it takes weeks or months of counseling and treatment to get a full understanding of a claimant’s mental health condition. Over this period of time your doctor can fully analyze your ability to perform daily tasks and recognize any periods of decompensation or deterioration when you may need extra support to perform tasks.
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