Social security claims of psychiatric disability: Elements of case adjudication and the role of primary care physicians

When first introduced into law, social security was designed to safeguard economic security for U.S. citizens who were retired or disabled. Primary care physicians are often contacted by the Social Security Administration (SSA) to provide clinical information about the impairments affecting their patients who have applied for disability. The disability determination process is often elusive to physicians. This article is written to describe the process involved in adjudicating disability claims according to SSA standards. Because psychiatric disturbances constitute the largest reason for applications for disability, this article addresses the sorts of information required of clinicians that would expedite disability adjudication of claims involving psychiatric disorders. Practical suggestions are offered for clinicians to employ when preparing medical reports. The potential impact of the disability claim on the doctor-patient relationship is also discussed.