Will Standardized Tests Be Used to Evaluate Disability Claims of the Mentally Ill?

The Social Security Administration (SSA) recently proposed new regulations for how it determines whether someone with a mental disorder is eligible for disability payments. Mental health advocates are concerned that the proposed rules will lead to the use of standardized testing to determine whether those with mental illness qualify for payments.

In order to qualify as "disabled" for purposes of receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), an applicant must have a severe impairment that prevents the applicant from performing substantial gainful activity, i.e., work. The SSA uses a complicated "listing of impairments" to determine if an applicant's disability makes it impossible for him to work. The listing has two paragraphs, one that defines the impairment and one that describes four ways that the impairment affects an applicant's ability to work. An applicant must have an impairment that meets the definition in the first paragraph and that results in at least "marked" limitations in two of the four criteria found in the second paragraph or an "extreme" limitation in one of the four criteria.

The new regulations update the definitions of many mental illnesses, but the portion of the new regulations that has caused the greatest concern is the new definition of a "marked" limitation. In the proposed regulation, the SSA says that "Although we do not require standardized test scores to determine whether you have marked limitations, we will generally find that you have marked limitation of a paragraph B mental ability when you have a valid score that is at least two, but less than three, standard deviations below the mean on an individually administered standardized test designed to measure that ability and the evidence shows that your functioning over time is consistent with the score. . . Marked limitation is also the equivalent of the level of limitation we would expect to find on standardized testing with scores that are at least two, but less than three, standard deviations below the mean."

Although the SSA has used a variation of this definition for childhood disabilities, this is the first time that the agency has discussed standardized testing when it comes to evaluating adult disabilities, and it has raised concerns among people in the disability community that the government will begin to require standardized testing of people who claim to be disabled due to mental illness. After advocates cried "foul," the SSA reopened the public comment period for the proposed regulations, and it also issued a statement promising that "[t]he proposed rules for adults and children do not state that adjudicators should obtain standardized tests, encourage them to do so, or indicate that there are standardized tests for all serious mental disorders. Rather, our proposed rules state only that if a person has a standardized test and the scores are two standard deviations below the mean, the test will show that the person has a 'marked'' limitation."

To read an article in the Chicago Tribune giving an overview of the controversy along with reactions from some mental health advocates, click here.

To read the proposed regulations, click here.

To read the SSA's statement clarifying the proposal, click here.