Psychological Testing in the Service of Disability Determination (2015) / Chapter Skim
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1 Introduction
1 Introduction
Pages 15-32
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From page 15... ...
administers two disability programs: Social Security Disability Insurance (SSDI) , for disabled individuals and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSI)
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In some situations, the examiner is unable to make a determination because the evidence in the case record is insufficient or inconsistent. In such cases, the examiner may ask the applicant to attend a consultative examination, which SSA purchases.1 SSA establishes the presence of a medically determinable impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs.
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(%) Congenital anomalies 0.20 0.81 5.40 Endocrine, nutritional, and metabolic 3.40 2.68 0.70 diseases Infectious and parasitic diseases 1.40 1.35 0.10 Injuries 4.10 2.62 0.50 Intellectual disability 4.20 19.15 9.60 Other mental disorder 27.60 38.41 57.90 Neoplasms 3.10 1.33 1.20 Disease -- Blood and blood forming organs 0.30 0.40 1.10 Disease -- Circulatory system 8.40 4.26 0.50 Disease -- Digestive system 1.70 1.04 1.20 Disease -- Genitourinary system 1.70 1.02 0.30 Disease -- Musculoskeletal system and 29.80 12.78 0.80 connective tissue Disease -- Nervous system and sense organs 9.30 7.68 7.80 Disease -- Respiratory system 2.90 2.04 2.80 Disease -- Skin and subcutaneous tissue 0.20 0.17 0.20 Other 0.20 0.27 7.80 Unknown 1.40 3.99 2.10 NOTE: SSDI = Social Security Disability Insurance; SSI = Supplemental Security Income.
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Nevertheless, disability examiners and consultative examiners may request psychological testing, within the confines of the rules of each state's Disability Determination Services (DDS) , if they think the test results would inform the adjudication of an individual's disability claim.
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. In carrying out this task, the Committee on Psychological Testing, Including Validity Testing, for Social Security Administration Disability Determinations was asked by the sponsor to address several specific topics, including testing norms, the administration of relevant tests and the qualifications for administering them, the interpretation and reporting of test results, and economic considerations relevant to the use of such tests for the disability evaluation process.4 The 11-member committee included experts in the areas of adult and pediatric neuropsychology, psychology, psychiatry, disability medicine, behavioral economics, and economics (see Appendix B)
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Provide guidance on the general relevance and applicability of psycho logical tests, including SVTs, in the context of other relevant evidence to SSA disability determinations in claims involving physical and mental disorders; and 3. Provide guidance on how to use the results of psychological tests, including SVTs, in the context of disability determinations.
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. Disability in children under 18 years of age is defined as a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.
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On this definition, disability refers to a participation restriction, namely, an inability to participate in work-related activity. Disability in children refers to "marked and severe functional limitations" relative to typically functioning peers of the same age.
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The linkages among an individual's anatomy, diagnosis, and impairment are not sufficient to determine the presence of work disability. As the 2007 IOM report Improving the Social Security Disability Decision Process states with respect to work disability: Work disability … results from the interaction of individuals' impairments, functional limitations resulting from the impairments, assistive technolo gies to which they may have access, and attitudinal and other personal characteristics (such as age, education, skills, and work history)
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The first four categories capture the tests that are most relevant to disability determinations. Standardized psychological tests can be divided into measures of typical behavior and tests of maximal performance.
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For this reason, the report, when appropriate, may refer to performance validity when discussing a particular publication, despite the original source using the term symptom validity. Table 1-3 provides a summary of the psychological terms discussed in this section, and Figure 1-2 shows the relationships among the different terms.
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a administers the test o Occupational or interest tests Can be divided into cognitive • Cognitive tests and non-cognitive o Intelligence testsa measures o Neuropsychological testsa o Achievement tests o Aptitude tests Symptom validity Embedded in self-report Assesses validity in self-report tests (SVTs) psychological tests (e.g., measures, e.g., non-cognitive personality, mood scales)
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Similarly, symptom validity tests do not measure non-cognitive status but are used to examine whether a person is providing an accurate report of his or her actual symptom experience. Because cognitive tests frequently are performance based and non-cognitive measures generally involve self-report, performance validity tests and symptom validity tests are shown as being associated with these types of tests.
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In addition, decisions about which specific tests are most appropriate for particular individuals in a particular set of circumstances properly fall in the realm of clinical decision making. Instead, the committee reviewed categories of psychological tests, including validity tests, and this report provides general guidance on the use of such tests in SSA disability determinations for claims involving physical and mental disorders.
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and multiculturalism in the use of psychological tests (self-report measures and performancebased cognitive tests as well as corresponding validity tests) in making disability determinations.
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. REPORT ORGANIZATION Chapter 2 describes the current SSA disability determination process, focusing on areas relevant to the use of psychological tests.
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2012. Performance validity and symptom validity in neuropsychological assess ment.
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Presentation to the IOM Committee on Psychological Testing, Including Validity Testing, for Social Security Administration Disability Determinations, June 25, 2014, Washington, DC.
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Key Terms
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