Psychological Testing in the Service of Disability Determination (2015) / Chapter Skim
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7 Conclusions and Recommendations
7 Conclusions and Recommendations
Pages 197-208
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From page 197... ...
• SSA disability determinations are based on the medical and all relevant evidence in an applicant's case record. Physical or mental impairments must be established by objective medical evidence con sisting of medical signs and laboratory findings, which may include psychological and other standardized test results.
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From page 198... ...
SSA provides general guidance that good psychological tests are valid and reliable and have appropriate ormative data. For this reason, there is variation among states n about when and which standardized psychological tests can be pur chased, with the exception of performance validity tests (PVTs)
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From page 199... ...
In the context of SSA disability applicants, neither scenario rules out disability, but both suggest the need for addi tional assessment of the alleged impairment with the goal of mak ing an accurate determination of disability. • SVTs and PVTs provide information about the validity of standard ized non-cognitive and cognitive test results when administered as part of the test or test battery and are an important addition to the medical evidence of record for specific groups of applicants.
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From page 200... ...
The applicant alleges a mental disorder (i.e., schizophrenic, paranoid, and other psychotic disorders; affective disorders; anxiety-related disorders; and personality disorders) unaccom panied by cognitive complaints or a disorder with somatic symptoms that are disproportionate to demonstrable medical morbidity (i.e., somatoform disorders, multisystem illnesses, and chronic idiopathic pain conditions)
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From page 201... ...
By objective medical evidence in this and the following recommendation, the committee means medical signs and/or laboratory or test results that constitute clear objective medical evidence of a significant mental disorder and related functional impairment of sufficient severity to make a disability determination. An example would be a severe brain injury associated with significant functional deficits (e.g., minimally conscious state)
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From page 202... ...
STANDARDIZED COGNITIVE TESTS AND PERFORMANCE VALIDITY TESTS The following conclusions and recommendation pertain specifically to the use of standardized cognitive tests and associated PVTs in SSA disability determinations: • Standardized cognitive test results are essential to the determina tion of all cases in which an applicant's allegation of cognitive impairment is not accompanied by objective medical evidence. • The results of cognitive tests are affected by the effort put forth by the test-taker.
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From page 203... ...
• All cognitive evaluations should include a statement of evidence of the validity of the results, which could include performance validity test results, analysis of internal data consistency (e.g., item response theory) , and other corroborative evidence as well as discussion of the test norms relative to the individual being assessed.
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From page 204... ...
Recommendation 3: The Social Security Administration should ensure that psychological testing that is considered as part of a disability evaluation is performed by qualified specialists properly trained in the administration and interpretation of standardized psychological tests. • "Qualified" means that the specialist must be currently licensed or certified to administer, score, and interpret psychological tests and have the training and experience to administer the test and inter pret the results.
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From page 205... ...
EVALUATION AND RESEARCH Based on its examination of the literature and dialogues with experts in a variety of areas, including psychological and neuropsychological testing, performance validity testing and symptom validity testing, and the disability evaluation process both within SSA and in other arenas, the committee recognizes many questions remain with regard to the use of standardized psychological testing in the disability determination process. As part of its assessment of the use of standardized psychological tests for the disability evaluation process, the committee was asked to discuss the costs and cost-effectiveness of requiring a single test or a combination of tests.
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From page 206... ...
• In light of this unexplained variability, systematic use of standard ized psychological testing as recommended by the committee is expected to improve the accuracy and consistency of disability determinations. Recommendation 4: The Social Security Administration (SSA)
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From page 207... ...
The value of standardized assessment tools, including psychological tests, to assessments of individuals' work-related functional capac ity is an area that would benefit from further research. Recommendation 6: The Social Security Administration and other federal agencies should support a program of research to investigate the value of standardized assessment, including psychological testing, in disability determinations.
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