The American Association for Disability Policy Reform
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Physical and Psychological Examinations
SUMMARY:
The Social Security Administration uses physical and psychological examinations to try to determine whether or not persons applying for disability benefits are able to work, claiming that these are valuable parts of the disability determination process. However, the examinations the Administration uses are limited almost entirely to the simple, brief and inexpensive tests that were available in the 1950's. None was designed to determine whether or not a person could sustain work activities as needed in a job. Except in extreme cases, these exams are practically worthless. The idea that, except in extreme cases, physical and psychological examinations can determine whether or not a person is able to work is one of the falsehoods most commonly promoted by the Social Security Administration.
DETAILS:
In determining whether or not a person is able to work, the challenge is to determine what work activities he or she is able to sustain for 40 hours a week on a regular basis as needed in a job. (Note that the Social Security Administration has decided that there are no part-time jobs.) Unfortunately there is no scientific evidence that any of the tests used in any of these examinations can be used to predict a person's ability to sustain any activity for 40 hours a week, as needed in a job. Also, there is no scientific evidence that any combination of the tests used in any of these examinations can be used to predict a person's ability to sustain an activity for 40 hours a week, as needed in a job.
Consider physical examinations, which often include the following: (Remember that we are not considering the extreme cases, which are a small portion of disability applicants. They are the easy cases, for which examinations are rarely needed anyway.)
- inspection of the skin, ears, eyes, nose and throat: There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- auscultation of (listening to) the lungs and heart: There is no known correlation between the results of either of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- auscultation and palpation of the abdomen: There is no known correlation between the results of either of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- testing reflexes (knee jerks, etc.): There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- having a person stand and walk for a few minutes: There is no known correlation between the results of this test and a person's ability to sustain any activity for 40 hours a week, as needed in a job. Although standing and walking can be tested for longer periods of time, motivation becomes an increasing factor in performance, making longer tests of little value in determining a person's ability to stand and walk for most of 40 hours a week, as needed in many jobs.
- having a person lift and carry weights of increasing size: There is no known correlation between the results of this test and a person's ability to sustain any activity for 40 hours a week, as needed in a job. Although lifting and carrying can be tested for longer periods of time, motivation becomes an increasing factor in performance, making longer tests of little value in determining a person's ability to lift and carry for most of 40 hours a week, as needed in many jobs.
- having a person bend, squat, and reach: There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job. Although these can be tested for longer periods of time, motivation becomes an increasing factor in performance, making longer tests of little value in determining a person's ability to bend, squat and reach for much of 40 hours a week, as needed in some jobs.
- blood chemistry tests: There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- x-rays: There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- others: There is no known correlation between the results of any other tests and a person's ability to sustain any activity for 40 hours a week, as needed in a job. Recall that we have not been considering the extreme cases.
Physical examinations can show the presence of disease but cannot determine the extent to which physical illness affects the ability to sustain work activity as needed in a job. There is also no known correlation between any combination of the above tests and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
Consider psychological examinations, which often include the following: (Remember that we are not considering the extreme cases, which are a small portion of disability applicants. They are the easy cases, for which examinations are rarely needed anyway.)
- obtaining a brief psychiatric history: There is no known correlation between the results of this and a person's ability to sustain any activity for 40 hours a week, as needed in a job. Since most people are reluctant to disclose their psychiatric histories to a stranger hired by the government, it is normally not possible to obtain a good psychiatric history from most examinations purchased by the Social Security Administration.
- IQ tests: Although higher scores suggest greater intellectual ability, there is no known correlation between the results of IQ tests and a person's ability to sustain any activity for 40 hours a week, as needed in a job. The results are also greatly dependent upon motivation.
- tests of memory: Because memory is heavily dependent upon effort, it almost can't be tested. There is no known correlation between the results of any memory test and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
- the Minnesota Multiphasic Personality Inventory (MMPI): The MMPI attempts to measure a person's concern with bodily symptoms, depression, masculinity or feminity, suspiciousness, anxiety and other personality characteristics. There is no known correlation between the results of any of these and a person's ability to sustain any activity for 40 hours a week, as needed in a job. It was never designed as a test of the ability to work and isn't such a test.
- others: There is no known correlation between the results of any other psychological test and a person's ability to sustain any activity for 40 hours a week, as needed in a job. There is also no known correlation between any combination of the above and a person's ability to sustain any activity for 40 hours a week, as needed in a job.
Conclusion: Except in extreme cases, in which examinations are rarely needed, the examinations the Social Security Administration uses are of little value in determining whether or not a person is able to work.
The idea that, except in extreme cases, physical and psychological examinations can determine whether or not a person is able to work is one of the falsehoods most commonly promoted by the Social Security Administration.
Last updated on 1/12/2020.