Read this description of a patient from a fellow psychiatric blogger (Thought Broadcast):
"When I first saw her, she appeared overweight but otherwise in no distress. An interview revealed no obvious thought disorder, no evidence of hallucinations or delusions, nor did she complain of significant mood symptoms. During the interview, she told me, 'I just got my SSDI so I’m retired now.' I asked her to elaborate. 'I’m retired now,' she said. 'I get my check every month, I just have to keep seeing a doctor.'
When I asked why she’s on disability, she replied, 'I don’t know, whatever they wrote, bipolar, mood swings, panic attacks, stuff like that.' She had been off medications for over two months (with no apparent symptoms); she said she really 'didn’t notice' any effect of the drugs, except the Valium 20 mg per day, which 'helped me settle down and relax.'
Getting someone like this off of disability is nearly impossible. Even if they start to believe in themselves and begin to succeed, they would then lose their Medicaid and would not be able to pay for the treatment that might help them to maintain their employment and make further gains. They are literally trapped by the disability system into feeling themselves to be nothings and nobodies.
Principle #2. Return to work is a fundamental goal of treatment.
Principle #3. Occupational disability is a complex biopsychosocial phenomenon.
Principle #4. Symptoms are not impairments; impairments are not disability. A decline in function is often temporary and does not need to meet the threshold of total incapacity. Disability often includes interpersonal issues at work, physical complaints, other medical conditions, and psychological issues.
And check out this personal communication from Randy Bock, a family practitioner who specializes in addiction treatment:
Recently she was at [a halfway house]. They 'made' her apply for Social Security/disability (‘which they do for everyone’); so as to get their own bills paid regularly … including multiple drug tests/week. Additionally once she got her 'disability check' they were taking 'half her income' - some $400…
She says they wanted her to ‘leave her past’ (which in this case meant also her job) and ‘only look forward’, and that involved her not working (at all) for the subsequent 14 months in the halfway house.”