DB Disability Law Ledger™ – June 2012
MENTAL ILLNESS AND SUBSTANCE ABUSE: THE DUAL DIAGNOSIS
As a disability law firm, we often represent clients suffering from psychological impairments such as schizophrenia, bipolar disorder, major depression, and obsessive-compulsive disorder, to name a few. These mental illnesses are complicated and debilitating enough, and they often are exacerbated by accompanying substance abuse problems. Interestingly, that is not uncommon.
In fact, according to the Department of Justice’s National Drug Intelligence Center, “Many chronic drug abusers –the individuals we commonly regard as drug addicts—often simultaneously suffer from a serious mental disorder. Drug treatment and medical professionals call this condition a co-occurring disorder or a dual diagnosis.” Recent studies have even suggested that in cases of bipolar disorder, over 50% of these patients are substance abusers.
There is no one answer to this question. However, some in the medical community have theorized that drug abusers are using drugs or alcohol in an attempt to self-medicate; to relieve the symptoms of their mental illness. Others speculate that those with mental illness are particularly vulnerable to substance abuse, and that they may be more at risk of using drugs than the rest of the population. Still, others suggest that socioeconomic forces may contribute to the dual diagnosis.
How Does Dual Diagnosis Complicate Disability Claim?
That all depends upon whether the disability can be identified independent of substance abuse. The question to consider is: If the substance abuse ends, will the patient’s psychological impairment continue or improve? This answer is crucial in determining whether an insurer or the Social Security Administration, for that matter, will approve or deny a claim. Also complicated for a patient with a dual diagnosis is determining treatment options.
There often are treatment complications. One of the biggest problems in treating patients with a dual diagnosis (mental illness and drug addiction) is that each condition is treated separately, in a separate program. That means that patients must go from psych treatment to drug treatment; the two are not appropriately combined. Also, in the case of drug addiction treatment, the programs usually are confrontational and place the responsibility of the problem solely on the patient. For those substance abusers with mental illness, that course of treatment can be overwhelming, and actually be a set-back. Ideally, what is needed is a program that understands and addresses both conditions.
If you suffer from the dual diagnosis of mental illness and substance abuse, seek professional help immediately. If you suffer a long-term disability as a result of this condition, seek the advice of an experienced disability attorney.
MEDICAL SUPPORT AND YOUR DISABILITY CLAIM
As I have said many times on our firm’s blog as well as in our newsletters, critical to filing a disability claim is knowing that your doctors support you. Without sufficient medical support of your impairment, the hurdle just gets harder to climb.
If your doctor supports your claim, it is imperative to make sure that his or her treatment records accurately reflect the seriousness of your condition. Medical professionals often keep notes that they alone can translate; they tend to be illegible and/or too vague. However, bear in mind that insurance carriers, judges, and the Social Security Administration rely on your doctor’s treatment notes to confirm the severity of your disability. Specifically, they want to know how your impairment impedes your ability to work a full-time job.
You can help yourself. When you visit with your doctor (or doctors) do not forget to tell them how you are feeling. For instance, if you suffer from chronic fatigue syndrome, tell him or her the degree to which it affects your everyday life, i.e., you are too tired to get up in the morning, do the dishes, go the the grocery store, etc. If you suffer from arthritis, be specific about your limitations. If you suffer from severe depression, keep a journal of your condition and share it with your psychiatrist or psychologist. The only way they will know how much your condition affects you is if you tell them and keep telling them.
Your subjective pain and suffering does count, particularly if your doctors document it in their treatment notes. In addition, documenting your pain and suffering will assist your doctors in prescribing a treating regimen. For example, if you have migraine headaches and the medication your doctor has prescribed does not alleviate the pain, he or she will need to change it in order to help improve your condition.
MILITARY NEWS . . .
The Justice Department and the state of California have reached an agreement to insure that military service-members, their families and U.S. Citizens living abroad can participate in the upcoming June federal election primary. The Justice Department filed suit because the state of California failed to send absentee ballots to thousands of eligible military and overseas voters for the June 5, 2012 federal primary election at least 45 days prior, as required by the Uniformed and Overseas Citizens Absentee Voting Act (UOCAVA). Also, the state did not send the ballots by mail or electronically, as required by federal law.
The agreement reached between the Justice Department and California Secretary of State stipulates that affected voters are given sufficient opportunity to receive, cast and return their ballots in time to be counted. They will notified of these options via electronic or other expedited methods of communication, and given the option to have their ballots returned by express delivery at no extra cost.
GOVERNMENT ACCOUNTABILITY OFFICE REPORTS MORE NEEDS TO BE DONE IN HIRING DISABLED JOB SEEKERS
In July of 2012, President Obama signed Executive Order 13548, calling for the federal government to become a model employer of people with disabilities. The Office of Personnel Management (OPM) and the Department of Labor were charged with oversight responsibilities. The Executive Order committed the federal government to hire 100,000 disabled workers over the next five years.
However, based on a report by the Government Accountability Office (GAO), the federal government at its current pace likely will not meet those expectations. After reviewing hiring practices at the Department of Education, the Social Security Administration, the Veterans’ Administration, and the Office of Budget and Management, the GAO made the following recommendations to OPM:
- Incorporate information about plan deficiencies into its required regular reporting to the President on implementing the Executive Order and inform agencies about this process;
- Expedite the development of the mandatory training programs required by the Executive Order; and,
- Assess the accuracy of the data used to measure progress toward the Executive Order’s goals and, if needed, explore options for improving its ability to measure the population of federal employees with disabilities, including strategies for encouraging employees to voluntarily disclose disability status.