Symptom validity issues in the psychological consultative examination for social security disability

Abstract

This article is about Social Security Administration (SSA) policy with regard to the Psychological Consultative Examination (PCE) for Social Security Disability, particularly with respect to validation of the responses and findings. First, the nature of the consultation and the importance of understanding the boundaries and ethics of the psychologist's role are described. Issues particular to working with low-functioning claimants usually form a large part of these examinations. The psychologist must understand various forms of non-credible behavior during the PCE, and how malingering might be considered among other non-credible presentations. Issues pertaining to symptom validity testing in low-functioning claimants are further explored. SSA policy with respect to symptom validity testing is carefully examined, with an attempt to answer specific concerns and show how psychological science can be of assistance, particularly with evidence-based practice. Additionally, the nature and importance of techniques to avoid the mislabeling of claimants as malingerers are examined. SSA requires the use of accepted diagnostic techniques with which to establish impairment, and this article describes the implementation of that requirement, particularly with respect to validating the findings.

Keywords:

• Social Security
• Disability
• Malingering
• Low IQ

Acknowledgements

I wish to thank Aparna Rao and Eileen Bibbins for help with data collection and analysis. Thanks to Erica Prentkowski for a critical reading of this manuscript. I continue to be indebted to Dr. Thomas Frazier for his educative help with evidence-based assessment. I am particularly grateful to several psychological examiners from various DDSs nationwide who have given me many insights, much helpful information, and much of their valuable time, but who asked not to be named. I am most grateful to the action editor and reviewers of this manuscript, whose insights, extensive wordcraft, and incisive commentary made this a much better article.