Evaluation of the vocational factors impacting on psychiatric disability

It is imperative to recognize that psychiatric disorders that interfere with an individual's ability to perform prior work, eg, an executive secretary, accountant, or physician, do not necessarily preclude performance in any other work available in the national economy, eg, assembly-line work, housekeeping, or sales. To make these determinations, adjudicators employed by the SSA often will look at an individual's history of education, prior work achievements, and vocational factors to ascertain whether there are other aspects of work the individual is still capable of despite the presence of the alleged psychiatric illness. In many cases, skills acquired from prior education or work experience may be generalizable to other kinds of work settings and demands. Individuals older than age 55 are considered by the SSA to be of "advanced age" and thus are adversely affected by vocational factors, ie, they are less adaptable to newer work experiences. Consequently, individuals older than 55 are not expected to be able to take on work that is different from past relevant work. Thus, if deemed to have psychiatric symptoms impeding return to prior work, individuals with "advanced age" are deemed to be disabled and are awarded benefits. Relating the patient's psychiatric symptoms and signs to the vocational factors outlined here will best facilitate adjudication of disability claims through the SSA. Consideration of vocational factors also can open discussions between the patient and psychiatrist regarding rehabilitation. The psychiatrist may be instrumental in encouraging the patient to undertake vocational training and educational experiences that may foster independence, autonomy, and return to work with eventual self-sufficiency.