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Mental Impairments and Stress

As an experienced Ohio Disability Attorney, I see poor stress tolerance emerge as an issue in many of my mental impairment cases. One reason individuals with mental impairments are unable to work is that they cannot adapt to the ordinary demands and pressures of most jobs.

When determining what jobs an individual with a mental impairment can do, Ohio disability decision makers often conclude that a claimant with poor stress tolerance is capable of “routine, repetitive, low stress work.” But that is often not true.

Certainly some mentally impaired people may be able to deal with so-called routine, repetitive, low stress work. Others, perhaps the majority, find routine, repetitive work to be quite stressful.

Many people with mental impairments find one or more of the following demands of routine work so stressful that they cannot keep a job:

    • Speed.
    • Precision.
    • Complexity.
    • Deadlines.
    • Working within a schedule.
    • Making decisions or having little latitude for decision making.
    • Exercising judgment.
    • Completing tasks.
    • Working with other people.
    • Dealing with the public (strangers).
    • Dealing with supervisors.
    • Being criticized by supervisors.
    • Simply knowing that work is supervised.
    • Getting to work regularly.
    • Remaining at work for a full day.
    • Fear of failure at work.
    • Monotony.
    • Lack of collaboration on the job.
    • No opportunity for learning new things.
    • Underutilization of skills.
    • Lack of meaningfulness of work.

Social Security Administration’s position on stress and mental illness

The Social Security Administration has issued a ruling on stress and mental disorders. The ruling recognizes that routine, repetitive work can be stressful to many mentally ill individuals. The ruling states:

Stress and Mental Illness—Since mental illness is defined and characterized by maladaptive behavior, it is not unusual that the mentally impaired have difficulty accommodating to the demands of work and work-like settings. Determining whether these individuals will be able to adapt to the demands or “stress” of the workplace is often extremely difficult. This section is not intended to set out any presumptive limitations for disorders, but to emphasize the importance of thoroughness in evaluation on an individualized basis.

Individuals with mental disorders often adopt a highly restricted and/or inflexible lifestyle within which they appear to function well. Good mental health services and care may enable chronic patients to function adequately in the community by lowering psychological pressure, by medication, and by support from services such as outpatient facilities, day-care programs, social work programs and similar assistance.

The reaction to the demands of work (stress) is highly individualized, and mental illness is characterized by adverse responses to seemingly trivial circumstances. The mentally impaired may cease to function effectively when facing such demands as getting to work regularly, having their performance supervised, and remaining in the workplace for a full day. A person may become panicked and develop palpitations, shortness of breath, or feel faint while riding in an elevator; another may experience terror and begin to hallucinate when approached by a stranger asking a question. Thus, the mentally impaired may have difficulty meeting the requirements of even so-called “low stress” jobs.

Because response to the demands of work is highly individualized, the skill level of a position is not necessarily related to the difficulty an individual will have in meeting the demands of the job. A claimant’s condition may make performance of an unskilled job as difficult as an objectively more demanding job. For example, a busboy need only clear dishes from tables. But an individual with a severe mental disorder may find unmanageable the demands of making sure that he removes all the dishes, does not drop them, and gets the table cleared promptly for the waiter or waitress. Similarly, an individual who cannot tolerate being supervised may not be able to work even in the absence of close supervision; the knowledge that one’s work is being judged and evaluated, even when the supervision is remote or indirect, can be intolerable for some mentally impaired persons. Any impairment-related limitations created by an individual’s response to demands of work, however, must be reflected in the RFC assessment.

Despite this ruling, the Social Security Administration decision makers often take the position that routine repetitive work constitutes low stress work. If you have a mental impairment, this may be one reason why your application for Ohio disability benefits is denied. In that case, you should appeal to obtain a hearing where your Ohio disability attorney will help you explain to the judge how stress prevents you from working.

How your Ohio disability attorney will raise stress intolerance at your hearing

At your disability hearing, your Ohio disability attorney will ask you to tell the judge the specific kinds of things that you find stressful. Your Ohio disability attorney will ask you for a lot of examples of things you find stressful, and a description of what happens to you when you are under stress. For example, do you experience any of the following: panicky feelings, terror, a feeling of impending doom, fight or flight response, trembling, shaking, palpitations, chest pain, shortness of breath, smothering feeling, choking, feeling faint, unsteady, sweaty, nausea, stomach ache, numbness, tingling, hot flashes, chills, hallucinations, flashbacks, fear of dying, fear of going crazy, fear of doing something uncontrolled.

Ohio disability attorney offers assistance

Cases involving mental disorders and workplace stress are challenging. If you have a mental illness with stress intolerance, you are not already represented by an Ohio disability attorney, and you want our evaluation, you may contact me at:

John Paul Oreh
Northeast Ohio Social Security Disability Lawyer
E-mail
Phone: 216-896-0935
Fax: 216-896-7202

Social Security Disability Library