Psychiatric Advance Directives

Just developing in the areas of disability law and estate planning is the Psychiatric Advance Directive, essentially a variant of the advance medical directive or living will that provides specific guidance for the provision of psychiatric services in the event of a person’s disability. I believe that these directives can be an effective tool for folks who have an episodic or chronic psychiatric disorder where a specific treatment with a particular provider has proven effective in returning them to normal functioning. Instructions for the gatekeepers, if you will, the directive has the potential to insure quick access to the most effective treatment.

The PAD, however, also has the potential to complicate or thwart rational treatment decision making. I can envision circumstances where an episodically ill person preparing a PAD during a period when their illness is in remission, might give instructions that limit or prohibit treatments that while previously effective in returning them to their baseline functioning, were unpleasant or distasteful, or names an authorized individual to make treatment decisions that does not agree with the opinions of family or treatment providers.

That, of course, goes to the central controversy in mental health treatment, who makes the decisions and how the interests of the individual are to be protected. Although Virginia makes mention of the PAD in its Involuntary Civil Commitment forms, there is as yet no statutory provision recognizing the directives. It will be interesting to observe how the treatment/civil liberties balance is achieved!

Social Security Disability

(SSDI and SSI) A large percentage of people who apply for Social Security Disability have their cases denied at the application and reconsideration level. It has been my experience that a large number of those people can qualify for benefits if they appeal the denial of their reconsideration request to the next level, which is heard before an Administrative Law Judge.

Although these hearings are somewhat informal, it is my opinion that an applicant needs experienced counsel in order to prepare the case for trial, filling in gaps in the record that may have led to the previous denials, and to present the case to the Judge. This helps the claimant tell their story in a way that is both compelling and provides the information that the Judge needs to grant a favorable decision. I have twenty years’ experience in these cases, with consistently good results at both the Administrative Judge and Federal District Court levels.

I have handled disability cases involving various mental health issues such as depression and bipolar disorder, back and neck problems, fibromylagia, heart disease, chronic pain syndrome, arthritis, and many other disabling conditions.

I accept these cases on the contingent fee arrangement approved by the Social Security Administration, 25% of the past-due benefits up to $5,300.00.