Can You Interact Appropriately with Supervisors, Coworkers, and the Public?

Can You Interact Appropriately with Supervisors, Coworkers, and the Public?

Why Social Functioning Matters in Social Security Disability and Alabama Workers’ Compensation Cases

Most jobs require much more than technical skills or physical ability.  Whether someone works in an office, a factory, a hospital, a warehouse, or drives a truck, virtually every occupation requires employees to interact appropriately with other people.

That may include:

• accepting instructions from supervisors;
• working cooperatively with coworkers;
• assisting customers or patients;
• responding appropriately to criticism;
• controlling anger and frustration; and
• maintaining professional behavior under stressful circumstances.

For many individuals, however, illness or injury significantly affects these abilities.

Chronic pain, traumatic brain injuries (TBI), post-traumatic stress disorder (PTSD), depression, anxiety, medication side effects, and other medical conditions may alter how a person communicates, manages stress, and interacts with others.  These limitations may substantially affect the ability to maintain employment and frequently become important issues in both Social Security Disability and Alabama workers’ compensation claims.

Recommended Reading: Chronic Pain and Resulting Psychological Injuries

These Are Not Just Common-Sense Ideas—They Are Part of Social Security’s Rules

Many people are surprised to learn that Social Security has identified certain basic mental demands that are generally necessary for competitive, remunerative, unskilled work.

According to POMS DI 25020.010, those basic mental demands include the ability, on a sustained basis, to:

• understand, carry out, and remember simple instructions;
• make simple work-related decisions;
• respond appropriately to supervision, coworkers, and work situations; and
• deal with changes in a routine work setting.

The POMS further explains that a substantial loss of any one of these basic mental abilities may severely limit a person’s occupational base and may justify a finding that the individual cannot perform other work.

That is an important point.

Social Security does not require a claimant to prove he or she cannot interact with anyone.

Instead, the question is whether the claimant can interact appropriately in regular, competitive employment.

Working with Other People Is a Basic Job Requirement

Imagine two employees who possess identical technical skills.

Both know how to perform their jobs. Both are physically capable of completing the required work.

One employee accepts supervision, works well with coworkers, communicates respectfully, and remains calm under pressure. The other becomes angry when corrected, argues with supervisors, withdraws from coworkers, or experiences panic attacks when dealing with customers.

Although both employees possess the necessary job skills, their ability to maintain employment may be dramatically different.  Employers hire people to work with other people.

The inability to do so often becomes a significant vocational limitation.

Many Medical Conditions Can Affect Social Functioning

Problems interacting with others are not limited to psychiatric illnesses.  Numerous physical and psychological conditions may interfere with normal workplace relationships, including:

• PTSD;
• traumatic brain injuries;
• chronic pain;
• depression;
• generalized anxiety disorder;
• panic disorder;
• autism spectrum disorder;
• bipolar disorder;
• dementia;
• Parkinson’s disease;
• medication side effects; and
• sleep deprivation.

For example, chronic pain frequently causes irritability simply because constant pain is exhausting.  Likewise, someone recovering from a traumatic brain injury may experience impulsive behavior, emotional instability, or difficulty recognizing appropriate social cues.

The result is not necessarily intentional misconduct; rather, the person’s medical condition may have significantly altered normal behavior.

Recommended Reading: Why Mental Functional Limitations Matter in Social Security Disability and Alabama Workers’ Compensation Cases

 

What Social Security Actually Evaluates

When evaluating mental impairments, Social Security follows the special technique described in 20 C.F.R. §§ 404.1520a and 416.920a.

If a severe mental impairment exists, the agency must then determine the claimant’s Residual Functional Capacity (RFC) under 20 C.F.R. §§ 404.1545(c) and 416.945(c) by considering how mental limitations affect work-related activities.

POMS DI 25020.010 identifies several specific work-related social abilities, including the ability to:

• ask simple questions or request assistance;
• accept instructions and respond appropriately to criticism from supervisors; and
• get along with coworkers or peers without unduly distracting them or exhibiting behavioral extremes.

Those are not random examples.

They are the specific work functions Social Security expects adjudicators to evaluate when determining whether someone can sustain competitive employment.

This Is Also How Psychiatrists and Psychologists Are Asked to Evaluate Patients

One reason these issues become so important is that treating psychiatrists and psychologists are often asked to provide opinions regarding these exact work-related functions.  For example, the Mental Medical Source Opinion Form used by our office asks physicians to evaluate whether an individual can:

• respond appropriately to supervisors;
• respond appropriately to customers or members of the public;
• use judgment in simple work-related decisions;
• deal with changes in a routine work setting;
• maintain social functioning; and
• respond appropriately to customary work pressures.

The physician is also asked to identify the medical findings supporting those opinions, such as mental status examinations, psychological testing, observed behavior, symptoms, or medication side effects.

This illustrates an important point.

Disability decisions should be supported by objective medical evidence—not simply a diagnosis or a patient’s understandable frustration about being unable to work.

Recommended Reading: Your Symptoms are More Important than Your Diagnosis

What Does “Substantial Loss” Really Mean?

One of the most helpful explanations found in Social Security’s own policy manual concerns the phrase “substantial loss.” 

The POMS explains that this phrase cannot be reduced to a specific percentage or numerical rating.  Instead, an individual has a substantial loss of a basic mental ability when he or she cannot perform that activity in regular, competitive employment, but could do so only in a sheltered or specially supported work setting.

That distinction is critical.

Many individuals tell us “I can do that if nobody bothers me.”

or

“I can work if everyone understands my condition.”

Unfortunately, competitive employment generally does not provide unlimited accommodations, constant supervision, or unusually patient coworkers.  The legal question is whether the person can perform those activities under ordinary workplace conditions.

How These Issues May Affect an Alabama Workers’ Compensation Claim

Alabama workers’ compensation law applies a different legal standard, but many of these same limitations may become important when determining vocational disability.

Under § 25-5-57(a)(3), Ala. Code 1975, permanent partial disability involving body-as-a-whole injuries is evaluated by considering the worker’s loss of earning capacity.

Suppose an employee develops PTSD after a fall off a ladder at work.

Or imagine a construction worker suffers a traumatic brain injury that causes impulsive behavior and difficulty accepting supervision.

Or consider an employee whose chronic pain and medication side effects result in irritability and emotional instability.

Each may remain physically capable of performing portions of the job, yet their impaired social functioning may significantly reduce the ability to obtain or maintain reasonably suitable employment.

Those are factors vocational experts frequently evaluate when assessing loss of earning capacity.

Recommended Reading: What is the Role of the Vocational Expert?

Recommended Reading: What Do Permanent Work Restrictions Mean in Workers’ Compensation and Social Security Disability Cases?

The Bottom Line

Successful employment requires much more than physical strength or technical knowledge.

It requires the ability to work appropriately with supervisors, coworkers, customers, and others in an ordinary work environment.

That is why Social Security specifically evaluates these work-related mental abilities and why physicians are often asked to provide detailed opinions concerning them. Likewise, Alabama workers’ compensation cases may require careful consideration of how mental and emotional limitations affect an injured worker’s ability to earn a living after a serious work injury.

Understanding these principles helps explain why two people with similar medical diagnoses—or even similar physical restrictions—may experience very different vocational outcomes.

Coming Next…

In our next article, we’ll examine another fundamental requirement of competitive employment:

Can You Adapt to Changes in the Workplace? Why Flexibility, Stress Tolerance, and Adaptability Matter in Social Security Disability and Alabama Workers’ Compensation Cases

We’ll explain why even routine workplace changes—such as a new supervisor, revised work procedures, schedule changes, production quotas, or unexpected interruptions—can become overwhelming for individuals living with chronic pain, PTSD, traumatic brain injuries, depression, anxiety, and other disabling conditions, and why Social Security specifically recognizes the ability to respond appropriately to changes in a routine work setting as one of the basic mental demands of competitive employment.