Mental Status Examinations

Claims based on psychiatric impairments are unique in many aspects but particularly because examinations do not tell the whole story and symptoms take on greater emphasis. A claimant may have a euthymic mood, intact memory, and normal mini mental status exam but still suffer from a debilitating mental illness. See e.g. Valadez v. Comm'r of Soc. Sec., 2023 WL 239997 *9 (M.D. Fla. Jan. 18, 2023). There the Court importantly noted:

In remanding this case, I point out that an ALJ must consider “the fundamental differences between the relaxed, controlled setting of a medical clinic and the more stressful environment of the workplace.” Simon, 7 F.4th at 1107 (quoting Morales v. Apfel, 225 F.3d 310, 319 (3d Cir. 2000)) (“for a person who suffers from an affective disorder or personality disorder marked by anxiety, the work environment is completely different from home or a mental health clinic”); see also Schink, 935 F.3d at 1263 (“it is not inconsistent – or even that unlikely ... that a patient with a highly disruptive mood disorder, in a structured one-on-one conversation with a mental health professional, might be capable of ‘be[ing] redirected’ from his ‘tangential’ thought processes so as to ‘remain on topic.’ ”); Castro v. Comm'r of Soc. Sec., 783 F.App'x 948, 956 (11th Cir. 2019) (“Without more, we cannot say that [the treating physician's] observations of Castro's judgment, insight, thought process, and thought content in a treatment environment absent work stressors were inconsistent with his assessments about the limitations she would face in a day-to-day work environment”). Although Simon involved a claimant diagnosed with bipolar disorder, Plaintiff's mental health diagnosis of major depressive disorder with psychosis is a chronic condition too. Chronic mental disorders are characterized by “unpredictable fluctuation of their symptoms, and thus it is not surprising that even a highly unstable patient will have good days or possibly good months.” Id. (quoting Scott v. Astrue, 647 F.3d 734, 740 (7th Cir. 2011)). For those who suffer from chronic disorders, “ ‘a snapshot of any single moment says little about [a person's] overall condition,’ and an ALJ who relies on such snapshots to discredit the remainder of a psychiatrist's findings demonstrates a ‘fundamental, but regrettably all-too common, misunderstanding of mental illness.’ ” Id. (quoting Punzio v. Astrue, 630 F.3d 704, 710 (7th Cir. 2011)). Like the claimant in Simon, the Plaintiff's diagnosis caused Plaintiff to experience more serious symptoms than those acknowledged by the ALJ.