“Bereavement Exclusion” Exclusion

This is one loss I won’t grieve over.  Ever hear of the “bereavement exclusion?”  It has, apparently, passed away.  I had come across the term in my work as a Social Security disability lawyer.  Doctors (sometimes the claimant’s own treating doctors, but more often the ones Social Security hires to examine the claimant or review the file) occasionally attribute the claimant’s symptoms (crying spells, changes in appetite & sleep, inability to concentrate) to a recent loss – often the death of one or both parents, but sometimes a spouse or relative or even a pet – and dismiss the impairment as unlikely to last.  So I was interested to hear on NPR about how the “bereavement exclusion” is being removed from the DSM-IV, the manual practitioners use to diagnose mental health conditions.

As I understand it, the controversy centers around whether those who suffer intense emotional upset that lasts more than two weeks after the loss may be suffering from depression and could need treatment, or whether a label and treatment at that stage is premature and could interfere with the natural progression of the stages of grief.  As one doctor said in the story:  Pain is also a natural part of healing after we break a bone, but that doesn’t mean we don’t treat the pain.

I haven’t lost a parent yet, let alone a sibling or a child, but in my experience with my clients, it seems that sometimes the death is the last straw, breaking the already burdened camel’s back.  Sometimes another person’s death makes us face our own mortality, and in the case of people already struggling with disabilities, our morbidity. Pile on losing your job and part of your identity along with your financial independence, and that can be pretty depressing. (Receiving unemployment benefits treats only one part of the symptoms that accompany that loss.) Possibly manageable in the absence of any bodily pain, but when compounded by physical problems, it can all become too much for any one individual to stand.  I’m not a doctor, and I don’t want our culture blunted or our senses dulled any more than the next guy, but I would hope that any line-drawing should err on the side of easing human suffering, short- or long-term, and if one must have a diagnosis to deserve or afford medically necessary treatment (talk therapy or medications), let alone disability benefits “based on a medically determinable condition likely to last for more than 12 months,” then I’m all for it.

– Posted by Mary McKee

Posted in Blog, Disabilities.