Evaluations for Disability Determination | Mercer Island

Board-certified psychiatrist Dr. Cara Erkut provides thorough psychiatric evaluations for disability determination on Mercer Island, serving patients and referring agencies across Seattle, Bellevue, and the greater Eastside.

Why a Thorough Evaluation Matters

Disability claims involving psychiatric conditions get denied every day. Not because the person isn’t struggling. Not because the condition isn’t real. They get denied because the documentation doesn’t clearly connect the diagnosis to specific functional limitations in language that agencies and insurers actually need to see.

That is where a well-done psychiatric evaluation makes all the difference. A thorough evaluation doesn’t just confirm that you have a diagnosis. It lays out exactly how that condition affects your ability to work, concentrate, interact with others, and manage yourself day to day. It bridges the gap between what you experience and what the decision-makers need on paper.

Types of Disability Evaluations I Provide

Disability evaluations are not one-size-fits-all. The format, focus, and reporting requirements vary depending on who is requesting the evaluation and why. I tailor each assessment to meet the specific standards and criteria that the requesting agency or party requires.

Conditions I Evaluate

Psychiatric disability can result from a wide range of conditions. Some are obvious to the person experiencing them. Others have been misdiagnosed for years or complicated by overlapping symptoms. Part of the evaluation process is getting the diagnosis right in the first place, because the accuracy of the diagnosis directly affects the strength of the documentation.

These conditions can look very different from one person to the next. Two people with the same diagnosis of major depression might have completely different functional profiles. One might still manage basic self-care but cannot sustain concentration for an 8-hour workday. Another might struggle to leave the house at all. My job during the evaluation is to capture your specific picture, not a textbook description.

What the Evaluation Involves

I approach disability evaluations the same way I approach everything in my practice: systematically, thoroughly, and with attention to the details that actually matter.

Before the Appointment

I review all available medical records, treatment history, and any documentation provided by the referring party. This preparation is important because it means we can spend the evaluation focused on the clinical interview rather than going through paperwork together.

The Clinical Interview

The evaluation appointment typically lasts 60 to 90 minutes. During this time, I conduct a comprehensive psychiatric assessment that covers your psychiatric history, your medical history, your family history, your social and occupational functioning, and a formal mental status examination.

I ask detailed questions about your daily life. Not just whether you have symptoms, but how those symptoms play out in real situations. Can you follow a conversation for 30 minutes? Can you handle a schedule? How do you manage conflict or stress? What does a typical day actually look like for you?

After the Appointment

Based on the interview and record review, I prepare a detailed written report. This is not a one-page letter. It is a comprehensive clinical document that includes diagnostic formulation, functional analysis, and my professional opinion on the questions the referring party has asked.

Functional Capacity: The Heart of Any Disability Evaluation

Here is something many people do not realize about disability claims: having a diagnosis is not enough. Insurance companies, employers, and HR teams do not approve disability or accommodation requests based on a diagnosis alone. What they need to see is how that diagnosis limits your ability to function in your actual job.

Whether the evaluation is for a short-term disability claim or a workplace accommodation request, I assess functioning across four key areas. These same areas are used across disability evaluation frameworks because they capture the most job-relevant aspects of psychiatric impairment.

For each of these areas, I rate the degree of limitation and provide specific clinical evidence supporting that rating. I describe what you can and cannot do in concrete terms. Vague statements like “patient has difficulty functioning” do not help your case. Specific observations and examples do.

The Written Report

The report is really the product of this entire process. It is what the judge, the claims examiner, or the insurance reviewer will read. And in many cases, it is the single most important document in the claim.

My reports typically include the following components:

• Identifying information and reason for referral
• Summary of records reviewed
• Detailed clinical interview findings
• Mental status examination results
• DSM-5-TR diagnostic formulation with supporting evidence
• Functional capacity assessment across all relevant domains
• Clinical opinion on disability-related questions
• Prognosis and treatment recommendations when applicable

I write reports that are detailed enough to be useful but clear enough that a non-clinician can follow the reasoning. Every opinion I include is supported by the clinical evidence gathered during the evaluation.

Serving Washington State

My practice is located on Mercer Island, easily accessible from Seattle, Bellevue, and surrounding communities.

Meet Dr. Erkut

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