[Expert decisions concerning disability pensions in the area of psychiatry--in view of a court-appointed expert].

Inability of social services to provide a non-working person with the necessary minimal financial support as well as a high unemployment rate make acquiring of a disability pension appear the only means of coming to terms with existential problems. After the fairly tolerant decision policy of the Social Insurance Institution (ZUS) in the first half of the 1990s, the criteria of granting disability pensions hassince been made stricter--through replacing of the former disability pensions by the concept of inability to work. The author evaluates the theory and practice of experts' decision-making in the prospect of his over ten year experience as an expert appointed by the Regional Court of Law in Cracow. Mental disorders are rated third among disturbances most frequently indicated as the reason for deciding about long-term inability to work. Psychiatric disorders, unlike most illnesses from other domains of medicine--do not require the use of modern methods of instrumental diagnostics. The only instrument supporting the clinical diagnosis is a psychological examination--especially in regards to the assessment of the depth of intellectual deficit. In psychiatry, clinical diagnosis is of a descriptive character: "As the district psychiatrist perceives or wants to perceive the patient during the examination--so does he describe this patient in the medical documentation". It is verification of actual intensity of mental disorders during a short examination--here the examination by a Social Insurance Institution's expert physician or an expert appointed by court--that becomes a problem. Of special importance in decision making must be prescribed to medical documentation, including regularity of treatment, applied pharmacotherapy, hospital treatment and its duration, etc.