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Social Security Disability Claims

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Social Security Disability Claims: Social Security Evaluation of Mental Impairments

Social Security Evaluation of Mental Impairments

Authored By: Alaska Legal Services - Anchorage LSC Funded
Contents
Social Security Disability Claims Social Security Disability Claims

Social Security Disability Claims

Social Security Disability Claims

Listings for Mental Impairments

We’ve discussed the steps SSA takes when it evaluates a disability claim. You might remember that at Step 3, SSA must decide whether an impairment meets one of the “listings.” This is a list containing specific criteria for impairments affecting different body systems, including mental disorders. In this section, we’ll explore how mental impairments are evaluated in a bit more detail. The mental listing criteria are typically broken into specific symptoms and functional restrictions. The listings for mental disorders are arranged in 11 categories:

  • neurocognitive disorders;
  • schizophrenia spectrum and other psychotic disorders;
  • depressive, bipolar and related disorders;
  • intellectual disorder;
  • anxiety and obsessive-compulsive disorders;
  • somatic symptom and related disorders;
  • personality and impulse-control disorders;
  • autism spectrum disorder;
  • neurodevelopmental disorders;
  • eating disorders; and
  • trauma-and stressor-related disorders.

Although it is beyond this presentation to go into detail regarding each of these listings, you might find it useful to get a glimpse of one, just so you have a better idea of what SSA is looking at. We hope you don’t find this too technical.

Part A & B Criteria

The Part A criteria refers to a paragraph in the rules for each Listing that names a number of signs and symptoms that are frequently associated with the particular impairment.  Part B criteria address a number of functional limitations that might accompany an impairment. The four areas of functioning covered by the Part B criteria are:

Understanding, remembering, or applying information.  This area of mental functioning refers to the abilities to learn, recall, and use information to perform work activities.  Examples include:  understanding and learning terms, instructions, procedures; following one- or two-step oral instructions to carry out a task; describing work activity to someone else; asking and answering questions and providing explanations; recognizing a mistake and correcting it; identifying and solving problems; sequencing multi-step activities; and using reason and judgment to make work-related decisions. 

Interacting with others- This area of mental functioning refers to the abilities to relate to and work with supervisors, co-workers, and the public.  Examples include:  cooperating with others; asking for help when needed; handling conflicts with others; stating own point of view; initiating or sustaining conversation; understanding and responding to social cues (physical, verbal, emotional); responding to requests, suggestions, criticism, correction, and challenges; and keeping social interactions free of excessive irritability, sensitivity, argumentativeness, or suspiciousness. 

Concentration, persistence, or maintaining pace.  This area of mental functioning refers to the abilities to focus attention on work activities and stay on task at a sustained rate.  Examples include:  initiating and performing a task that you understand and know how to do; working at an appropriate and consistent pace; completing tasks in a timely manner; ignoring or avoiding distractions while working; changing activities or work settings without being disruptive; working close to or with others without interrupting or distracting them; sustaining an ordinary routine and regular attendance at work; and working a full day without needing more than the allotted number or length of rest periods during the day. 

Adapting or managing oneself.  This area of mental functioning refers to the abilities to regulate emotions, control behavior, and maintain well-being in a work setting.  Examples include:  responding to demands; adapting to changes; managing your psychologically based symptoms; distinguishing between acceptable and unacceptable work performance; setting realistic goals; making plans for yourself independently of others; maintaining personal hygiene and attire appropriate to a work setting; and being aware of normal hazards and taking appropriate precautions.  These examples show the nature of this area of mental functioning -- documentation of all of the examples is not required.

Depressive, Bipolar and Related Disorders

So for example, if you are claiming disability based upon depression or bi-polar disorder, SSA needs medical documentation that you satisfy the specific Part A and Part B criteria, or Part A and Part C criteria for that listing. Here's what you'd need to show:

Part A criteria

Depressive disorder-  five or more of the following:

Bipolar disorder -  three or more of the following:

  • Depressed mood;
  • Pressured speech;
  • Diminished interest in almost all activities;
  • Flight of ideas;
  • Appetite disturbance with change in weight;
  • Inflated self-esteem;
  • Sleep disturbance;
  • Decreased need for sleep;
  • Observable psychomotor agitation or retardation;
  • Distractibility;
  • Decreased energy;
  • Involvement in activities that have a high probability of painful consequences that are not recognized;
  • Feelings of guilt or worthlessness;
  • Increase in goal-directed activity or psychomotor agitation.
  • Difficulty concentrating or thinking;
 
  • Thoughts of death or suicide.
 

And Either Part B or Part C Criteria

Part B criteria- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:

  • Understand, remember, or apply information.
  • Interact with others
  • Concentrate, persist, or maintain pace
  • Adapt or manage oneself

Part C criteria - Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:

  • Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
  • Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.

What evidence do you need to support your mental disorder?

You need evidence from an acceptable medical source to establish that you have a mental disorder, the severity of your mental disorder, and its effects on your ability to function in a work setting. 

Evidence from medical sources.  SSA will consider all medical evidence about your disorder from your physician, psychologist, and other medical sources, which include health care providers such as physician assistants, psychiatric nurse practitioners, licensed clinical social workers, and clinical mental health counselors. 

Evidence from you and people who know youSSA will consider all relevant evidence about your mental disorder and your daily functioning that it receives from you and from people who know you.  This may include information from your family, caregivers, friends, neighbors, clergy, case managers, social workers, shelter staff, or other community support and outreach workers. SSA will also consider evidence from school, vocational training, work, and work-related programs.