Rules for evaluating mental illness or impairments
Social Security has specific rules for evaluating mental illness or mental impairments. They look at such impairments in terms of both symptoms (A Criteria) and functional limitations (B Criteria). They also include an alternate means of assessing severity by looking at conditions that are chronic in spite of treatment. ( C Criteria).
Impairments are divided into categories that are designed to correlate with diagnoses. For example, there are specific criteria for:
- Neurocognitive disorders,
- Depressive and Bipolar type disorders,
- Anxiety Related disorders,
- Psychotic disorders,
- Personality disorders,
- Autism
- Eating Disorders and
- Post Traumatic Stress Disorder.
Specific symptoms must be present for each disorder. We believe that to establish disability based on mental impairments, it is most important to document the functional impairments that a claimant suffers. Social Security looks at four specific elements of function in determining the severity of functional impairment.
Elements of function
- Understand, remember, or apply information;
- Interact with others;
- Concentrate, persist, or maintain pace; and
- Adapt or manage oneself.
Qualifications for mental impairment benefits
To be entitled to benefits, an individual must establish that they suffer from extreme impairment in one of these areas of function or marked impairment in two areas of function. Extreme limitation of function would indicate absolutely no ability to function in a specific area and marked limitation of function would indicate very limited ability to function in an area.
SSA looks very closely at a claimant’s activities of daily living as a primary source of information about all four of the areas of functioning. For instance, difficulties in a daily living task may result from difficulty in understanding what to do, trouble concentrating on the task at hand, being unable to engage in the task around others, or becoming so frustrated in the task that the person loses self-control in the situation.
Because symptoms and functional impairment can change over time, Social Security will consider exacerbations and remissions in the applicant’s conditions in the context of how they affect the applicant’s ability to function on a regular and continuing basis, defined as 8 hours a day, 5 days a week, or an equivalent work schedule.
Social Security also uses an alternative severity criterion for those situations where a claimant has achieved marginal adjustment, but whose symptoms are diminished because of psychosocial supports or treatment. To meet this criteria, a condition must remain serious and persistent for a period of two years despite treatment.
For a more information about adult mental disorders from the Social Security Administration, click here.
It can be difficult to establish disability based on mental impairments and we suggest working with a Social Security Lawyer who is well qualified in obtaining the specific documentation for such a claim. Please feel free to contact us at 801-532-4556 for assistance with your claim.
