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SOCIAL SECURITY DISABILITY INSURANCE (SSDI) - SSA Releases New Mental Impairment Listings

The Social Security Administration (SSA) has issued final rules revising medical criteria for evaluating mental disorders in adults and children in Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims. These rules go into effect on January 17, 2017 and includes some major changes.

Whether a person meets a listing level impairment is Step 3 of the Sequential Evaluation for Social Security Disability Insurance (SSDI) or SSI claims. If a person meets or equals a listing level impairment, then he or she is found disabled and the government does not even consider whether claimant has the residual functional capacity to return to past relevant work or other work that exists in significant numbers in the economy.

The following are some key changes contained to the mental disorder listings:

  •  
    • Creation of a listing for eating disorders and trauma- and stressor- related disorders.
    • Separation of neurodevelopmental disorders from 12.10 into its own listing.
    • Removal of substance addiction disorders altogether.
    • Changes to 12.02:
      • a new title of neurocognitive disorders
      • removing "repeated episodes of deterioration or decompensation, each of extended duration" and replacing it with a requirement of "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 page; or
        • Adapt or manage oneself.
      • In addition, Paragraph C now also requires "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," as opposed to an "inability to function outside of the highly supportive living arrangement, with an indication of continued need for such an arrangement" for at least one year.
      • Also in 12.2 Paragraph A has been changed from requiring a loss of measured I.Q. of at least 15 points to "medical documentation of a significant cognitive decline from a prior level of functioning in one or more of the cognitive areas of:
        • Complex attention;
        • Executive function;
        • Learning and memory;
        • Language;
        • Perceptual-motor; or
        • Social cognition.
    • 12.05 for intellectual disorders (formerly known as mental retardation) has also seen many changes. 12.05 can now be satisfied in two ways either finding of significant sub-average general intellectual functioning, evidence by cognitive inability to participate in standardized testing with significant deficits in adaptive functioning or evidence supporting disorder beginning prior to age 22 with a full-scale I.Q. of 70 or below or a full-scale I.Q. of 71-75 accompanied by a verbal or performance I.Q. score of 70 or below and significant deficits in adaptive functioning manifested by 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; or
      • Adapt or manage oneself.
    • 12.06 formerly known as anxiety-related disorder has been retitled anxiety and obsessive-compulsive disorders;
    • Eating disorder has been created at 12.13 requiring evidence of a persistent alteration in eating or eating-related behavior that results in a change in consumption or absorption of food and that significantly impairs physical or psychological health with an 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; or
      • Adapt or manage oneself.
    • 12.15 is the new listing for trauma-and stressor-related disorders. Some of the criteria are the same as listings 12.02, 12.04 and 12.06 but Paragraph A requires medical documentation of exposure to actual or threatened death, serious injury or violence, subsequent involuntary re-experience of the traumatic event, avoidance of external reminders of the event, disturbance in mood and behavior, and increases in arousal and reactivity.

 

 

If you need more information about a Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, Railroad Retirement Board disability, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation.  We can be reached at (865) 584-1211 or (800) 806-4611 or through our website.

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