How Does the Social Security Administration Evaluate Mental Conditions?

     In Social Security Disability or SSI claims, often mental impairments are the sole problem or maybe the difference between winning and losing a close case.  Like physical impairments, the existence of the mental impairments alone will not be the basis for a Favorable Decision unless the condition meets or equals a listing, but often the functional limitations can be so severe that, on their own or in combination with physical impairments, no work is available.  

     The SSA uses evaluation techniques set forth within 20 C.F.R. §§ 404.1520(a), 416.920(a)(a).  SSA is required to take the following steps:

  1. evaluate the claimant’s pertinent symptom signs and laboratory findings to determine whether the claimant has a medically determinable mental impairment;
  2. specify the symptoms, signs, and laboratory findings that substantiate the presence of the impairments and document the findings; and
  3. rate the degree of functional limitation(s) resulting from the impairment.

20 C.F.R. §§ 404.1520(a), 416.920(a).

     The SSA has identified four broad functional areas in which it will rate the degree of a claimant’s functional limitations:

  1. activities of daily living;
  2. social functioning;
  3. concentration, persistence or pace; and
  4. episodes of decompensation.

     When rating the first three areas of functioning, the SSA uses the following rating terms:

  •  None – absent or minimal limitations.  If limitations are present, they are transient and/or expected reactions to psychological stresses.
  • Mild – there is a slight limitation in this area, but the individual can generally function well. 
  • Moderate – there is more than a slight limitation in this area, but the individual is still able to function satisfactorily. 
  • Marked – there is serious limitation in this area.  There is a substantial loss in the ability to effectively function. 
  • Extreme – there is a major limitation in this area.  There is no useful ability to function in this area. 

20 C.F.R. §§ 404.1520(a)(c), 416.920(a)(c). 

     As to episodes of decompensation, the SSA uses a four point scale of: none; 1 or 2; 3; and 4 or more.  The last point on each scale represents a degree of limitation that is incompatible with the ability to do any gainful activity. 

     After SSA rates the degree of functional limitation resulting from claimant’s mental impairments, it will determine the severity of the mental impairments to determine if they meet or equal a listed mental disorder.  If all the findings are None, Mild, or Moderate, a listing will not be satisfied.  If the mental impairments are severe or extreme, the SSA should compare the medical findings about the impairments and the degree of functional limitations with the appropriate listed mental disorder.  More often than not, the SSA will find that the claimant does not meet a listed impairment and the decision will then come down to whether jobs exist consider the residual functional capacity of the claimant. 

      If you need more information about a Social Security Disability/SSI matter, personal injury matter (car wreck, boating accident, slip and fall, etc.), EEOICPA claim, long or short-term disability, VA 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, through Facebook, or through our website.  Our office handles claims throughout East Tennessee, including Knoxville, ChattanoogaKingsport, Bristol, Johnson City, Morristown, Maryville, Rogersville, Dandridge, Tazewell, New Tazewell, Jefferson City, Strawberry Plains, Sevierville, Gatlinburg, Loudon, Kingston, Halls, Maynardville, Crossville, Cookeville, Jamestown, Sweetwater, Lenoir City, Athens, Oak Ridge, Clinton, LaFollette, Lake City, Jacksboro, Bean Station, Cosby, Newport, White Pine, Mosheim, Wartburg, Sunbright, Pigeon Forge, and Deer Lodge.


About farmerdreiser

Based in Knoxville, Tennessee, The Law Offices of Tony Farmer and John Dreiser provide comprehensive representation to injured victims throughout eastern Tennessee in personal injury, Social Security disability, and workers' compensation cases.
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