How The Social Security Administration Handles Intellectual Deficiency Disability Claims

The Social Security Administration (SSA) has published a standard for evaluating disability claims based upon intellectual deficiencies (formerly referred to as mental retardation). In all cases of intellectual disability, the person claiming benefits must prove deficits in adaptive functioning which were evident before the age of 22.

Deficits in adaptive functioning normally refer to limitations in activities of daily living such as communication, social participation and independent living. Work history, ability to avail oneself of community resources, academic performance, ability to care for onself’s own health and safety, communicate, and display self–direction, all are considered as a part of this. The deficits need not be universal, but it’s helpful to establish deficits and at least two of these domains.

First, if mental incapacity is evidenced by dependence upon others for personal needs, such as toileting, eating, dressing, or bathing, and inability to follow directions, such that intelligence testing cannot be performed, you may be considered disabled. Few people are so profoundly impaired that they meet this standard.

Second, a person with a valid verbal, performance, or full scale IQ of 59 or less, who also has the requisite deficits in adaptive functioning established before age 22, is considered disabled. This standard fits an outdated IQ test known as the WAIS-III, which described IQ scores separately on a verbal, performance, and full scale standard. Current IQ tests, known as a WAIS-IV, use different scales. Somehow the person deciding the claim now has to find a way to fit the current scales in with the existing legal standard which was designed for the old test. Only the full scale IQ is an exact match.

Third, a person with a valid verbal, performance, or full scale IQ of 60 through 70 and an additional physical or other mental impairment which imposes additional and significant work–related limitations, is considered disabled. People with intellectual functioning in this range are normally considered disadvantaged, but not disabled, until an additional condition producing further limitation produces complete disability.

Fourth, a person with an IQ in the 60–70 range, who has two of the following will qualify: marked restriction of activities of daily living; marked difficulty in maintaining social functioning; marked difficulty in maintaining concentration, persistence, or pace; or repeated episodes of decompensation, each of an extended duration. Marked is considered less than extreme, but more than moderate. Some subjective judgment is involved in making this determination. Episodes of decompensation are normally mental hospitalizations.

Most people who qualify for benefits based upon intellectual disability are awarded on the third standard. That is, their IQ is in the 60–70 range, and they have an additional medical problem producing a significant limitation. In these cases, the critical issue is normally whether the deficits in adaptive functioning manifested in the developmental period, or are severe enough. School records are very helpful in making this determination.

Do not be surprised if the SSA revises its standard to fit in with new IQ testing procedures, and the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

If you have questions about disability benefits for a loved one who is intellectually deficient, contact our offices today.