February 2020


Social Security Disability Newsletter


Social Security’s
Four Critical Questions

Understanding these questions is critical for health care providers, advocates and Claimants who need this assistance


Social Security Disability claims are all about symptoms and the proof of how those symptoms impact day-to-day function. “Proof” is the content of the medical charts from the physicians, psychologists, counselors, therapists and case managers. Social Security will determine the extent of a claimant’s ability to perform work based upon the findings in those charts.

The question then is: what does Social Security look for? The answer has been evolving but there is a clear trend.

In 2017, Social Security revised the functional questions asked in mental impairment cases. These changes made proof of the functional problems more difficult. For some reason (because they are harder to prove?) SSA has decided that those mental health functional issues should also become a focus in non-mental impairment claims.

Those same mental health questions have since been added to the Listings of Impairments for almost every neurologic impairment including Multiple Sclerosis, Epilepsy; and Strokes. In an older version, they are now in the Listings for Lupus, Scleroderma, Inflammatory Arthritis and other systemic conditions.

The mental health functional questions have even been added to Chronic Hematologic conditions such as anemia. Therefore, understanding these questions is critical for health care providers, advocates and Claimants who need this assistance.

While some of the Listings vary slightly, the focus is on these four questions:

Question 1:
How do documented symptoms impact the ability to “....understand, remember or apply information?” This focuses on limitations in learning, recalling and using information in a work setting. Examples include following one- or two-step instructions, asking appropriate questions, and being able to recognize and correct mistakes.

Question 2:
How do the symptoms impact the ability to “Interact with Others?” Among other issues, what do the medical charts document about the impact on the ability to relate to supervisors and co-workers, cooperate with others, and keep social interactions free of argumentativeness and excessive irritability?

Question 3:
How is the ability to “Concentrate, Persist or Maintain Pace” impacted? Here SSA will look for problems in maintaining appropriate work pace, ignoring or avoiding distractions, sustaining an ordinary routine, being able to complete a workday without excessive breaks and being able to be in proximity to others with causing distractions.

Question 4:
What are the limits in the ability to “Adapt or Manage Oneself?” What do the charts document about the ability to manage change in a work setting; maintain personal hygiene; set realistic goals and understand the difference between acceptable and unacceptable work performance?

In the “real world” these issues are typically NOT the focus of medical treatment. Yet, without this documentation, claimants will often be denied benefits even if their seizure condition, or multiple sclerosis, or systemic medical condition is severe. What cannot be over-emphasized is that medical providers must keep some focus on these issues.


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Disability news blogIf you wish to learn more about the Social Security Disability process, and how your agency and staff can help people needing this assistance, please call so that we can arrange a free in-service training to discuss these issues.

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