The Eighth Circuit recently considered the importance of current documentation of IQ. A man applied for Social Security Disability Insurance (SSDI) and supplemental security income (SSI) benefits claiming disability due to a number of severe impairments, including a mental disorder, but not any intellectual impairment. According to the Social Security Administration’s Consultative Examinations: A Guide for Health Professionals (also known as the “Green Book”), “[i]f the evidence provided by the claimant’s own medical sources is inadequate to determine if he or she is disabled, additional medical information may be sought…by arranging for a [Consultative Examination (CE)].” A clinical psychologist was called upon to perform a consultative mental examination regarding the man’s claimed disability due to the mental disorder.
The clinical psychologist who performed the man’s consultative mental examination, concluded that the man suffered from mild mental retardation, in addition to his mental disorder. In diagnosing the man with a mild intellectual impairment, the psychologist did not administer an IQ test. The Green Book’s guidelines for minimum content requirements for CE reports on adult claimants with intellectual impairment indicate that the report should include, “[c]urrent documentation of IQ by a standardized, well-recognized, individually administered measure.”
Current documentation of an IQ test plays a number of different roles in the determination of eligibility for Social Security benefits for intellectual impairment. In this recent case, the Eighth Circuit laid out the roles of IQ tests under 20 C.F.R. Pt. 404, subpt. P, app. 1 § 12.05, the Social Security regulations’ disability listing for intellectual impairment. The Social Security regulations’ disability listing for intellectual impairment refers to significantly below average general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of the impairment before age 22. In addition, one of four sets of requirements must also be satisfied. To meet one set of requirements (12.05C) a claimant would need (1) a valid verbal, performance, or full scale IQ of 60 to 70; (2) an additional “severe” impairment; and (3) evidence supporting the onset of intellectual and adaptive functioning disability before age 22. First, current documentation of an IQ test is required to determine whether a claimant meets the first requirement.
Second, current documentation of an IQ test can be used to determine whether the onset of intellectual and adaptive functioning disability occurred before age 22 under the third requirement. The Eighth Circuit held that an IQ at an earlier age can be inferred because a person’s IQ is presumed to remain stable over time in the absence of any evidence of a change in a claimant’s intellectual functioning. A claimant can establish an onset of intellectual and adaptive functioning disability before age 22 with an IQ test score recorded after the developmental period plus evidence of the claimant’s intellectual functioning prior to age 22. Evidence of the claimant intellectual functioning prior to age 22 could include placement in special education classes in school; inability to complete high school; trouble with math, reading and writing; and evidence of violent altercations before age 22.
Finally, in the case of intellectual impairment, current documentation of an IQ test can have greater impact than merely a diagnosis. If a claimant meets the Social Security regulations’ disability listing for intellectual impairment and is not working, the claimant is presumed unable to work and is awarded benefits without a determination as to whether the claimant actually can perform prior work or other work. The standard five-step process to determine whether an individual is disabled is: (1) whether the claimant is currently employed; (2) whether the claimant is severely impaired; (3) whether the impairment is, or is comparable to, a listed impairment; (4) whether the claimant can perform past relevant work; and if not, (5) whether the claimant can perform any other kind of work. If a claimant meets the Social Security regulations’ disability listing for intellectual impairment and is not working, the inquiry stops after step three.
See: <c>Lott v. Colvin, 2014 WL 6704564 (C.A.8 (Ark.), November 28, 2014)</c> (not designated for publication).
By Sarah Kelman, JD, and the experts and editors at Medical Law Perspectives.
For more details, see the Scalpel Weekly News, December 8, 2014.
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For more information on consultative evaluations, see Medical Law Perspectives, June 2013 Report: Independent Medical Evaluations: Legal Risks and Responsibilities