Big Changes for Mental Health Listings: Dementia and Neurocognitive Requirements for Social Security

January 5, 2017

This last September, the Social Security Administration (“SSA”) released its final rule on the revision of medical criteria for evaluating mental disorders in adults and children.  It took over six years for SSA to publish the rule, and the rule is effective January 17, 2017.

The rule ushers in new major changes to the current medical condition listings and adds a few brand new listings.  Consequently, those who did not qualify as “disabled” under the old law may fit within one of the altered listings. However, there are certain catches that claimants and attorneys need to be cognizant of.

For example, the newly titled “neurocognitive disorder listing” (SSA legalese for the brain impairment, commonly know as “dementia”) no longer includes “repeated episodes of deterioration or decompensation, each of extended duration.” Under the same neurocognitive disorder listing, the listing now includes an “extreme limitation of one, or marked limitation of two, of the following areas of mental functioning: (1) understand, remember, or apply information; (2) interact with others; (3) concentrate, persist, or maintain pace; or (4) adapt or manage oneself.”

The listing still requires that the mental disorder was in existence for over a period of at least two years, which is now categorized as “serious and persistent,” and continues to require marginal adjustment.  However now, for a neurocognitive impairment, a claimant must seek “medical treatment, mental health therapy, psychosocial support, or a highly-structured setting that is ongoing and that diminishes the symptoms and signs of [the] mental disorder.”  This is in opposition to the old language that required an “inability to function outside of a highly-supported living arrangement, with an indication of continued need for such an arrangement,” for at least one year.

In addition, the old rule permitted documentation that showed a loss of at least 15 IQ points to satisfy part of the neurocognitive impairment listing.  Now, there must be “medical documentation of a significant cognitive decline from a prior level of functioning in one or more of the cognitive areas of (1) complex attention, (2) executive function, (3) learning and memory, (4) language, (5) perceptual-motor, or (6) social cognition.”  Therefore, the new rule significantly increases the amount of medical attention a claimant requires if the claimant suffers from a neurocognitive impairment. It is much more important that a claimant seek continual medical treatment.

If you’re suffering from dementia or another cognitive impairment in Oklahoma, Kansas, or Arkansas, Contact Us and we will help you find a free clinic so you can get the necessary medical documentation for your claim!