SSA Publishes Helpful Administrative Message

Empire Justice December 22, 2014

SSA has issued an Administrative Message (AM) that deals primarily with the use of the Medical-Vocational Guidelines, particularly Rule 204.00.  The AM was published in conjunction with SSA’s release of eCAT 9.0, which includes “enhancements” related to Rule 204.00.  What is eCAT?  According to SSA, it is a tool in that documents the evaluation process in disability claims, helping the analyst to document, analyze, and adjudicate claims.  It stands for “Electronic Claims Analysis Tool.  It can be found in most if not all electronic folders. http://www.socialsecurity.gov/newsletter/archives/2011/oct2011.html.

According to the AM, the new version of eCAT prevents adjudicators from inadvertently using Rule 204.00 to direct a determination.  It reminds adjudicators that Rule 204.00, which describes an impairment that does not preclude heavy work as “generally sufficient” for a finding of not disabled, cannot be used to direct a determination, but may be cited as a “framework” for both allowances and denials.  The most common type of allowance using 204.00 as a framework is when a claimant has a mental impairment preventing him or her from meeting the basic mental demands of unskilled work.  The rule should only be applied at step five of the sequential evaluation.

The AM also includes some very helpful reminders to adjudicators for evaluating mental impairments that may be especially useful for advocates arguing lack of adaptive functioning in intellectual disabilities claims. For example:

  • “Borderline intellectual functioning is a medically determinable impairment.”
  • “For claimants who allege attending special education classes, it is important to make a reasonable effort to obtain school records, particularly if the claimant was in a special education program in the last ten years.”
  • “Use care when looking at the issue of adaptive functioning in cases with Intelligence Quotient (IQ) scores falling within the range for listing 12.05 Intellectual Disability.  The ability to drive, engaging in common everyday activities, and previous employment do not preclude a diagnosis of Intellectual Disability, and do not necessarily preclude a finding of disability under listing 12.05.”

The AM is an internal SSA document but can and should be cited as:  Office of Retirement and Disability Policy, Soc. Sec. Admin., AM-14056 (Sept. 15, 2014) (copy attached as Ex. A). (To the best of Plaintiff’s representative’s knowledge, AM-14056 is not available at Social Security’s web site, i.e., www.socialsecurity.gov.)

New POMS may be forthcoming, but in the meantime the AM is available as DAP # 568.