In cases of mental retardation or traumatic brain injury, Social Security often has to make a subjective decision about whether the disability applicant can do unskilled labor -- unless the applicant's I.Q. is low enough to satisfy the official disability listing for mental retardation (now often referred to as intellectual developmental disorder).
To assess the applicant's mental ability, the SSA will require medical documentation supporting a diagnosis of decreased mental function and results of tests administered by a psychiatrist or psychologist that demonstrate an inability to perform simple, routine, repetitive tasks (SRRTs). If the applicant's medical record doesn't include these test results, the Social Security Administration (SSA) will send the applicant to a mental status examination.
What Are the Disability Criteria for Mental Retardation?
If an applicant was mentally retarded or had a very low IQ prior to age 22, the applicant can be automatically approved for disability benefits due to mental retardation if the individual has one of the following:
- an IQ below 60
- an IQ of 60-70 with a separate physical or mental impairment that makes it difficult to do work-related activities
- an IQ of 60-70 that results in at least two of the following:
- Significant difficulty with activities of daily living (bathing, dressing, cooking, cleaning, or getting to work)
- Serious problems with social interactions
- Serious difficulty with concentration or finishing tasks on time, or
- Repeated episodes of worsening symptoms (periods of decompensation).
If the applicant's IQ is unknowable because the individual can't follow directions well enough to undergo an IQ test, the individual will qualify for disability benefits if he or she relies on others for help with personal needs, such as bathing, dressing, eating, or personal hygiene). The SSA will require testimony or records from caregivers regarding the assistance that the applicant requires.
What Are the Disability Criteria for Organic Brain Dysfunction?
those cases in which low IQ is the result of an organic brain
syndrome, such as a traumatic brain injury, closed head injury, or a
degenerative disease such as Alzheimer's disease or Parkinson's disease,
approval for disability will hinge on a concept known as premorbid IQ. Premorbid IQ refers to the claimant’s IQ before the injury. If a
claimant’s IQ after injury measures at least 15 points lower than his
or her premorbid IQ, the individual may be awarded disability
Unfortunately, very few people can document, or even know for that matter, their premorbid IQ score, so it is usually difficult to demonstrate the required 15-point drop.
In addition to the 15-point decrease in IQ, the applicant must have the same problems as a person with an IQ of 60-70 in the mental retardation listing: difficulty with activities of daily living (ADLs), social functioning, concentration and pace, or periods of decompensating.
What About Applicants Who Don’t Meet the Above Requirements?
If the applicant's IQ does not meet the listing requirements above for mental retardation or organic mental disorders, the applicant could still qualify for disability benefits if his or her IQ is close to those discussed above, but under 85.
The applicant will need to prove that he or she can't simple repetitive tasks, which will be hard to do unless the applicant also has other physical or mental impairments. The SSA will prepare a mental residual function capacity (MRFC) for the applicant, and, if the applicant has a physical medical condition that impairs his or her capacity to work, a physical RFC. The SSA will then consider whether the applicant's mental and physical RFCs allow the applicant to do simple, unskilled work. If not, the applicant will be granted disability benefits. (For more information, see our article on disability for borderline intellectual functioning.)
In preparing a mental RFC, the SSA will consider whether the applicant can follow simple instructions, whether the applicant functions well socially, whether the applicant can follow directions, and how the applicant's low IQ interferes with his or her ability to complete even simple tasks. For more information, see our article on the mental RFC and how Social Security decides disability.
A low IQ can play a big role in the adjudicator’s decision (that is, the decision of the initial claims examiner or the administrative law judge, if the case goes to an appeal hearing) to award disability benefits to someone with a physical impairment. This is particularly true if the individual in question is older. Social Security recognizes that the older one is, the harder it is to find gainful employment, and the harder it is to learn new skills, particularly when a brain injury or diminished mental capacity is involved. For this reason, older individuals tend to stand a better chance of receiving disability benefits on the basis of lowered IQ when combined with other types of mental or physical impairments.