Social Security now refers to disorders involving low IQ as “intellectual disorder” (previously it used the term "intellectual disability," and before that, "mental retardation"). In cases of intellectual disorder, the Social Security Administration (SSA) often has to make a decision about whether the disability applicant can mentally do unskilled work, which is the simplest work possible. If this capacity is lacking, Social Security will approve the applicant for disability benefits.
To assess an applicant's mental ability, Social Security will require the results of IQ tests and other medical documentation supporting a diagnosis of decreased intellectual function. If the applicant's medical record doesn't include IQ test results, Social Security will send the applicant for an IQ test (at the expense of Social Security).
Most people with intellectual disorder, however, have had an IQ test with which they were diagnosed. The IQ tests most often used are the Wechsler Adult Intelligence Scale (WAIS) and the Stanford-Binet. However, Social Security does not require any particular type of intelligence test, as long as it is generally recognized as a valid, standardized test that has been shown to be accurate. IQ tests must be given individually—tests administered to a group of people at the same time, such as in school or military, do not qualify. Most IQ tests have a verbal score, a performance score, and a full scale score.
Social Security sets out criteria for meeting its intellectual disorder listing, listing 12.05, which was changed significantly in 2017. The new listing, described below, applies to applications filed after January 17, 2017.
First, Social Security requires that the applicant's intellectual disorder must have existed before he or she turned 22 years old. (Cognitive decline that happened after age 22—for instance, due to brain injury or dementia—would be evaluated under Social Security's neurocognitive listing instead. More on this below.) People with intellectual disorder usually have a long history documented by school and medical records, so Social Security can usually easily verify whether an applicant had intellectual difficulties before age 22. If that's not the case, a recent federal court case found that, if an adult applicant has evidence of cognitive limitations, it's up to Social Security, not the applicant, to prove that the applicant did not have these limitations before age 22. (Talavera v. Astrue, 697 F.3d 145 (2d Cir. 2012).)
Second, a diagnosis of intellectual disorder can no longer be made on the basis of IQ scores alone. There must also be evidence of significant problems in adaptive function—how well the person can deal with the actual challenges of life—such as personal care, social functioning, preparing meals, handling money, paying bills, driving, shopping, planning, and other daily activities a person must cope with to live independently.
Once Social Security establishes that the onset of intellectual disorder was before age 22, there are two ways that the listing for intellectual disorder can satisfied.
If the applicant has a full scale IQ score of 70 or below, or a full scale IQ score of 71-75 with a verbal or performance score of 70 or below, Social Security will look at whether the applicant also has significant deficits in “adaptive functioning” (how well the applicant handles tasks and responsibilities). An applicant who has an extreme limitation in one of the following areas of mental functioning, or a “marked” limitation in two of the following areas, will qualify for benefits:
Note that Social Security defines “marked” as less than extreme, but worse than moderate. Extreme is less severe than a complete loss of an ability, but worse than marked. Marked and extreme are matters of professional judgment for a Social Security psychiatrist or psychologist reviewing the medical evidence.
If an applicant's IQ is unknowable because their intellectual functioning is so low that they can't follow directions well enough to undergo an IQ test, Social Security will assess whether they need to rely on others for help with the most basic personal needs, such as bathing, dressing, eating, or personal hygiene. Social Security will require testimony or records from caregivers regarding the assistance that the applicant requires.
If your IQ scores and/or limitations don't meet the listing requirements for intellectual disorder, you could still qualify for disability benefits. Social Security will assess disability for someone with borderline intellectual functioning, which is diagnosed for someone with IQ scores between 71 and 84, under the listing for neurodevelopmental disorders. IQ scores above 84 are not generally considered to produce meaningful limitations, but Social Security will still consider you for disability if you can't do simple, unskilled work.
You will need to prove that you can't do simple repetitive tasks, which will likely be hard to do unless you also have other physical or mental impairments, in addition to subaverage IQ. Social Security will first prepare a mental residual function capacity (MRFC) for you, and, if you have a physical medical condition that impairs your ability to work, a physical RFC. In preparing a mental RFC, Social Security will consider whether you can whether you function well socially, follow simple instructions, and do "one- and two-step work," and how your low IQ interferes with your ability to complete even simple tasks.
A claims examiner or judge will then consider whether your mental and physical RFCs allow you to do any simple, unskilled work. If not, you will be granted disability benefits.
A low IQ can play a big role in the disability examiner or judge's decision (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 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.
Many types of brain abnormalities can result in a decreased IQ, but not all would not be evaluated under the listing for an intellectual disorder. For example, a person whose IQ slipped after a head injury is not considered by Social Security to have an intellectual disorder. Individuals with cognitive dysfunction where there is a known cause are evaluated by Social Security under the listing for “neurocognitive disorders.”
Neurocognitive disorders that result in decreased intellectual ability include various forms of dementia, brain trauma, strokes, infections, or anything else that negatively affects brain function. Neurocognitive disorders can occur before or after age 22. For more information, see our article on getting disability for a neurocognitive disorder.