Social Security's Psychiatric Review Technique Form

If your disability claim is based on a mental condition, such as anxiety or autism, the Social Security Administration (SSA) uses some special procedures for evaluating a claim. The medical or psychological consultant assisting the claims examiner with your case must usually complete a Psychiatric Review Technique Form (PRTF) as part of your claim evaluation process.

Read on to learn what the PRTF is, what kind of information it records, and how that might affect the outcome of your Social Security disability claim.

What's a Psychiatric Review Technique Form (PRTF)?

A PRTF is a form Social Security uses in the process of deciding whether you qualify for disability based on a mental condition. Social Security has a physician, psychologist, or psychiatrist (called a medical consultant) complete the form to help determine whether your condition meets the legal definition of disability.

The PRTF is also used to check whether or not your mental condition meets the requirements for automatic disability approval under one of the disability listings in Social Security's Blue Book.

To "meet" a listing, your mental condition must fulfill the specific criteria listed for that condition. Generally, if your mental condition meets a listing (or "equals" a listing in severity), you'll automatically qualify medically for disability benefits.

Before a PRTF is prepared, a doctor or psychologist hired by Social Security must complete a mental residual functional capacity (MRFC) assessment.

What Does a Social Security PRTF Include?

Once your initial MRFC is completed, Social Security will then have another medical consultant prepare your Psychiatric Review Technique Form. The doctor or psychologist will use the PRTF to evaluate the severity of your mental condition. If Social Security is planning to deny your claim, the agency must have a psychologist or psychiatrist complete the medical portion of the case review rather than a physician.

The form is divided into four sections.

PRTF Section I: Medical Summary

The medical consultant who completes the PRTF will first indicate how severe your mental impairment is and whether you meet the requirements of a listing. The medical consultant can choose from eight options:

• No medically determinable impairment (MDI)—meaning Social Security will deny your claim, because you must have a medically determinable condition to qualify for disability benefits. (20 C.F.R. § 404.1521.)
• Impairment(s) not severe—meaning that, even though you have a medically determinable condition, it isn't serious enough to interfere with your ability to work.
• Impairment(s) severe but not expected to last a year—meaning your medical condition won't meet the 12-month duration requirement. (Social Security will deny your claim.)
• Meets a listing (along with which listing)—meaning the doctor believes your condition meets the requirements of a listing. (Social Security will automatically approve your disability claim.)
• Equals a listing (along with which listing)—meaning the doctor believes your condition is equally severe as a listing. (Social Security will automatically approve your disability claim.)
• Coexisting non-mental impairment that require referral to another medical specialty—meaning you have a physical condition (in addition to your mental impairment) that needs to be reviewed by a different medical consultant before Social Security can decide your claim.
• Insufficient evidence—meaning your file doesn't contain enough medical information about your condition for the medical or psychological consultant to complete the PRTF.

If your condition meets or equals a listing, the medical consultant will use the next part of Section I to indicate which listing you met. The choices include the 11 categories of mental conditions in the listings, followed by their listing numbers:

• neurocognitive disorders (12.02)
• schizophrenia spectrum and other psychotic disorders (12.03)
• depressive and bi-polar related disorders (12.04)
• intellectual disorder (12.05)
• anxiety and obsessive-compulsive disorders (12.06)
• somatic symptom and related disorders (12.07)
• personality and impulse-control disorders (12.08)
• autism spectrum disorders (12.10)
• neurodevelopmental disorders (12.11)
• eating disorders (12.13)
• trauma- and stressor-related disorders (12.15)

(Learn more about what it means to meet or equal a mental impairment listing.)

PRTF Section II: Documentation of Evidence

If you have one of the mental conditions listed above, the medical consultant will use this section to indicate which symptoms of that condition you have. Each mental condition is listed, followed by its particular set of required symptoms (called the "paragraph A criteria" because of how the listings are organized).

For example, to meet the paragraph A criteria of the anxiety disorder listing, the doctor will need to indicate that you have medical documentation of three or more of the following symptoms:

• restlessness
• easily fatigued
• difficulty concentrating
• irritability
• muscle tension, or
• sleep disturbance.

If you have a medically determinable mental condition, but your symptoms don't satisfy the specific requirements listed for that condition, the doctor or psychologist can state this on the PRTF. The doctor could then add details about your symptoms and any medical documentation in your file.

PRTF Section III: Rating of Functional Limitations

In this section, the medical consultant will indicate the functional limitations caused by your mental condition. Functional limitations negatively impact your ability to live a normal life.

The first part of Section III asks for information about the severity of your limitations (the "paragraph B criteria" of the listings). The doctor or psychologist completing your PRTF will assess your limitations in four areas:

• understanding and applying information (your ability to follow directions)
• interacting with others (like friends, family, and coworkers)
• concentrating, persisting, and maintaining pace (your ability to get your work done on time), and
• adapting or managing yourself (regulating your emotions or managing your behavior in a work environment)

For each of these functions, the medical consultant will select the degree of limitation from the following options:

• none
• mild
• moderate
• marked (severe), and
• extreme.

Two "marked" limitations or one "extreme" limitation will generally satisfy the listing criteria.

The second part of Section III covers an alternate way to qualify for benefits for five of the mental impairment listings (meeting the "paragraph C criteria" of these listings). This alternative recognizes that you may have had success treating your disorder with intensive interventions. The following conditions provide this alternative method of meeting the listings:

• neurocognitive disorders (12.02)
• schizophrenia spectrum and other psychotic disorders (12.03)
• depressive and bi-polar related disorders (12.04)
• anxiety and obsessive-compulsive disorders (12.06), and
• trauma- and stressor-related disorders (12.15).

To meet the paragraph C criteria for one of these listings, the medical consultant must find that you have a medically documented history of the disorder for at least two years. Your medical records must also include evidence of ongoing medical treatment or therapy that you rely on to diminish your symptom, as well as evidence that your adaptation to daily life is fragile, despite treatment.

The doctor or psychologist will complete this section by indicating one of the following:

• your mental condition meets all or some of the criteria above
• the evidence doesn't show that you meet the criteria above, or
• there isn't enough evidence to establish that you meet the criteria above.

PRTF Section IV: Consultant's Notes

The PRTF also contains a blank area where the consulting doctor or psychologist can write in additional information needed. If, for instance, you have one of the mental conditions with paragraph C criteria, like post-traumatic stress disorder (PTSD), but there isn't enough evidence to establish that you meet the paragraph C criteria, the doctor will explain that finding in this section.

Required Review of the PRTF

If your initial disability claim is denied, you have the right to request a reconsideration. (Reconsideration is the first step in the disability appeals process).

In reconsiderations, the PRTF should be reviewed and certified as accurate by a psychological consultant. If a different medical consultant (other than the consultant who signed the PRTF for the initial determination) reviews it, they can affirm the initial PRTF if they agree with it. If not, they can indicate the reasons behind the disagreement. Sometimes, a disagreement results in a new psychological review technique form being completed.

You can request a copy of your PRTF to review. Read the completed form carefully to be sure that it accurately reflects the symptoms and limitations of your mental condition.

Learn how to get a copy of your Social Security disability application file.

_{Updated October 25, 2023}