Representing People With

Social Security Disability, Veterans Benefits

and Injury and Accident Claims

Rating SSA’s “4 Questions” is Art, Not Science

Published on March 16th, 2020

In a recent newsletter, we described the four key questions being used by Social Security to evaluate the severity of a range of medical problems. While these questions were initially used in mental impairment claims, SSA spread their use to virtually all neurological conditions and to many other medical impairments.

Briefly the four questions are:
1. How do symptoms impact the ability to understand, remember or apply information;
2. How is the ability to interact with others impacted;
3. What is the impact on concentration persistence or maintain pace; and,
4. How is the ability to adapt or manage oneself impacted.

If two of these four areas of function are “markedly impaired” SSA will usually find a mentally ill claimant entitled to benefits. For some neurological conditions, only one of these functional abilities needs to be markedly impaired.

Assuming the symptoms of the illness are consistently documented by the treating professionals, the issue is how to rate the severity of the impact.
Truly there is no objective standard and the ultimate decision-making rests with the Social Security Administration. However, SSA provides some guidance with definitions of the terms mild, moderate, marked and extreme.

“No impairment” in a specific functional ability means that the patient can function in this area independently, appropriately, effectively and on a sustained basis.
A “mild impairment” means that there is a slight limitation in the ability to function independently, appropriately and effectively on a sustained basis.
A “moderate impairment” indicates that that functioning is fair.
“Marked impairment” is characterized by a serious limitation in that area of function. This is the level of functioning that SSA believes significantly impacts the ability to work.
An “extreme limitation” means that there is no ability to function in this area independently, appropriately and effectively on a sustained basis.
Clearly even these definitions are subjective. The decisions are based upon the content of the clinical charts of the treating medical professionals.
One key is that the rating of severity should be based upon the most severe limitations. For example, a worker must be able to concentrate and persist without distraction and maintain a competitive pace. If any one of these three functional capabilities is markedly impaired then that suffices to meet SSA’s threshold. The same is true for the ability to understand and remember, and apply information as well as the ability to both manage and adapt in work settings.

For conditions such as Lupus, an older version of these criteria is still in the Listings and the focus is upon at least one marked limitation in activities of daily living, or in maintaining social functioning or in the ability to complete tasks in a timely manner due to deficiencies in maintaining concentration, persistence or pace.
Medical records which focus on these functional criteria will be stronger support for SSDI and SSI benefits.

Back to News

Need Legal Assistance?

See How Our Attorneys At Jackson & MacNichol Can Help You

Social Security
Disability


Social Security Disability Insurance payments are available to wage earners who have become disabled. Supplemental Security Income payments are available to those with limited income who are disabled.

We represent SSD cases in Maine, Boston, and the whole of New England.

Veterans Disability
Benefits


As a proud member of the National Association of Veterans' Advocates (NOVA), we offer representation at all stages of the benefits claim process.

We represent Veterans in their disability benefits cases nationwide.

Estate Planning
Services


Estate planning involves more than just writing a will. It’s an active process of evaluating your needs, keeping track of your assets, and determining what legal actions need to be taken to meet your goals and protect your loved ones.

We offer a no obligation, complementary estate planning and asset protection review.

Contact Us

Jackson & MacNichol

Attorneys at Law

238 Western Ave.
South Portland, ME
04106

Call Us Today

888-897-1653

Start Your Disability Claim by Contacting Our Attorneys Get Started Now!

Copyright 2021 Jackson & MacNichol, All Rights Reserved