Social Security recognizes that limited or “borderline” intellectual functioning can support a finding of “disabled” by an Administrative Law judge. Remember that the main issue in any Social Security disability case has to do with a claimant’s capacity to perform entry-level, unskilled work. Limited intellectual functioning can, on its own, exclude all but the most simple, one or two step, repetitive jobs, and any other factor such as depression, inappropriate social behavior, physical limitations can convince a judge to approve a claim for benefits.
Generally, I use two arguments to help my clients win when their impairment involves borderline intellectual functioning:
Argument 1: Does the Claimant Meet a Listing?
Social Security recognizes that certain mental impairments are so severe, that if an accurate diagnosis is made and there are medical records that support that diagnosis, a Social Security decision maker (i.e., the judge) can issue a favorable decision without a full inquiry into the specifics of the claimant’s limitations. These severe impairments are published in something called the “Blue Book” which lists dozens of severe impairments broken down by body system. If your or your loved one’s condition equals one of these described impairments, you should be approved quickly and you will be deemed to have met a “listing.”
The impairments described in the “Blue Book” are known as “listings” and a person whose condition fits a Blue Book condition “meets a listing.” Listing level cases are often approved early on in the process since the State Agency adjudicators (claims adjustors) are trained to look for language that tracks the listings in the medical records they review.
The listing that is associated with borderline intellectual functioning is Listing 12, which described mental impairments. Several of the 12.00 Listing sections can apply to persons with limited mental functioning, but the one that seems to be used most in the cases of those with a low IQ is Listing 12.05 – Mental Retardation.
Here is the 12.05 Listing in its entirety:
12.05 Mental retardation: Mental retardation refers to significantly subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of the impairment before age 22.
The required level of severity for this disorder is met when the requirements in A, B, C, or D are satisfied.
A. Mental incapacity evidenced by dependence upon others for personal needs (e.g., toileting, eating, dressing, or bathing) and inability to follow directions, such that the use of standardized measures of intellectual functioning is precluded;
B. A valid verbal, performance, or full scale IQ of 59 or less;
C. A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing an additional and significant work-related limitation of function;
D. A valid verbal, performance, or full scale IQ of 60 through 70, resulting in at least two of the following:
1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Marked difficulties in maintaining concentration, persistence, or pace; or
4. Repeated episodes of decompensation, each of extended duration.
As you can see, a claimant can meet 12.05 if he has:
- a full scale IQ of 59 or less; or
- a full scale IQ of 60-70 plus some other significant physical or mental impairment
If you believe that you or a loved one meets the listing at 12.05 or any other listing, make sure to highlight this assertion for the adjudicator or the judge. It would also help to have a treating doctor and/or psychologist/psychiatrist write up a narrative report that specifically states that the claimant meets the listing.
Argument 2: Has the Claimant’s Functional Capacity for Work Been So Reduced by his Limited Intellectual Functioning and his other Mental and Physical Impairments that he would Not be a Reliable Worker at any Job?
A more common argument for approval in a Social Security claim is the “functional capacity” argument. Here, I would be arguing that my client cannot reliably perform even the easiest entry level job that exists because of limitations that arise from his limited intellect and/or other medical or mental health issues.
Unlike the listing, when I argue for disability based on functional capacity, I have to identify specific activity and capacity limitations that would likely preclude work. If I am successful the judge will incorporate these activity and capacity limitations into his hypothetical question to the vocational witness, who will testify that based on those limitations there are no jobs that exist in significant numbers in the regional or national economy.
Usually when I am representing a client with limited intellectual functioning it is a good idea to bring a witness (usually a parent or sibling) to testify about my client’s poor ability to meet a schedule or perform tasks in a timely manner. Often my client himself has a difficult time recognizing his own limitations.
Here are some case studies that describe hearings I tried on behalf of clients with borderline intellectual functioning:
Borderline Intellectual Functioning Case Study #1 – 34 year old man with IQ of 79, depression and occasional inappropriate behavior in dealing with the public and co-workers