Section 388-447-0040 - Progressive evaluation process step II-How does the department determine the severity of mental impairments? If you are diagnosed with a mental impairment by a professional described in WAC 388-447-0005, we use information from the medical evidence provider to determine how the impairment limits work-related activities.
(1) We review the following psychological evidence to determine the severity of your mental impairment: (a) Psychosocial and treatment history records;(b) Clinical findings of specific abnormalities of behavior, mood, thought, orientation, or perception;(c) Results of psychological tests; and(d) Symptoms observed by the examining professional that show how your impairment affects your ability to perform basic work-related activities.(2) If you are diagnosed with an intellectual disability, the diagnosis must be based on the Wechsler adult intelligence scale (WAIS). The following test results determine the severity rating: Intelligence Quotient (IQ) Score | Severity Rating |
85 or above | 1 |
71 to 84 | 3 |
70 or lower | 5 |
(3) If you are diagnosed with a mental impairment with physical causes, we assign a severity rating based on the most severe of the following four areas of impairment: (a) Short term memory impairment;(b) Perceptual or thinking disturbances;(c) Disorientation to time and place; or(d) Labile, shallow, or coarse affect.(4) We base the severity of an impairment diagnosed as a mood, anxiety, thought, memory, personality, or cognitive disorder on a clinical assessment of the intensity and frequency of symptoms that: (a) Affect your ability to perform basic work-related activities; and(b) Are consistent with a diagnosis of a mental impairment as listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).(5) We base the severity rating for a functional mental impairment on accumulated severity ratings for the symptoms in subsection (5) of this section as follows: Condition | Severity Rating |
(a) The clinical findings and objective evidence are consistent with a significant limitation on performing one or more basic work activities. | Moderate (3) |
(b) You are diagnosed with a functional disorder with psychotic features; (c) You have had two or more hospitalizations for psychiatric reasons in the past two years; (d) You have had more than six months of continuous psychiatric inpatient or residential treatment in the past two years; (e) The clinical findings and objective evidence are consistent with very significant limitations on ability to perform one or more basic work activities. | Marked (4) |
(f) The clinical findings and objective evidence are consistent with an inability to perform one or more basic work activities. | Severe (5) |
(6) If you are diagnosed with any combination of mental retardation, mental impairment with physical causes, or functional mental impairment, we assign a severity rating as follows: Condition | Severity Rating |
(a) Two or more disorders with moderate severity (3) ratings; or (b) One or more disorders rated moderate severity (3), and one rated marked severity (4). | Marked (4) |
(c) Two or more disorders rated marked severity (4). | Severe (5) |
(7) We deny incapacity when you haven't been diagnosed with a significant physical impairment and the overall severity of your mental impairment is one or two;(8) We approve incapacity when your overall mental severity rating is severe (5).Wash. Admin. Code § 388-447-0040
Adopted by WSR 13-24-044, filed 11/26/13, effective 1/1/2014Amended by WSR 18-18-007, Filed 8/23/2018, effective 9/23/2018