PDFWAC 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; | Marked | (4) |
(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. | ||
(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 | Marked | (4) |
(b) | One or more disorders rated moderate severity (3), and one rated marked severity (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).
[Statutory Authority: RCW 74.04.050, 74.040.055 [74.04.055], 74.04.057, 74.08.090, and 2018 c 48. WSR 18-18-007, § 388-447-0040, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.08A.100, 74.04.770, 74.08.025, 74.62.030, and 2013 2nd sp.s. c 10. WSR 13-24-044, § 388-447-0040, filed 11/26/13, effective 1/1/14.]