SOCIAL AND HEALTH SERVICES
(Economic Services Administration)
Effective Date of Rule: Thirty-one days after filing.
Purpose: The department is amending WAC 388-448-0050 PEP step II -- How we determine the severity of mental impairments, the amendments replace obsolete and outdated medical descriptions and references.
Citation of Existing Rules Affected by this Order: Amending WAC 388-448-0050.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090.
Adopted under notice filed as WSR 08-22-054 on November 3, 2008.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: May 18, 2009.
Stephanie E. Schiller
(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 practitioner that
impairment of)) how your impairment affects your
ability to perform basic work-related activities.
(2) We exclude diagnosis and related symptoms of alcohol or substance abuse or addiction;
(3) If you are diagnosed with mental retardation, 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|
(a) Short term memory ((
defect for recent events))
Impoverished, slowed, perseverative thinking, with
confusion or disorientation)) Perceptual or thinking
disturbances; (( or))
(c) Disorientation to time and place; or
(d) Labile, shallow, or coarse affect.
(4))) (5) We base the severity of (( the)) a functional
(( psychotic or nonpsychotic)) disorder(( , excluding alcoholism
or drug addiction,)) on a clinical assessment of the intensity
and frequency of symptoms that:
Clinical assessment of these twelve symptoms:
Depressed mood, suicidal trends, verbal expression of anxiety
or fear, expression of anger, social withdrawal, motor
agitation, motor retardation, paranoid behavior,
hallucinations, thought disorder, hyperactivity, preoccupation
with physical complaints)) Affect your ability to perform
basic work related activities; and
Clinical assessment of the intensity and
pervasiveness of your symptoms and their effect on work
activities)) Are consistent with a diagnosis of a mental
impairment as listed in the Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition (DSM-IV).
(5))) (6) We base the severity rating for a functional
mental impairment on accumulated severity ratings for the
(( twelve)) symptoms in subsection (( (4)(a))) (5)(a) of this
section as follows:
|Symptom Ratings or Condition||Severity Rating|
|(a) The functional mental impairment
is diagnosed with psychotic
(b) You have had two or more hospitalizations for psychiatric reasons in the past two years;
(c) You have had more than six months of continuous psychiatric hospital or residential treatment in the past two years;
(d) The overall assessment of symptoms is rated three; or
(e) At least three symptoms are rated three or higher.
|(f) The overall assessment of
symptoms is rated four; or
(g) At least three symptoms are rated four or five.
|(h) The overall assessment of
symptoms is rated five; or
(i) At least three symptoms are rated five.
|(a) Two or more disorders with
ratings of three; or
(b) One or more disorders rated three; and one rated four.
|(c) Two or more disorders rated four.||5|
(8))) (9) We approve incapacity when you have an
overall mental severity rating of five(( , regardless of
whether you have a physical impairment)).
[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090. 00-16-113, § 388-448-0050, filed 8/2/00, effective 9/1/00.]