New Neurocognitive Disorder Listing

In our continuing effort to provide information related to Social Security’s new listings on mental impairments we are going to look at changes made to the Neurocognitive Disorder listing. And, as just a reminder, Social Security’s set of listings are used in evaluating disability claims judging a condition’s severity and how it limits a person’s ability to function. We will post the current listing for Neurocognitive Disorder followed by the new listing, which will take effect January 17, 2017.

Current Neurocognitive Disorder Listing

12.02 Organic mental disorders: Psychological or behavioral abnormalities associated with a dysfunction of the brain. History and physical examination or laboratory tests demonstrate the presence of a specific organic factor judged to be etiologically related to the abnormal mental state and loss of previously acquired functional abilities.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Demonstration of a loss of specific cognitive abilities or affective changes and the medically documented persistence of at least one of the following:
  2. Disorientation to time and place; or
  3. Memory impairment, either short-term (inability to learn new information), intermediate, or long-term (inability to remember information that was known sometime in the past); or
  4. Perceptual or thinking disturbances (e.g., hallucinations, delusions); or
  5. Change in personality; or
  6. Disturbance in mood; or
  7. Emotional lability (e.g., explosive temper outbursts, sudden crying, etc.) and impairment in impulse control; or
  8. Loss of measured intellectual ability of at least 15 I.Q. points from premorbid levels or overall impairment index clearly within the severely impaired range on neuropsychological testing, e.g., the Luria-Nebraska, Halstead-Reitan, etc;

AND

  1. Resulting in at least two of the following:
  2. Marked restriction of activities of daily living; or
  3. Marked difficulties in maintaining social functioning; or
  4. Marked difficulties in maintaining concentration, persistence, or pace; or
  5. Repeated episodes of decompensation, each of extended duration;

OR

  1. Medically documented history of a chronic organic mental disorder of at least 2 years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
  2. Repeated episodes of decompensation, each of extended duration; or
  3. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
  4. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

New Neurocognitive Disorder Listing

12.02 Neurocognitive disorders, satisfied by A and B, or A and C:

  1. Medical documentation of a significant cognitive decline from a prior level of functioning in one or more of the cognitive areas:
  2. Complex attention;
  3. Executive function
  4. Learning and memory;
  5. Language;
  6. Perceptual – motor; or
  7. Social cognition.

AND

  1. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
  2. Understand, remember, or apply information.
  3. Interact with others.
  4. Concentrate, persist, or maintain pace.
  5. Adapt or manage oneself.
  6. Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 year s, and there is evidence of both:
  7. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
  8. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.