[Code of Federal Regulations]

[Title 20, Volume 1]

[Revised as of April 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 20CFR220.101]



[Page 277-278]

 

                      TITLE 20--EMPLOYEES' BENEFITS

 

                  CHAPTER II--RAILROAD RETIREMENT BOARD

 

PART 220_DETERMINING DISABILITY--Table of Contents

 

                   Subpart H_Evaluation of Disability

 

Sec.  220.101  Evaluation of mental impairments.



    (a) General. The steps outlined in Sec.  220.100 apply to the 

evaluation of physical and mental impairments. In addition, in 

evaluating the severity of a mental impairment(s), the Board will follow 

a special procedure at each administrative level of review. Following 

this procedure will assist the Board in--

    (1) Identifying additional evidence necessary for the determination 

of impairment severity;

    (2) Considering and evaluating aspects of the mental impairment(s) 

relevant to the claimant's ability to work; and

    (3) Organizing and presenting the findings in a clear, concise, and 

consistent manner.

    (b) Use of the procedure to record pertinent findings and rate the 

degree of functional loss. (1) This procedure requires the Board to 

record the pertinent signs, symptoms, findings, functional limitations, 

and effects of treatment contained in the claimant's case record. This 

will assist the Board in determining if a mental impairment(s) exists. 

Whether or not a mental impairment(s) exists is decided in the same way 

the question of a physical impairment is decided, i.e., the evidence 

must be carefully reviewed and conclusions supported by it. The mental 

status examination and psychiatric history will ordinarily provide the 

needed information. (See Sec.  220.27 for further information about what 

is needed to show an impairment.)

    (2) If the Board determines that a mental impairment(s) exists, this 

procedure then requires the Board to indicate whether certain medical 

findings which have been found especially relevant to the ability to 

work are present or absent.

    (3) The procedure then requires the Board to rate the degree of 

functional loss resulting from the impairment(s). Four areas of function 

considered by the Board as essential to work have been identified, and 

the degree of functional loss in those areas must be rated on a scale 

that ranges from no limitation to a level of severity which is 

incompatible with the ability to perform those work-related functions.



For the first two areas (activities of daily living and social 

functioning), the rating is done based upon the following five-point 

scale; none, slight, moderate, marked, and extreme. For the third area 

(concentration, persistence, or pace), the following five-point scale is 

used: never, seldom, often, frequent, and constant. For the fourth area 

(deterioration or decompensation in work or work-like settings), the 

following four-point scale is used: never, once or twice, repeated 

(three or more), and continual. The last two points for each of these 

scales represent a degree of limitation which is incompatible with the 

ability to perform the work-related function.

    (c) Use of the procedure to evaluate mental impairments. Following 

the rating of the degree of functional loss resulting from the 

impairment(s), the Board then determines the severity of the mental 

impairment(s).

    (1) If the four areas considered by the Board as essential to work 

have been rated to indicate a degree of limitation as ``none'' or 

``slight'' in the first and second area, ``never'' or ``seldom'' in the 

third area, and ``never'' in the fourth area, the Board can generally 

conclude that the impairment(s) is not severe, unless the evidence 

otherwise indicates that there is significant limitation of the 

claimant's mental ability to do basic work activities (see Sec.  

220.102).

    (2) If the claimant's mental impairment(s) is severe, the Board must 

then determine if it meets or equals a listed mental impairment. This is 

done by comparing the Board's prior conclusions based on this procedure 

(i.e., the presence of certain medical findings considered by the Board 

as especially relevant to a claimant's ability to



[[Page 278]]



work and the Board's rating of functional loss resulting from the mental 

impairment(s)) against the criteria of the appropriate listed mental 

disorder(s).

    (3) If the claimant has a severe impairment(s), but the 

impairment(s) neither meets nor equals the Listings, the Board will then 

do a residual functional capacity assessment for those claimants 

(employees, widow(er)s, and children) whose applications are based on 

disability for any regular employment under the Railroad Retirement Act.

    (4) At all adjudicative levels, the Board will, in each case, 

incorporate the pertinent findings and conclusions based on this 

procedure in its decision rationale. The Board's rationale must show the 

significant history, including examination, laboratory findings, and 

functional limitations that the Board considered in reaching conclusions 

about the severity of the mental impairment(s).