DI 24510.063 Completion of Section I of SSA-4734-F4-SUP
A. Operating Policy
For each of the items under the four headings, A through D, one of the five boxes to the right of each item must be checked.
B. Operating Procedure
Complete Section I by checking the appropriate boxes.
1. Check Box 1
“Not Significantly Limited,” when the effects of the mental disorder do not prevent the individual from consistently and usefully performing the activity.
2. Check Box 2
“Moderately Limited,” when the evidence supports the conclusion that the individual's capacity to perform the activity is impaired.
NOTE: The degree and extent of the capacity or limitation must be described in narrative format in Section III.
3. Check Box 3
“Markedly Limited,” when the evidence supports the conclusion that the individual cannot usefully perform or sustain the activity.
4. Check Box 4
When there is no allegation of limitation of this activity, or the medical evidence does not indicate limitations in a particular area and no limitation would be expected, based on the nature of the illness and the rater's clinical experience.
5. Check Box 5
When there is insufficient evidence and either a problem in this aspect of work function has been alleged, the evidence suggests a problem, or the MC's clinical judgment suggests the likelihood of a problem.
NOTE: Absence of a rating (i.e., checking blocks 1, 2, or 3) for one or more items in a subsection in section I does not automatically preclude a narrative RFC statement for that subsection. Other items in the subsection may be ratable and may indicate such a level of functional loss that the disability examiner can conclude that the individual's capacity for work is severely compromised, in spite of the absence of a rating for other items.
Discussion with the disability examiner will resolve whether additional information about a subsection is necessary for a useful assessment of mental RFC.