Regulation 404.1520a and 416.920a state that a special procedure is to be followed
in evaluating the severity of mental impairments. This procedure requires that pertinent
signs, symptoms, functional limitations, and effects of treatment be recorded by the
MC/PC on a standard document, which is the Psychiatric Review Technique Form (PRTF).
The PRTF is an adjudicative tool that provides a technique for organizing findings
of a mental disorder(s). It facilitates the MC/PC's analysis and decision that: (1)
The reported mental disorder is not severe, or (2) that additional medical and/or
other evidence is needed, or (3) that the findings of the reported mental disorder(s)
meet or are medically equivalent to the requirements of a listed mental disorders
category, or (4) that a mental residual functional capacity assessment is required.
The PRTF does not substitute for an MC/PC's judgment. Rather, it serves to document
that judgment and the specific information on which that judgment was based.
Section III of the PRTF contains subsections for each of the listed mental impairment
categories with checkblocks to indicate whether the capsule definition for a listed
category has been satisfied. Under each of these categories are criteria which are
used to substantiate the existence of the impairment with checkblocks for indicating
the presence or absence of each criterion, plus an “other” category for the MC/PC's substitution of criteria other than those cited in the subsection.
Section IV of the PRTF requires the MC/PC to rate functional limitations that are
essential to work: (1) Activities of daily living, (2) social functioning, (3) concentration,
persistence, or pace, and (4) deterioration or decompensation in work or work-like
Inclusion of a finding in the “other” block in section II does not necessarily mean that the MC/PC believes the finding
to be of diagnostic or prognostic importance equal to the listed findings. Rather,
it means that there is a finding not found in the listing, that he/she believes should
be considered in the overall evaluation of the case. For this and other reasons, checking
of the “other” block, even when accompanied by appropriate functional manifestations covered in
paragraph B or C, does not automatically require a finding of medical equivalence.
As has been mentioned before, however, the finding of severe functional restriction
requires careful review of the clinical data, because a listing may be met or equaled
or it may be an indication that the functional data have not been correctly evaluated.
(Instructions on the purpose and completion of the PRTF are in DI 24505.025.)