TN 1 (01-05)

SI 00530.920 Medical Impairment Codes for Good Cause Decisions

NOTE: On April 1, 2009, SSA changed its policy of not paying fleeing felons. Follow the instructions below only for felony warrants with offense codes 4901, 4902, or 4999. Follow the Martinez settlement instructions in GN 02613.860 GN 02613.885 for all other felony warrant codes.

On May 9, 2011, SSA changed its policy and no longer suspends or denies benefits or payments based solely on a probation or parole violation warrant (i.e., warrants with offense codes 5011, 5012, 8101, 8102, or 9999 or “Blank” and an offense charge symbol of “probation or parole violation”). Follow the Clark Court Order instructions in GN 02615.100 GN 02615.190 for all probation or parole violation warrants.

We will make additional changes to this section, as necessary, in the future.

A. Exhibit – mental disability diagnostic codes for fugitive good cause decisions

These diagnostic categories indicate a person lacks the mental capacity to resolve a warrant.

NOTE: The diagnostic codes listed below could either be primary or secondary to meet the good cause criteria.

Adult Diagnostic Category

Impairment Code

Organic Mental Disorders

2940

Schizophrenic, Delusional (Paranoid), Schizoaffective, and Other Psychotic Disorders

2950

Mood Disorders

2960

Autistic Disorders and Other Pervasive Developmental Disorders

2990

Mental Retardation

3180

B. Descriptions of mental diagnostic codes

  • Organic Mental Disorders Impairment code: 2940

Psychological or behavioral abnormalities associated with a brain dysfunction due to a physical cause.

ADULT (12.02) This condition can include one or more of the following: loss of specific cognitive abilities or affective changes. These people suffer from one or more of the following: disorientation to time and place, memory impairment, hallucinations/delusions, personality changes, mood disturbances, explosive temper outbursts, sudden crying-loss of impulse control.

CHILD (112.02) This condition can include one or more of the following: arrested development, disorientation, memory impairment, hallucinations, delusions, illusions or paranoid thinking, apathy, hostility, mania, depression, sudden crying, temper outbursts, disturbance of concentration.

  • Schizophrenic, Paranoid and Other Psychotic Disorders Impairment code: 2950

Psychotic, schizophrenic, or paranoid behaviors.

ADULT (12.03) This condition can include delusions or hallucinations, catatonic behavior, incoherence, illogical thinking or speech problems, emotional withdrawal or isolation.

CHILD (112.03) In children this condition has the same behavioral description.

  • Affective/Mood Disorders Impairment code: 2960

Disturbance of mood, manic or depressive (Bipolar) syndrome.

ADULT (12.04) Affective disorder which refers to prolonged emotion of depression or elation and can include: loss of interest, loss of appetite, sleep disturbance, decreased energy, guilt feelings or worthlessness, trouble thinking or concentrating, thoughts of suicide, hallucinations, delusions, paranoid thinking, hyperactivity, speech difficulty, easily distracted behaviors.

CHILD (112.04) Mood disorder including depressed or irritable mood, lack of pleasure or interest in activities, appetite or weight increase or decrease and many of the adult characteristics of affective disorder.

  • Autistic and other Pervasive Developmental Disorders Impairment code: 2990

Autism is a disorder characterized by impaired social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests. Other pervasive developmental disorders share some or all of these characteristics, with varying degrees of limitation.

ADULT (12.10) This disorder includes a lack of verbal/nonverbal communication skills and social interaction, and activities/interests that are stereotyped and repetitive in nature.

CHILD (112.10) The same symptoms are present as in the ADULT listing.

 

  • Mental Retardation Impairment code: 3180

Significant sub average intellectual functioning.

ADULT (12.05) Disabled people in this category have very low IQs and are dependent upon others for personal needs. They have difficulty in following directions, functioning socially, maintaining concentration and persistence.

CHILD (112.05) The same general conditions as found under the ADULT listing.


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http://policy.ssa.gov/poms.nsf/lnx/0500530920
SI 00530.920 - Medical Impairment Codes for Good Cause Decisions - 06/06/2013
Batch run: 06/06/2013
Rev:06/06/2013