Assessment of functional limitations is a complex and highly individualized process
that requires consideration of multiple issues and all relevant evidence to obtain
a longitudinal picture of the person's overall degree of functional limitation. We
consider all relevant and available clinical signs and laboratory findings, the effects
of symptoms, and how functioning may be affected by factors including, but not limited
to, chronic mental disorders, structured settings, medication, and other treatment.
We rate the degree of functional limitation based on the extent to which the impairment(s)
interferes with the person's ability to function independently, appropriately, effectively,
and on a sustained basis in a work setting. We consider such factors as the quality
and level of overall functional performance, any episodic limitations, the amount
of supervision or assistance required, and the settings in which the person is able
to function. For more information about the evidence and factors to consider when
rating the degree of functional limitation, see DI 34001.032 (12.00C through F of the adult mental disorders listings).
We rate the degree of functional limitation in four broad areas of mental functioning:
Understand, remember, or apply information;
Concentrate, persist, or maintain pace; and
These four areas of mental functioning are commonly referred to as the “paragraph
B criteria.” For a description of the paragraph B criteria, see DI 34001.032 (12.00E of the adult mental disorders listings).
We rate the degree of limitation in the paragraph B criteria using the following five-point
scale: none, mild, moderate, marked, and extreme. The rating of extreme on the scale
represents a degree of limitation that is incompatible with the ability to do any
gainful activity. For more information about how to use the paragraph B criteria to
evaluate mental disorders, see DI 34001.032 (12.00F of the adult mental disorders listings).