Social Security Disability and SSI Claims Based on Learning Disabilities

The rule which directs how a claim for intellectual disability, learning disability, mental retardation, low IQ or special needs is called Social Security Listing 12.05.  The listing states that if a person has a valid IQ score of 59 or less, and also displays adaptive functioning deficits that were present prior to the age of 22, his or her impairments meet this listing and he or she is disabled.  The listing also dictates a finding of disability if a person has a valid IQ score between 60 and 70, plus another severe impairments which impacts their ability to work.  As with the first scenario, a person must also have adaptive functioning deficits prior to the age of 22 in order to meet the requirements of the listing.  It is helpful to have an experienced Social Security Disability lawyer assist with showing adaptive deficits.   It is also important to emphasize that the IQ scores must be valid, a determination usually made by the examining physician.  Often scores will be deemed invalid if the examiner reports the claimant wasn’t putting forth their best effort, if they were fatigued, or if they were under the influence of any substances, prescribed or illegal, during the testing.  It is therefore very important for claimants taking IQ tests to put forth their best efforts in IQ examinations.

While the language of Listing 12.05 is relatively straightforward, it is often difficult to be found disabled under this provision. It is helpful to have an experienced Social Security attorney assist with claims of this type.  Judges frequently find that the adaptive functioning deficits requirement is not met where a person wasn’t in resource or special education classes or can’t prove they were, or if they have performed any work, even minimal, part-time, or simple work, during their adult life.  It remains unclear why judges seem more reticent to grant claims based on intellectual disability than based on other impairments, but under the law at least, they should grant claims where individuals meet this listing.

Case law is varied on the subject in different circuits.  Some circuits have ruled low IQ in childhood is presumptive if a person has low IQ scores in adulthood, so long as there is no intervening event such as a traumatic brain injury that could have resulted in an organic lowering of a person’s IQ.  Other circuits have remained silent on the subject, leaving Disability Judges to interpret the Listing on their own.  In nearly all hearings, judges will ask specific questions designed to determine how cognitively impaired an individual is, even when IQ scores themselves dictate a finding of disability.  They often ask about whether an individual claiming intellectual disability has a driver’s license, if they are capable of living on their own, if they need reminders to see doctors or to make appointments, if they can read and write, do math, or to what extent they were involved in resource classes when in school.  All of these questions are aimed at making a determination of whether adaptive functioning deficits exist to a degree severe enough to justify a finding that an individual meets Listing 12.05.  It is helpful in these claims to obtain school records if possible, statements from family members or friends who assist the claimant, and vocational evidence from past employers if the individual has ever tried to work.  This information is often difficult to obtain, and admittedly not examined with the same level of scrutiny that medical evidence is in disability cases.  However, in the case of intellectual disability this may be all the evidence there is to obtain, given the fact that there is no real treatment that improves the cognitive functioning of people with low IQ.   It may also be advisable to request a psychological medical expert be present at hearings where a claimant is alleging that he or she meets Listing 12.05.

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