The categories of Mental Retardation and Substance Addiction Disorders each differ and are not discussed as part of this review. They require special expertise and attention to detail beyond the scope of this paper.

The B criteria are applied to the category for which the A criteria are fulfilled. The purpose of the B criteria for mental disorders is to describe the functional restrictions that are incompatible with work and are associated with the mental impairments of the A criteria. The B criteria follow:

  • marked restriction of activities of daily living;

  • marked difficulties in maintaining social functioning;

  • marked difficulties in maintaining concentration, persistence, or pace; and

  • repeated episodes of decompensation, each of extended duration.

As an example, the SSA describes activities of daily living to include cleaning, shopping, cooking, taking public transportation, caring for one’s grooming and hygiene, among others. These activities are referred to as activities of daily living and instrumental activities of daily living in the professional literature.

The C criteria apply to all categories except Mental Retardation, Personality Disorder, Substance Addiction, and Autistic Disorder.6 The C criteria are additional considerations for cases that do not reach the threshold of the B criteria. For example, the C criteria for Schizophrenia, Paranoid, and Other Psychotic Disorders are intended to compensate for such instances when claimants are living in supportive residential settings or are otherwise adapted to a special environment that could not be sustained if the person went to work. These C criteria also consider individuals who have a history of serious episodes of disorder or disability and are currently functioning at a relatively high level through the benefits of medication but whose delicate functional status would be jeopardized by the additional stress of work. In other words, the relatively high degree of functioning is attributed to the compensatory medications or supports. Work would jeopardize this accomplishment and would vitiate the level of functioning attained. The C criteria for Anxiety-Related Disorders are designed to accommodate individuals with agoraphobia who are totally unable to function outside their homes but can function successfully within the home.

The following description of the forms show how decisions are made that put the sequential evaluation into effect for the medical component of the disability determination.

6  

Although the Listings for both Mental Retardation and Substance Addiction Disorders do have C criteria, they are of an entirely different conceptual nature.



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