limitations are redundant with functions of body parts of the Listings of physical impairments (e.g., reaching in all directions [Residual Physical Functional Capacity Assessment] and range of motion in joints [physical Listings]).


Prior to developing a program of research, identifying issues for research, and specifying research mechanisms and methodologies, a strategy for establishing priorities needs to be created. At present, compelling research questions are vying for attention. The IOM committee may wish to consider establishing a working group to draft an outline of work that addresses the following three issues preliminary to creating priorities for research:

  1. Using SSA information, identify weak points in the existing adjudication process (e.g., slight limitation denials) and identify strong points that can be built on or generalized across claims based on physical and mental disorders:

    • Develop a plan for “fixing” the sequential process. For example, if the first two steps work well, keep them. Then go to the third step to look at problem areas (keeping in mind that for claims based on mental disorders, steps 2 and 3 are not readily distinguishable as steps only for the decision that is made).

    • Acknowledging that there will always be inherently difficult claims, develop a way of preselecting them and creating a process for handling them (e.g., panel of reviewers).

  1. Explore the differences between the adjudication materials for claims based on mental disorders and those used on physical disorders to see if the strengths identified by the APA study might not apply to the adjudication of physically disordered claimants, and attend to the weaknesses as well:

    • If the A criteria are to be eliminated as has been suggested at times, identify some method of documenting the association of the health condition with the disabled state.

    • Explore the factors that need to be included in the medical evidence and how the medical evidence will interface with SSA assessment forms.

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