WAC 388-447-0020

Effective January 1, 2014

WAC 388-447-0020 How does the department assign severity ratings to my impairments?

(1) "Severity rating" is a rating of the extent of your impairment and how it impacts your ability to perform the basic work activities detailed in WAC 388-447-0001. Severity ratings are as-signed in Steps II through IV of the progressive evaluation process (PEP). The following chart provides a description of levels of limitations on work activities and the severity ratings that would be assigned to each.

   Effect on Work Activities Degree of Impairment Numeric Value
 (a)  There is no effect on your performance of one or more basic work-related activites.  None  1
 (b)  There is no significant limit on your performance of one or more basic work-related activities.  Mild  2
 (c) There are significant limits on your performance of one or more basic work-related activity.  Moderate  3
 (d)  There are very significant limits on your performance of one or more basic work-related activities.  Marked  4
 (e)  You are unable to perform at least one basic work-related activity.  Severe  5

(2) We use the description of how your condition impairs your ability to perform work activities given by the medical evidence provider to establish severity ratings when the impairments are supported by, and consistent with, the objective medical evidence.

(3) A contracted doctor reviews your medical evidence and the ratings assigned to your impairment when:

(a) The medical evidence indicates functional limitations con-sistent with at least a moderate physical or mental impairment; and

(b) Your impairment has lasted, or is expected to last, nine months or more with available treatment.

(4) The contracted doctor reviews the medical evidence, severity ratings, and functional assessment to determine whether:

(a) The medical evidence is objective and sufficient to support the findings of the medical evidence provider;

(b) The description of impairments is supported by the medical evidence; and

(c) The severity rating, duration, and assessment of functional limitations assigned by DSHS are consistent with the medical evidence.

(5) If the medical evidence provider's description of your im-pairments is not consistent with the objective medical evidence, we will:

(a) Assign a severity rating, duration, and functional limita-tions consistent with the objective medical evidence;

(b) Clearly describe why we rejected the medical provider's opinion; and

(c) Identify the medical evidence used to make the determination.

 

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.