WAC 388-448-0050

Effective September 1, 2000

WAC 388-448-0050 PEP Step II - How we determine the severity of mental impairments

If you are diagnosed with a mental impairment, we use information from the provider to determine if your impairment prevents you from being gainfully employed. We review the psychological evidence to determine the severity of your mental impairment.

  1. The severity of your mental impairment is based on:  

    1. Psychosocial and treatment history;

    2. Clinical findings;

    3. Results of psychological tests; and

    4. Symptoms observed by the examining practitioner that show impairment of your ability to perform basic work-related activities.

  2. If you are diagnosed with mental retardation, the diagnosis must be based on the Wechsler Adult Intelligence Scale (WAIS). The following test results determine the severity rating:

Intelligence Quotient (IQ) Score

Severity Rating

85 or above

1

71 to 84

3

70 or lower

5

  1. If you are diagnosed with a mental impairment with physical causes, we assign a severity rating based on the most severe of the following three areas of impairment:

    1. Memory defect for recent events;

    2. Impoverished, slowed, perseverative thinking, with confusion or disorientation; or

    3. Labile, shallow, or coarse affect.

  2. We base the severity of the functional psychotic or nonpsychotic disorder, excluding alcoholism or drug addiction, on:

    1. Clinical assessment of these twelve symptoms: depressed mood, suicidal trends, verbal expression of anxiety or fear, expression of anger, social withdrawal, motor agitation, motor retardation, paranoid behavior, hallucinations, thought disorder, hyperactivity, preoccupation with physical complaints; and

    2. Clinical assessment of the intensity and pervasiveness of your symptoms and their effect on work activities.

  3. We base the severity rating for a functional mental impairment on accumulated severity ratings for the twelve symptoms in subsection (4)(a) of this section as follows.

Symptom Ratings or Condition

Severity Rating

  1. The functional mental impairment is diagnosed with psychotic features;

  2. You have had two or more hospitalizations for psychiatric reasons in the past two years;

  3. You have had more than six months of continuous psychiatric hospital or residential treatment in the past two years;

  4. The overall assessment of symptoms is rated three; or

  5. At least three symptoms are rated three or higher.

3

  1. The overall assessment of symptoms is rated four; or

  2. At least three symptoms are rated four or five.

4

  1. The overall assessment of symptoms is rated five; or

  2. At least three symptoms are rated five.

5
  1. If you have more than one type of mental impairment, we assign a severity rating as follows:

Condition

Severity Rating

  1. Two or more disorders with ratings of three; or

  2. One or more disorders rated three, and one rated four.

4
  1. Two or more disorders rated four.

5

  1. We deny incapacity when you do not have a significant physical impairment and your overall mental severity rating is one or two;

  2. We approve incapacity when you have an overall mental severity rating of five, regardless of whether you have a physical impairment.

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.