WAC 388-449-0035

Effective June 1, 2012

WAC 388-449-0035 How does the department assign severity ratings to my impairment?

1.    "Severity rating"  is a rating of the extent of your impairment and how it impacts your ability to perform the basic work activities. The following chart provides a description of limitations on work activities and the severity ratings assigned to each.

Effect on Work Activities 

Degree of Impairment

Numerical Value 

(a) There is no effect on your performance of one or more basic work-related activities. 

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 activities. 

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 basic work-related activities. 

Severe

5

 

2.    We use  the description of how your condition impairs your ability to perform work activities given by the acceptable medical source or treating provider, and review other evidence you provide, to establish severity ratings when the impairments are supported by, and consistent with, 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 consistent with at least a moderate physical or mental health impairment;

b.    Your impairment has lasted, or is expected to last, nine months or more with available medical treatment; and

c.    You were not an active ABD recipient previously determined likely to be disabled as defined in WAC 388-449-0010  through 388-449-0100.

4.    The contracted doctor reviews your medical evidence, severity rating, and functional assessment to determine whether:

a.    The Medical evidence is objective and sufficient to support the findings of the provider;

b.    The description of impairment(s) 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 impairment(s) is not consistent with the objective medical evidence, we will: 

a.    Assign a severity rating, duration, and functional limitations consistent with the objective medical evidence; and

b.    Clearly describe why we rejected the medical evidence 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.