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Functional Assessment for Adults with Disabilities

Completed

The U.S. Social Security Administration has requested that the National Academies of Sciences, Engineering, and Medicine conduct a study to (1) provide an overview of ways to collect information about the functional abilities an adult needs to meet the physical and mental demands of work; (2) discuss types of information that support findings of limitations in functional abilities relevant to work requirements as defined by the Department of Labor for the Occupational Information System (OIS); and (3) provide findings and conclusions regarding the collection of information and assessment of functional abilities relevant to work requirements.

Description

An ad hoc committee will:

  1. Identify and describe ways to collect information about an individual’s physical and mental (cognitive and noncognitive) functional abilities relevant to work requirements as defined by the Bureau of Labor Statistics’ Occupational Requirements Survey (ORS), such as sitting/standing/walking, lifting/carrying, vision, communication, decision making, and adaptability;
  2. Discuss the types of information that support findings of limitations in functional abilities relevant to work requirements as defined by the Department of Labor for the Occupational Information System (OIS);
  3. Provide findings and conclusions regarding the collection of information and assessment of functional abilities relevant to work requirements.

As a guide for literature review, information and data gathering, public sessions, discussions, deliberations, and report development, including findings and conclusions, the committee shall consider the following specific topics:

1. Identify and describe ways to collect information about an individual’s physical and mental (cognitive and noncognitive) functional abilities relevant to work requirements as defined by the Bureau of Labor Statistics’ Occupational Requirements Survey (ORS), such as sitting/standing/walking, lifting/carrying, vision, communication, decision making, and adaptability.
• Provide an overview of the functional assessment processes in at least three similar benefit programs that assess disability or vocational capabilities (national and state government programs, private sector programs, and foreign programs as applicable);
• Provide examples of forms, tools, guides, examinations, and other resources used by benefit programs that assess functional aspects of disability and vocational capabilities.
• Identify activities of daily living that correlate with the physical and mental (cognitive and noncognitive) demands of work.
• Provide examples of how to collect information on activities of daily living that correlate with the physical and mental (cognitive and noncognitive) demands of work.
2. Discuss the types of information that support findings of limitations in functional abilities relevant to work requirements as defined by the Department of Labor for the Occupational Information System (OIS).
• Describe the laboratory findings, signs, or symptoms of impairments that support findings of limitations in functional abilities relevant to work requirements;
• Explain what information, including that which pertains to level of severity and duration, may be found in medical or other evidence to support a finding that a person is unable to sustain physical and mental work activities on an ongoing and independent basis in the context of functional limitations;
• Identify any quantifiable limitations that may preclude certain levels of work (including sedentary) and give examples of the evidence to demonstrate such limitations.
3. Provide findings and conclusions regarding the collection of information and assessment of functional abilities relevant to work requirements.
• Explain how limitations in functional abilities relevant to work requirements are more or less associated with particular mental or physical impairments;
• Identify particular medical specialties and allied health fields that are likely to have the training and expertise to perform functional assessments related to work requirements;
• Identify tools that signify a functional assessment was performed, and how likely those reports are to be valid representations of a claimant’s functional limitations;
• In the context of disability assessment, describe the spectrum of changes to functional abilities relevant to work requirements related to the progression of common disease processes in example impairments. These could include, but are not limited to back disorders, cardiac impairments, or depression.
o Identify where along the spectrum an individual’s ability to perform functions relevant to work requirements is affected;
o Describe whether SSA could expect improvement, no improvement, or progressive worsening in the example impairments;
o Describe when significant changes in functional abilities relevant to work requirements may occur through the aging process for these examples, such as for adults with common age-related physical and mental impairments;
o Describe the efficacy of medications and other treatments on an individual’s ability to perform functional abilities relevant to work requirements for these examples, and whether that treatment causes its own subset of medical and/or psychological problems that negatively affect an individual’s functioning and how SSA could request an appropriate assessment of functional changes;
o Describe how the examples are similar to or different from other impairments.
• Discuss the advantages and disadvantages of generic functional assessment questionnaires that address a broad range of impairments and functional abilities relevant to work requirements, and targeted impairment-specific questionnaires, along with considerations in their use;
• Describe the best ways to determine the accuracy and validity of self-reported functional abilities, for example asking for input over the course of the claimant’s interactions with SSA and comparing for consistency.

Collaborators

Committee

Chair

Member

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Sponsors

Social Security Administration

Staff

Carol Spicer

Lead

Tom Cartaxo

Jennifer Flaubert

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