# SSR 11-2p: SSR 11-2p: Titles II and XVI: Documenting and Evaluating Disability in Young Adults

> Federal · Rulings · In force

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_11_2p

## Section

- **Citation:** SSR 11-2p
- **Heading:** SSR 11-2p: Titles II and XVI: Documenting and Evaluating Disability in Young Adults
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / DI / Disability Insurance — Medical / SSR 11-2p

## Text

Effective Date: September 12, 2011 Publication Date: September 12, 2011 Federal Register Vol. 76, No. 176, page 56263

POLICY INTERPRETATION RULING

Purpose : This SSR consolidates
information from our regulations on
documenting and evaluating disability in young adults. We also provide
guidance on how we apply our policies when we determine whether a young
adult is disabled under our rules.

Citations (Authority): Sections 216(i) , 222(c) , 223(a) , 223(c) , 223(d) , 223(f) , 225(b) , 1614(a)(3) , 1614(a)(4) , 1619 , and 1631(a) of the Social Security Act, as amended; Regulations No. 4, subpart B, section 404.130 ; subpart D, sections 404.316 , 404.327 - 404.330 , 404.339 - 404.340 , 404.348 , 404.350 , 404.352 , and 404.354 ; subpart P, sections 404.1505 , 404.1509 - 404.1510 , 404.1513 , 404.1520 - 404.1521 , 404.1525 - 404.1527 , 404.1545 - 404.1546 , 404.1560 - 404.1569a , 404.1571 - 404.1576 , 404.1584 , 404.1590 , 404.1594 , appendix 1 and appendix 2 ; and
Regulations No. 16, subpart I, sections 416.902 , 416.905 , 416.909 - 416.910 , 416.913 , 416.920 - 416.921 , 416.924a , 416.925 - 416.927 , 416.945 - 416.946 , 416.960 - 416.969a , 416.971 - 416.976 , 416.987 , 416.990 , and 416.994 , and
subpart M, sections 416.1320 , 416.1331 , and 416.1338 .

Introduction :

We consider people between the ages of 18 to approximately 25 to
be young adults. When we make disability determinations or decisions
for young adults, we use the same definition for disability as we do for
other adults. [1] We also use adult rules to make disability determinations
or decisions in several other situations:

- When a young adult files a claim for child [2] benefits on a parent's record based on a disability that began before he or she
attained age 22;

- When a child [3] who is receiving title XVI childhood disability
benefits attains age 18 and must undergo a disability
redetermination; [4] and
] We also use adult rules to make disability determinations
or decisions in several other situations:

- When a young adult files a claim for child [2] benefits on a parent's record based on a disability that began before he or she
attained age 22;

- When a child [3] who is receiving title XVI childhood disability
benefits attains age 18 and must undergo a disability
redetermination; [4] and

- When a young adult receiving disability benefits under title II
or XVI undergoes a continuing disability review (CDR) to determine
whether he or she is still disabled. [5]

When a young adult files a claim for child [2] benefits on a parent's record based on a disability that began before he or she
attained age 22;

When a child [3] who is receiving title XVI childhood disability
benefits attains age 18 and must undergo a disability
redetermination; [4] and

When a young adult receiving disability benefits under title II
or XVI undergoes a continuing disability review (CDR) to determine
whether he or she is still disabled. [5]

Like other adults, a young adult who applies for disability
benefits under title II or XVI [6] is "disabled"
if he or she has a medically determinable physical or mental
impairment(s) [7] that results in "an inability to do any substantial gainful
activity." [8]

We use a five-step sequential evaluation process to determine
disability:

- Is the person engaging in substantial gainful activity (SGA)? [9] If yes, the person is not disabled.

- Does the person have a medically determinable physical or
mental impairment(s) that is severe? [10] If no, the person is not disabled.

- Does the person have an impairment(s) that meets or medically
equals a listing in the Listing of Impairments (listings)? [11] If yes and the impairment(s) meets the duration requirement,
the person is disabled.
GA)? [9] If yes, the person is not disabled.

- Does the person have a medically determinable physical or
mental impairment(s) that is severe? [10] If no, the person is not disabled.

- Does the person have an impairment(s) that meets or medically
equals a listing in the Listing of Impairments (listings)? [11] If yes and the impairment(s) meets the duration requirement,
the person is disabled.

- Does the person have the residual functional capacity (RFC) [12] to do past relevant work? If yes, the person is not disabled. Does the person have the RFC to adjust to other work that
exists in significant numbers in the national economy, considering his
or her age, education, and previous work
experience? [13] If no, the person is disabled.
If yes, the person is not disabled. [14]

Is the person engaging in substantial gainful activity (SGA)? [9] If yes, the person is not disabled.

Does the person have a medically determinable physical or
mental impairment(s) that is severe? [10] If no, the person is not disabled.

Does the person have an impairment(s) that meets or medically
equals a listing in the Listing of Impairments (listings)? [11] If yes and the impairment(s) meets the duration requirement,
the person is disabled.

Does the person have the residual functional capacity (RFC) [12] to do past relevant work? If yes, the person is not disabled. Does the person have the RFC to adjust to other work that
exists in significant numbers in the national economy, considering his
or her age, education, and previous work
experience? [13] If no, the person is disabled.
If yes, the person is not disabled. [14]

Does the person have the RFC to adjust to other work that
exists in significant numbers in the national economy, considering his
or her age, education, and previous work
experience? [13] If no, the person is disabled.
If yes, the person is not disabled. [14]
or her age, education, and previous work
experience? [13] If no, the person is disabled.
If yes, the person is not disabled. [14]

Does the person have the RFC to adjust to other work that
exists in significant numbers in the national economy, considering his
or her age, education, and previous work
experience? [13] If no, the person is disabled.
If yes, the person is not disabled. [14]

This SSR explains the evidence we need to document a young
adult's impairment-related limitations, other considerations for
evaluating limitations, disability insured status, issues related to the
sequential evaluation process, and resolving inconsistencies in the
evidence. We also discuss continued payments for young adults
participating in vocational rehabilitation plans.

Policy Interpretation

The abilities, skills, and behaviors that young adults use to do basic
work activities are essentially the same as those that older
adolescents [15] use for age-appropriate activities. [16] Thus, the evidence we consider when we make disability determinations for
young adults is
generally the same as, or similar to, the evidence we consider for
making disability determinations for older adolescents under title XVI.
Because the abilities, skills, and behaviors are essentially the same,
the same considerations for evaluating limitations in an older
adolescent also apply to young adults.

I. Sources of evidence about a young adult's ability
to work

Once we have evidence from an acceptable medical source [17] that
establishes the existence of at least one medically determinable
impairment (MDI), we consider all relevant evidence in the case record
to determine whether a young adult is disabled. This evidence may come
from acceptable medical sources and from a wide variety of "other
sources." [18] Although
we always need evidence from an acceptable medical
source, we will determine what other evidence we need based on the facts
of the case.
medically determinable
impairment (MDI), we consider all relevant evidence in the case record
to determine whether a young adult is disabled. This evidence may come
from acceptable medical sources and from a wide variety of "other
sources." [18] Although
we always need evidence from an acceptable medical
source, we will determine what other evidence we need based on the facts
of the case.

- Medical sources In addition to providing evidence establishing an MDI,
acceptable medical sources can provide information about how an
impairment(s) affects a young adult's ability to do work-related
activities. For example, a physician might discuss the impact of asthma
on a young adult's participation in physical activities, or a
speech-language pathologist might discuss how a language disorder
contributes to limited attention and problems on a job. We may receive evidence from other medical sources who are
not "acceptable medical sources," such as nurse-practitioners,
physicians' assistants, naturopaths, chiropractors, audiologists,
occupational therapists (OTs), physical therapists (PTs), and
psychiatric social workers (PSWs). We cannot use evidence from these
sources to establish that a young adult has an MDI. However, we can use
evidence from these sources to determine the severity of the
impairment(s) and how it affects the young adult's ability to do
work-related activities. This evidence can be very helpful, especially
if a source sees the young adult regularly. For example: A PSW might comment on the young adult's ability to deal with
changes in a routine work setting. An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk. An OT might comment on the young adult's ability to use fine
motor skills to use a computer.
For example: A PSW might comment on the young adult's ability to deal with
changes in a routine work setting. An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk. An OT might comment on the young adult's ability to use fine
motor skills to use a computer.

- Non-Medical Sources. Evidence from other sources who are not
medical sources, but who know and have contact with the young adult, can
also help us evaluate the severity and impact of a young adult's
impairment(s). These sources include family members, educational
personnel (for example, teachers and counselors), public and private
social welfare agency personnel, and others (for example, friends,
neighbors, and clergy). Therefore, we consider evidence in the case
record from non-medical sources when we determine the severity of the
young adult's impairment(s) and how the young adult is able to function.

- School programs Evidence from school programs, including secondary and
post-secondary schools, can also help us evaluate the severity and
impact of a young adult's impairment(s). Many young adults who received special education (including
transition services) or related services [19] before they attained age 18
continue to receive these services until they are age 22. Other young
adults may participate in postsecondary programs, including college or
vocational training. [20] Young adults who receive special education services after age
17 will have an Individualized Education Program (IEP), [21] including an
IEP transition plan. The IEP transition plan describes a student's
levels of functioning based on reasonable estimates by both the student
and the special education team. It also identifies the kinds of
vocational and living skills the young adult needs to develop in order
to function independently as an adult
fter age
17 will have an Individualized Education Program (IEP), [21] including an
IEP transition plan. The IEP transition plan describes a student's
levels of functioning based on reasonable estimates by both the student
and the special education team. It also identifies the kinds of
vocational and living skills the young adult needs to develop in order
to function independently as an adult. The IEP transition goals may range from the development of
skills appropriate to supervised and supported work and living settings
to those needed in independent work and living situations. For example,
an IEP transition goal for an 18-year-old might be, "The student will
independently use public transportation," while specific objectives
would identify the skills to be developed (for example, reading a bus
schedule) and the particular instruction methods to be used to develop
the skills (for example, one-to-one tutoring with practice reading a bus
schedule). The goals in an IEP may be set at a level that the young adult
can readily achieve to foster a sense of accomplishment and may be lower
than what would be expected of a young adult without impairments. In
this regard: A young adult who achieves a goal may or may not have
limitations. The young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low. A young adult who does not achieve a goal likely has an
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

Medical sources
e young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low. A young adult who does not achieve a goal likely has an
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

Medical sources

- In addition to providing evidence establishing an MDI,
acceptable medical sources can provide information about how an
impairment(s) affects a young adult's ability to do work-related
activities. For example, a physician might discuss the impact of asthma
on a young adult's participation in physical activities, or a
speech-language pathologist might discuss how a language disorder
contributes to limited attention and problems on a job.

- We may receive evidence from other medical sources who are
not "acceptable medical sources," such as nurse-practitioners,
physicians' assistants, naturopaths, chiropractors, audiologists,
occupational therapists (OTs), physical therapists (PTs), and
psychiatric social workers (PSWs). We cannot use evidence from these
sources to establish that a young adult has an MDI. However, we can use
evidence from these sources to determine the severity of the
impairment(s) and how it affects the young adult's ability to do
work-related activities. This evidence can be very helpful, especially
if a source sees the young adult regularly. For example: A PSW might comment on the young adult's ability to deal with
changes in a routine work setting. An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk. An OT might comment on the young adult's ability to use fine
motor skills to use a computer.
For example: A PSW might comment on the young adult's ability to deal with
changes in a routine work setting. An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk. An OT might comment on the young adult's ability to use fine
motor skills to use a computer.

In addition to providing evidence establishing an MDI,
acceptable medical sources can provide information about how an
impairment(s) affects a young adult's ability to do work-related
activities. For example, a physician might discuss the impact of asthma
on a young adult's participation in physical activities, or a
speech-language pathologist might discuss how a language disorder
contributes to limited attention and problems on a job.

We may receive evidence from other medical sources who are
not "acceptable medical sources," such as nurse-practitioners,
physicians' assistants, naturopaths, chiropractors, audiologists,
occupational therapists (OTs), physical therapists (PTs), and
psychiatric social workers (PSWs). We cannot use evidence from these
sources to establish that a young adult has an MDI. However, we can use
evidence from these sources to determine the severity of the
impairment(s) and how it affects the young adult's ability to do
work-related activities. This evidence can be very helpful, especially
if a source sees the young adult regularly. For example:

- A PSW might comment on the young adult's ability to deal with
changes in a routine work setting.

- An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk.

- An OT might comment on the young adult's ability to use fine
motor skills to use a computer.

A PSW might comment on the young adult's ability to deal with
changes in a routine work setting.
ting.

- An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk.

- An OT might comment on the young adult's ability to use fine
motor skills to use a computer.

A PSW might comment on the young adult's ability to deal with
changes in a routine work setting.

An OT or PT might evaluate the impact of a neurological disorder
on the young adult's activities and comment on muscle tone and strength
and how it affects his or her ability to stand and walk.

An OT might comment on the young adult's ability to use fine
motor skills to use a computer.

Non-Medical Sources.

Evidence from other sources who are not
medical sources, but who know and have contact with the young adult, can
also help us evaluate the severity and impact of a young adult's
impairment(s). These sources include family members, educational
personnel (for example, teachers and counselors), public and private
social welfare agency personnel, and others (for example, friends,
neighbors, and clergy). Therefore, we consider evidence in the case
record from non-medical sources when we determine the severity of the
young adult's impairment(s) and how the young adult is able to function.

School programs

Evidence from school programs, including secondary and
post-secondary schools, can also help us evaluate the severity and
impact of a young adult's impairment(s).

- Many young adults who received special education (including
transition services) or related services [19] before they attained age 18
continue to receive these services until they are age 22. Other young
adults may participate in postsecondary programs, including college or
vocational training. [20]
chools, can also help us evaluate the severity and
impact of a young adult's impairment(s).

- Many young adults who received special education (including
transition services) or related services [19] before they attained age 18
continue to receive these services until they are age 22. Other young
adults may participate in postsecondary programs, including college or
vocational training. [20]

- Young adults who receive special education services after age
17 will have an Individualized Education Program (IEP), [21] including an
IEP transition plan. The IEP transition plan describes a student's
levels of functioning based on reasonable estimates by both the student
and the special education team. It also identifies the kinds of
vocational and living skills the young adult needs to develop in order
to function independently as an adult.

- The IEP transition goals may range from the development of
skills appropriate to supervised and supported work and living settings
to those needed in independent work and living situations. For example,
an IEP transition goal for an 18-year-old might be, "The student will
independently use public transportation," while specific objectives
would identify the skills to be developed (for example, reading a bus
schedule) and the particular instruction methods to be used to develop
the skills (for example, one-to-one tutoring with practice reading a bus
schedule).
living situations. For example,
an IEP transition goal for an 18-year-old might be, "The student will
independently use public transportation," while specific objectives
would identify the skills to be developed (for example, reading a bus
schedule) and the particular instruction methods to be used to develop
the skills (for example, one-to-one tutoring with practice reading a bus
schedule).

- The goals in an IEP may be set at a level that the young adult
can readily achieve to foster a sense of accomplishment and may be lower
than what would be expected of a young adult without impairments. In
this regard: A young adult who achieves a goal may or may not have
limitations. The young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low. A young adult who does not achieve a goal likely has an
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

Many young adults who received special education (including
transition services) or related services [19] before they attained age 18
continue to receive these services until they are age 22. Other young
adults may participate in postsecondary programs, including college or
vocational training. [20]

Young adults who receive special education services after age
17 will have an Individualized Education Program (IEP), [21] including an
IEP transition plan. The IEP transition plan describes a student's
levels of functioning based on reasonable estimates by both the student
and the special education team. It also identifies the kinds of
vocational and living skills the young adult needs to develop in order
to function independently as an adult.
ter age
17 will have an Individualized Education Program (IEP), [21] including an
IEP transition plan. The IEP transition plan describes a student's
levels of functioning based on reasonable estimates by both the student
and the special education team. It also identifies the kinds of
vocational and living skills the young adult needs to develop in order
to function independently as an adult.

The IEP transition goals may range from the development of
skills appropriate to supervised and supported work and living settings
to those needed in independent work and living situations. For example,
an IEP transition goal for an 18-year-old might be, "The student will
independently use public transportation," while specific objectives
would identify the skills to be developed (for example, reading a bus
schedule) and the particular instruction methods to be used to develop
the skills (for example, one-to-one tutoring with practice reading a bus
schedule).

The goals in an IEP may be set at a level that the young adult
can readily achieve to foster a sense of accomplishment and may be lower
than what would be expected of a young adult without impairments. In
this regard:

- A young adult who achieves a goal may or may not have
limitations. The young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low.

- A young adult who does not achieve a goal likely has an
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

A young adult who achieves a goal may or may not have
limitations. The young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low.
n
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

A young adult who achieves a goal may or may not have
limitations. The young adult may be developing or acquiring skills at a
slower rate than young adults without impairments and may have achieved
the goal simply because it was set low.

A young adult who does not achieve a goal likely has an
impairment-related limitation(s). A young adult's failure to achieve a
goal, however, does not, by itself, establish that the impairment(s) is disabling .

II. Considerations Related to Evaluating a Young
Adult's Impairment-Related Limitations

We evaluate a young adult's impairment-related limitations when
we:

- Determine whether his or her MDI(s) is "severe"? that is,
significantly limits his or her physical or mental ability to do basic
work activities;

- Determine whether his or her MDI(s) meets or medically equals a
listed impairment; and

- Assess his or her RFC.

Determine whether his or her MDI(s) is "severe"? that is,
significantly limits his or her physical or mental ability to do basic
work activities;

Determine whether his or her MDI(s) meets or medically equals a
listed impairment; and

Assess his or her RFC.

The examples in the sections below do not necessarily establish
that a young adult is disabled, only that the person may have
limitations that affect what work he or she may be able to do.
t is,
significantly limits his or her physical or mental ability to do basic
work activities;

Determine whether his or her MDI(s) meets or medically equals a
listed impairment; and

Assess his or her RFC.

The examples in the sections below do not necessarily establish
that a young adult is disabled, only that the person may have
limitations that affect what work he or she may be able to do.

- Evidence Regarding Functioning From Educational
Programs As we discussed in section I.C above, we may have evidence about a
young adult's functioning from school programs, including IEPs. This
evidence may indicate how well a young adult can use his or her physical
or mental abilities to perform work activities. The following examples
of school-reported difficulties might indicate difficulty with work
activities: Difficulty in understanding, remembering, and carrying out
simple instructions and work procedures during a school-sponsored work
experience; Difficulty communicating spontaneously and appropriately in the
classroom; Difficulty with maintaining attention for extended periods in a
classroom; Difficulty relating to authority figures and responding
appropriately to correction or criticism during school or a work-study
experience; Difficulty using motor skills to move from one classroom to
another.

- Community Experiences, Including Job Placements A young adult may receive services in a community setting(s)
through a school or a community agency, such as a mental health center
or vocational rehabilitation agency. These services may include: Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills)
ob Placements A young adult may receive services in a community setting(s)
through a school or a community agency, such as a mental health center
or vocational rehabilitation agency. These services may include: Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills). On-the-job training (OJT) , or placement in various work sites in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming). Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits. A young adult may participate in several—or even many—OJT or
work experience placements that are unpaid, paid at SGA levels, or paid
at less than SGA levels. Some young adults have multiple placements as
part of a transition plan that expose them to a variety of work
settings. Other young adults have multiple placements because of
unsatisfactory performance. Regardless of whether the work was SGA, information about how well
a young adult performed in these placements can help us assess how the
young adult functions. For example, a young adult who was unable to
sustain OJT placements may have limitations in the ability to understand
and remember instructions or to persist at work-related tasks. In
contrast, a young adult who performed OJT placements successfully may
have a good ability to respond appropriately to supervision. In
addition, information about the degree to which a young adult needs
special supports in order to work (such as in supported or transitional
employment programs) may also help us assess the young adult's
functioning.
ions or to persist at work-related tasks. In
contrast, a young adult who performed OJT placements successfully may
have a good ability to respond appropriately to supervision. In
addition, information about the degree to which a young adult needs
special supports in order to work (such as in supported or transitional
employment programs) may also help us assess the young adult's
functioning.

- Psychosocial Supports and Highly Structured or
Supportive Settings As for all adults, psychosocial supports and highly structured
or supportive settings may reduce the demands on a young adult and help
him or her function. However, the young adult's ability to function in
settings that are less demanding, more structured, or more supportive
than those in which people typically work does not necessarily show how
the young adult will be able to function in a work setting. We will
consider the kind and extent of support or assistance and the
characteristics of any structured setting in which the young adult
spends his or her time when we evaluate the effects of his or her
impairment(s) on functioning.

- Extra Help and Accommodations Working requires a person to be able to do the tasks of a job
independently, appropriately, effectively, and on a sustained basis. In
this regard, the analysis for adult disability determination purposes is
similar to our "extra help" rules for children. [22] If an adult with an
impairment(s) needs or would need greater supervision or assistance, or
some other type of accommodation, because of the impairment(s) than an
employee who does not have an impairment, the adult has a work-related
limitation. We consider how independently a young adult is able to function,
including whether the young adult needs help from other people or
special equipment, devices, or medications to perform day-to-day
activities
ter supervision or assistance, or
some other type of accommodation, because of the impairment(s) than an
employee who does not have an impairment, the adult has a work-related
limitation. We consider how independently a young adult is able to function,
including whether the young adult needs help from other people or
special equipment, devices, or medications to perform day-to-day
activities. If a young adult can function only if he or she receives
more help than would generally be provided to people without medical
impairments, we consider how well the young adult would function without
the extra help. The more extra help or support of any kind that a young
adult receives because of his or her impairment(s), the less independent
he or she is in functioning, and the more severe we will find the
limitation to be. Accommodations Accommodations are practices and procedures that allow a
person to complete the same activity or task as other people.
Accommodations can include a change in setting, timing, or scheduling,
or an assistive or adaptive device. Some young adults with impairments need accommodations in
their educational program in order to participate in the general
curriculum or in a transitional program. [23] The fact that a young adult
receives or has received accommodations as a part of his or her IEP or
Section 504 plan, [24] may
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting. Some accommodations may indicate an impairment(s) that meets
or medically equals a listing
wing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting. Some accommodations may indicate an impairment(s) that meets
or medically equals a listing. For example, the need for an
augmentative or alternative communication or AAC device (for example, an
electronic picture board or an electrolarynx) might indicate a speech
impairment that meets listing 2.09 or an impairment that meets one of
the neurological listings in section 11.00 of the listings. When we determine whether a person can perform his or her
past relevant work, we do not consider potential accommodations unless
his or her employer actually made the accommodation. This means that we
cannot find that a young adult can do past relevant work with
accommodations unless the young adult actually performed that work with
those same accommodations and is still able to do so now. When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25] Effects of treatment, including medications Treatment, including medications, can have a positive effect on
a person's ability to function in a work setting. For example, a young
adult who takes an antidepressant medication may be able to interact
appropriately with supervisors and co-workers. Treatment, however, may
not resolve all of the functional limitations that result from an
impairment(s). Medications or other treatment may cause side effects
that affect the mental or physical ability to work
person's ability to function in a work setting. For example, a young
adult who takes an antidepressant medication may be able to interact
appropriately with supervisors and co-workers. Treatment, however, may
not resolve all of the functional limitations that result from an
impairment(s). Medications or other treatment may cause side effects
that affect the mental or physical ability to work. For example, an
anti-epileptic medication may cause drowsiness that affects the ability
to concentrate; daily chest percussion therapy for cystic fibrosis may
cause fatigue because of the physical effort involved in the therapy.
The frequency of a young adult's treatment may preclude him or her from
maintaining a full-time work schedule; that is, 8 hours a day, 5 days a
week on a sustained basis.

- Work-Related Stress Working involves many factors and demands that can be
stressful. For example, some people may experience stress related to
the demands of getting to work regularly, having work performance
supervised, or remaining in the workplace for a full day, 5 days a week
on a sustained basis. Moreover, one person's reaction to stress
associated with the demands of work may be different from another's,
even among people with the same impairments. Sources familiar with the young adult may provide insight
about the effect of stress on his or her physical or mental functioning
and what, if any, psychosocial supports or structure he or she would
need when experiencing work-related stress. [26] We consider
impairment-related limitations created by a person's response to the
demands of work when we assess RFC.

Evidence Regarding Functioning From Educational
Programs
ng adult may provide insight
about the effect of stress on his or her physical or mental functioning
and what, if any, psychosocial supports or structure he or she would
need when experiencing work-related stress. [26] We consider
impairment-related limitations created by a person's response to the
demands of work when we assess RFC.

Evidence Regarding Functioning From Educational
Programs

As we discussed in section I.C above, we may have evidence about a
young adult's functioning from school programs, including IEPs. This
evidence may indicate how well a young adult can use his or her physical
or mental abilities to perform work activities. The following examples
of school-reported difficulties might indicate difficulty with work
activities:

- Difficulty in understanding, remembering, and carrying out
simple instructions and work procedures during a school-sponsored work
experience;

- Difficulty communicating spontaneously and appropriately in the
classroom;

- Difficulty with maintaining attention for extended periods in a
classroom;

- Difficulty relating to authority figures and responding
appropriately to correction or criticism during school or a work-study
experience;

- Difficulty using motor skills to move from one classroom to
another.

Difficulty in understanding, remembering, and carrying out
simple instructions and work procedures during a school-sponsored work
experience;

Difficulty communicating spontaneously and appropriately in the
classroom;

Difficulty with maintaining attention for extended periods in a
classroom;

Difficulty relating to authority figures and responding
appropriately to correction or criticism during school or a work-study
experience;

Difficulty using motor skills to move from one classroom to
another.

Community Experiences, Including Job Placements
municating spontaneously and appropriately in the
classroom;

Difficulty with maintaining attention for extended periods in a
classroom;

Difficulty relating to authority figures and responding
appropriately to correction or criticism during school or a work-study
experience;

Difficulty using motor skills to move from one classroom to
another.

Community Experiences, Including Job Placements

- A young adult may receive services in a community setting(s)
through a school or a community agency, such as a mental health center
or vocational rehabilitation agency. These services may include: Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills). On-the-job training (OJT) , or placement in various work sites in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming). Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits.

- A young adult may participate in several—or even many—OJT or
work experience placements that are unpaid, paid at SGA levels, or paid
at less than SGA levels. Some young adults have multiple placements as
part of a transition plan that expose them to a variety of work
settings. Other young adults have multiple placements because of
unsatisfactory performance.
ood work
attitudes and habits.

- A young adult may participate in several—or even many—OJT or
work experience placements that are unpaid, paid at SGA levels, or paid
at less than SGA levels. Some young adults have multiple placements as
part of a transition plan that expose them to a variety of work
settings. Other young adults have multiple placements because of
unsatisfactory performance.

A young adult may receive services in a community setting(s)
through a school or a community agency, such as a mental health center
or vocational rehabilitation agency. These services may include: Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills). On-the-job training (OJT) , or placement in various work sites in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming). Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits.

- Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills).

- On-the-job training (OJT) , or placement in various work sites in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming).

- Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits.
es in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming).

- Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits.

Community-based instruction (CBI) , or instruction in a natural,
age-appropriate setting (for example, trips to the grocery store to
develop math, sequencing, travel, and social skills).

On-the-job training (OJT) , or placement in various work sites in
the community for vocational training and experience, frequently in an
"enclave" (small group) of students with a job coach (for example,
placement in an enclave in a motel to learn housekeeping tasks such as
bed-making and vacuuming).

Work experience , or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and good work
attitudes and habits.

A young adult may participate in several—or even many—OJT or
work experience placements that are unpaid, paid at SGA levels, or paid
at less than SGA levels. Some young adults have multiple placements as
part of a transition plan that expose them to a variety of work
settings. Other young adults have multiple placements because of
unsatisfactory performance.

Regardless of whether the work was SGA, information about how well
a young adult performed in these placements can help us assess how the
young adult functions. For example, a young adult who was unable to
sustain OJT placements may have limitations in the ability to understand
and remember instructions or to persist at work-related tasks. In
contrast, a young adult who performed OJT placements successfully may
have a good ability to respond appropriately to supervision
t performed in these placements can help us assess how the
young adult functions. For example, a young adult who was unable to
sustain OJT placements may have limitations in the ability to understand
and remember instructions or to persist at work-related tasks. In
contrast, a young adult who performed OJT placements successfully may
have a good ability to respond appropriately to supervision. In
addition, information about the degree to which a young adult needs
special supports in order to work (such as in supported or transitional
employment programs) may also help us assess the young adult's
functioning.

Psychosocial Supports and Highly Structured or
Supportive Settings

As for all adults, psychosocial supports and highly structured
or supportive settings may reduce the demands on a young adult and help
him or her function. However, the young adult's ability to function in
settings that are less demanding, more structured, or more supportive
than those in which people typically work does not necessarily show how
the young adult will be able to function in a work setting. We will
consider the kind and extent of support or assistance and the
characteristics of any structured setting in which the young adult
spends his or her time when we evaluate the effects of his or her
impairment(s) on functioning.

Extra Help and Accommodations

Working requires a person to be able to do the tasks of a job
independently, appropriately, effectively, and on a sustained basis. In
this regard, the analysis for adult disability determination purposes is
similar to our "extra help" rules for children. [22] If an adult with an
impairment(s) needs or would need greater supervision or assistance, or
some other type of accommodation, because of the impairment(s) than an
employee who does not have an impairment, the adult has a work-related
limitation.
a sustained basis. In
this regard, the analysis for adult disability determination purposes is
similar to our "extra help" rules for children. [22] If an adult with an
impairment(s) needs or would need greater supervision or assistance, or
some other type of accommodation, because of the impairment(s) than an
employee who does not have an impairment, the adult has a work-related
limitation.

We consider how independently a young adult is able to function,
including whether the young adult needs help from other people or
special equipment, devices, or medications to perform day-to-day
activities. If a young adult can function only if he or she receives
more help than would generally be provided to people without medical
impairments, we consider how well the young adult would function without
the extra help. The more extra help or support of any kind that a young
adult receives because of his or her impairment(s), the less independent
he or she is in functioning, and the more severe we will find the
limitation to be.

- Accommodations Accommodations are practices and procedures that allow a
person to complete the same activity or task as other people.
Accommodations can include a change in setting, timing, or scheduling,
or an assistive or adaptive device. Some young adults with impairments need accommodations in
their educational program in order to participate in the general
curriculum or in a transitional program. [23] The fact that a young adult
receives or has received accommodations as a part of his or her IEP or
Section 504 plan, [24] may
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting
y
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting. Some accommodations may indicate an impairment(s) that meets
or medically equals a listing. For example, the need for an
augmentative or alternative communication or AAC device (for example, an
electronic picture board or an electrolarynx) might indicate a speech
impairment that meets listing 2.09 or an impairment that meets one of
the neurological listings in section 11.00 of the listings. When we determine whether a person can perform his or her
past relevant work, we do not consider potential accommodations unless
his or her employer actually made the accommodation. This means that we
cannot find that a young adult can do past relevant work with
accommodations unless the young adult actually performed that work with
those same accommodations and is still able to do so now. When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25]
erformed that work with
those same accommodations and is still able to do so now. When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25]

- Effects of treatment, including medications Treatment, including medications, can have a positive effect on
a person's ability to function in a work setting. For example, a young
adult who takes an antidepressant medication may be able to interact
appropriately with supervisors and co-workers. Treatment, however, may
not resolve all of the functional limitations that result from an
impairment(s). Medications or other treatment may cause side effects
that affect the mental or physical ability to work. For example, an
anti-epileptic medication may cause drowsiness that affects the ability
to concentrate; daily chest percussion therapy for cystic fibrosis may
cause fatigue because of the physical effort involved in the therapy.
The frequency of a young adult's treatment may preclude him or her from
maintaining a full-time work schedule; that is, 8 hours a day, 5 days a
week on a sustained basis.

Accommodations

- Accommodations are practices and procedures that allow a
person to complete the same activity or task as other people.
Accommodations can include a change in setting, timing, or scheduling,
or an assistive or adaptive device.
oung adult's treatment may preclude him or her from
maintaining a full-time work schedule; that is, 8 hours a day, 5 days a
week on a sustained basis.

Accommodations

- Accommodations are practices and procedures that allow a
person to complete the same activity or task as other people.
Accommodations can include a change in setting, timing, or scheduling,
or an assistive or adaptive device.

- Some young adults with impairments need accommodations in
their educational program in order to participate in the general
curriculum or in a transitional program. [23] The fact that a young adult
receives or has received accommodations as a part of his or her IEP or
Section 504 plan, [24] may
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting.

- Some accommodations may indicate an impairment(s) that meets
or medically equals a listing. For example, the need for an
augmentative or alternative communication or AAC device (for example, an
electronic picture board or an electrolarynx) might indicate a speech
impairment that meets listing 2.09 or an impairment that meets one of
the neurological listings in section 11.00 of the listings.

- When we determine whether a person can perform his or her
past relevant work, we do not consider potential accommodations unless
his or her employer actually made the accommodation. This means that we
cannot find that a young adult can do past relevant work with
accommodations unless the young adult actually performed that work with
those same accommodations and is still able to do so now.
- When we determine whether a person can perform his or her
past relevant work, we do not consider potential accommodations unless
his or her employer actually made the accommodation. This means that we
cannot find that a young adult can do past relevant work with
accommodations unless the young adult actually performed that work with
those same accommodations and is still able to do so now.

- When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25]

Accommodations are practices and procedures that allow a
person to complete the same activity or task as other people.
Accommodations can include a change in setting, timing, or scheduling,
or an assistive or adaptive device.

Some young adults with impairments need accommodations in
their educational program in order to participate in the general
curriculum or in a transitional program. [23] The fact that a young adult
receives or has received accommodations as a part of his or her IEP or
Section 504 plan, [24] may
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting.
be an indication that he or she has a
work-related limitation. For example, evidence showing that a student
requires an audiotape recording of oral directions for replay at school
because he cannot remember more than a one-step instruction might
indicate that the student will have the same inability to remember more
than a one-step instruction without special assistance in a work
setting.

Some accommodations may indicate an impairment(s) that meets
or medically equals a listing. For example, the need for an
augmentative or alternative communication or AAC device (for example, an
electronic picture board or an electrolarynx) might indicate a speech
impairment that meets listing 2.09 or an impairment that meets one of
the neurological listings in section 11.00 of the listings.

When we determine whether a person can perform his or her
past relevant work, we do not consider potential accommodations unless
his or her employer actually made the accommodation. This means that we
cannot find that a young adult can do past relevant work with
accommodations unless the young adult actually performed that work with
those same accommodations and is still able to do so now.

When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25]

Effects of treatment, including medications
ions and is still able to do so now.

When we determine whether a person can do other work that
exists in significant numbers in the national economy, we do not
consider whether he or she could do so with accommodations, even if an
employer would be required to provide reasonable accommodations under
the Americans with Disabilities Act of 1990. [25]

Effects of treatment, including medications

Treatment, including medications, can have a positive effect on
a person's ability to function in a work setting. For example, a young
adult who takes an antidepressant medication may be able to interact
appropriately with supervisors and co-workers. Treatment, however, may
not resolve all of the functional limitations that result from an
impairment(s). Medications or other treatment may cause side effects
that affect the mental or physical ability to work. For example, an
anti-epileptic medication may cause drowsiness that affects the ability
to concentrate; daily chest percussion therapy for cystic fibrosis may
cause fatigue because of the physical effort involved in the therapy.
The frequency of a young adult's treatment may preclude him or her from
maintaining a full-time work schedule; that is, 8 hours a day, 5 days a
week on a sustained basis.

Work-Related Stress

- Working involves many factors and demands that can be
stressful. For example, some people may experience stress related to
the demands of getting to work regularly, having work performance
supervised, or remaining in the workplace for a full day, 5 days a week
on a sustained basis. Moreover, one person's reaction to stress
associated with the demands of work may be different from another's,
even among people with the same impairments.
at can be
stressful. For example, some people may experience stress related to
the demands of getting to work regularly, having work performance
supervised, or remaining in the workplace for a full day, 5 days a week
on a sustained basis. Moreover, one person's reaction to stress
associated with the demands of work may be different from another's,
even among people with the same impairments.

- Sources familiar with the young adult may provide insight
about the effect of stress on his or her physical or mental functioning
and what, if any, psychosocial supports or structure he or she would
need when experiencing work-related stress. [26] We consider
impairment-related limitations created by a person's response to the
demands of work when we assess RFC.

Working involves many factors and demands that can be
stressful. For example, some people may experience stress related to
the demands of getting to work regularly, having work performance
supervised, or remaining in the workplace for a full day, 5 days a week
on a sustained basis. Moreover, one person's reaction to stress
associated with the demands of work may be different from another's,
even among people with the same impairments.

Sources familiar with the young adult may provide insight
about the effect of stress on his or her physical or mental functioning
and what, if any, psychosocial supports or structure he or she would
need when experiencing work-related stress. [26] We consider
impairment-related limitations created by a person's response to the
demands of work when we assess RFC.

III. Insured status for young adults
familiar with the young adult may provide insight
about the effect of stress on his or her physical or mental functioning
and what, if any, psychosocial supports or structure he or she would
need when experiencing work-related stress. [26] We consider
impairment-related limitations created by a person's response to the
demands of work when we assess RFC.

III. Insured status for young adults

- When a young adult has worked, we consider whether he or she
is insured for purposes of establishing a period of disability or
becoming entitled to disability insurance benefits. While the Social
Security Act provides the standard for determining insured status for
young adults aged 21 up to age 24, there is no similar statutory
standard for young adults under the age of 21. We use the same rule for
both groups—a young adult meets the disability insured status
requirements if he or she has 6 quarters of coverage in the 12-quarter
period ending with the quarter in which the disability began. [27]

- When our records do not establish disability insured status but
the claimant alleges sufficient work and earnings for that purpose, we
will look to see if there are any covered earnings that are not yet
shown in our records. Covered earnings from an unsuccessful work
attempt may also provide work credits that can establish disability
insured status.

When a young adult has worked, we consider whether he or she
is insured for purposes of establishing a period of disability or
becoming entitled to disability insurance benefits. While the Social
Security Act provides the standard for determining insured status for
young adults aged 21 up to age 24, there is no similar statutory
standard for young adults under the age of 21. We use the same rule for
both groups—a young adult meets the disability insured status
requirements if he or she has 6 quarters of coverage in the 12-quarter
period ending with the quarter in which the disability began. [27]
t provides the standard for determining insured status for
young adults aged 21 up to age 24, there is no similar statutory
standard for young adults under the age of 21. We use the same rule for
both groups—a young adult meets the disability insured status
requirements if he or she has 6 quarters of coverage in the 12-quarter
period ending with the quarter in which the disability began. [27]

When our records do not establish disability insured status but
the claimant alleges sufficient work and earnings for that purpose, we
will look to see if there are any covered earnings that are not yet
shown in our records. Covered earnings from an unsuccessful work
attempt may also provide work credits that can establish disability
insured status.

IV. Determining disability

- Determining Whether a Young Adult's Work Activity is
SGA [28] When we determine a young adult's earnings for SGA purposes, we
count only those earnings that are attributable to his or her own
productivity. We assume that a young adult's reported earnings are
attributable to his or her own productivity unless there is evidence
indicating that those earnings are greater than would be attributable to
his or her productivity. Work activity Many young adults with disabilities have worked. The work
experience may have been (or may be, if the person is still working)
subsidized, in a sheltered setting, or performed under special
conditions. As for any adult, we exclude subsidized earnings. [29] In addition: Some young adults whose impairments arose during military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA
ring military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA. We will consider the actual work
activity, not the amount of pay the service person receives or the duty
status of the service person, when we determine whether the work is
SGA. [30] Young adults may have impairment-related work expenses; that is,
expenses for an item or service that directly enables a person to work
and that the person necessarily incurs because of an impairment(s). We
deduct impairment-related work expenses from a person's wages or
self-employment income before we determine whether the wages or
self-employment income constitute SGA. [31] Volunteer service Young adults with disabilities may participate in
government-sponsored programs for volunteer activity, such as AmeriCorps
VISTA. We do not count as earnings payments a person receives from some
of these programs. [32] Unsuccessful work attempts Some people have brief periods of work with earnings at the SGA
level. We will consider the possibility that a brief period of work was
an unsuccessful work attempt when we are determining whether the work
was SGA. If a period of work is an unsuccessful work attempt, we will
not consider that work to be SGA when we determine if the young adult is
under a disability. [33] However, as we noted in section III.A, covered
wages or self-employment income from an unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.
re determining whether the work
was SGA. If a period of work is an unsuccessful work attempt, we will
not consider that work to be SGA when we determine if the young adult is
under a disability. [33] However, as we noted in section III.A, covered
wages or self-employment income from an unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.

- Determining Whether the Young Adult Has an MDI(s) Young adults often have the same kinds of impairments as
children; for example, attention deficit/hyperactivity disorder,
language disorders, or learning disorders. Sometimes, the impairment
may be evident before age 18; at other times, the impairment may not be
identified until later. We will consider all MDIs the young adult has,
including MDIs that are usually found in children.

- Determining Whether a Young Adult Can Do Past
Relevant Work Many young adults have performed work that was SGA for at least
brief periods. This work will usually meet the 15-year recency test for
past relevant work. If the work also lasted long enough for the young
adult to learn to do it, it will be past relevant work. [34] We do not
consider work done during a period of entitlement to disability benefits
under title II or title XVI to be past relevant work; [35] however, we may
consider the young adult's job performance when we assess his or her
RFC.

- Determining Whether a Young Adult Can Adjust to
Other Work As for any adult, we consider a young adult's RFC, age,
education, and work experience to determine if he or she can make an
adjustment to other work. A young adult does not need to have an
impairment(s) that meets or medically equals a listing to qualify for
disability benefits. We may find that a young adult is disabled because
of an inability to adjust to other work
Adjust to
Other Work As for any adult, we consider a young adult's RFC, age,
education, and work experience to determine if he or she can make an
adjustment to other work. A young adult does not need to have an
impairment(s) that meets or medically equals a listing to qualify for
disability benefits. We may find that a young adult is disabled because
of an inability to adjust to other work. When a young adult has only exertional (strength) limitations
and has an RFC and vocational factors that match the criteria of a rule
in the Medical-Vocational Guidelines in appendix 2 of subpart P of the
Regulations No. 4 (grid rules), the grid rules always direct a decision
of "not disabled" for young adults. In many young adult cases, however, the grid rules will not
direct a conclusion of "disabled" or "not disabled." For example, many
young adults who qualify for disability benefits have impairments (such
as mental and neurological disorders) that cause non-exertional
limitations. These limitations may erode the occupational base at some,
or even all, levels of exertion. [36] Other young adults have solely
exertional limitations but are unable to do a full range of work in one
of the exertional categories in appendix 2. Some young adults have
limitations that prevent them from performing even the full range of
sedentary work. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply: If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule
k. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply: If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule.
In this case, the exertional capacity will always fall between two rules
(that is, a sedentary and a light rule) that direct a conclusion of "not
disabled." [37] If a young adult has solely nonexertional limitations or both
exertional and nonexertional limitations, we follow the guidance in the
regulations and the relevant SSRs to determine any erosion of the
occupational base. [38] If the occupational base is significantly eroded, we
will find the young adult disabled despite his or her young
age. [39] If a young adult has a substantial loss of one or more of the
basic mental demands of competitive, remunerative, unskilled work, the
occupational base will be significantly eroded, despite vocational
factors that we would ordinarily consider favorable (for example, young
age, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to: Understand, remember, and carry out instructions; Make simple work-related judgments typically required for unskilled
work; Respond appropriately to supervision, coworkers, and work
situations; and Deal with changes in a routine work setting. Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work. A young adult needs only basic communication abilities to do
unskilled work
es in a routine work setting. Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work. A young adult needs only basic communication abilities to do
unskilled work. [41] Basic communication abilities include the ability to
hear and understand simple oral messages, including instructions, and to
communicate simple messages orally. If the person has these basic
communication abilities, there will not be a significant impact on the
unskilled occupational base. Nevertheless, when a person has a physical or mental
impairment(s) that affects communication, it is important to consider
the nature of the impairment and whether the person has other associated
limitations. Many disorders that cause limitations in basic
communication may cause other limitations as well. For example, a
physical disorder like cerebral palsy that can affect a person's facial
muscles and limit the ability to communicate simple messages orally may
also affect the arm muscles and limit the ability to lift and carry.
Language disorders, as well as mental and neurological impairments
commonly found in young adults who allege disability, may also cause
limitations in abilities such as the ability to concentrate, persist, or
maintain pace in job tasks, and the ability to adapt to changes in a
work setting. Language disorders are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly
ders are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly. Under the grid rules, we find younger individuals not
disabled even if we determine that their vocational factor of education
is "illiterate." However, a young adult's educational level can be an
indication of an underlying impairment(s) that affects our assessment of
RFC. [42] For example,
if a young adult, despite having attended high
school, is illiterate or has a limited reading ability, he or she may
have an MDI, such as a learning disability or language disorder. Any
such underlying MDI may affect a young adult's RFC. As we noted in
Section III.F.4.b, these types of disorders can cause limitations in
many areas. When illiteracy or limited reading ability is related to an
MDI, we consider how the underlying MDI affects the person's ability to
meet the requirements of work when we assess RFC. For example, a person
who has borderline intellectual functioning (BIF) may be limited in her
ability to understand and remember instructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]
nstructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]

- Additional considerations for age-18 redeterminations Young adult previously found disabled as a child under a
listing. [44] Although our rules use different words to describe the
concept, "listing-level severity" is generally the same for both parts
A and B of the listings. Most of the part B listings have an equivalent
listing in part A, and many contain identical criteria. Listings that
include functioning among their criteria are generally based on a
standard of "extreme" limitation in a specific function (such as
walking) or in a broad area (domain) of functioning (such as
concentration, persistence, or pace), or on "marked" limitations in two
areas of functioning. While the areas of functioning may differ between analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45] Young adult previously found disabled as a child based on
functional equivalence. To functionally equal the listings under title XVI, a
child's impairment(s) must result in "marked" limitations in two of the
childhood domains or an "extreme" limitation in one. [46] Although we do
not use these domains for adults, they describe aspects of functioning
that are relevant to our evaluation of a young adult's work-related
limitations
as a child based on
functional equivalence. To functionally equal the listings under title XVI, a
child's impairment(s) must result in "marked" limitations in two of the
childhood domains or an "extreme" limitation in one. [46] Although we do
not use these domains for adults, they describe aspects of functioning
that are relevant to our evaluation of a young adult's work-related
limitations. We use similar domains when we evaluate a child's mental
impairments and some physical impairments, such as immune disorders. We
may find that the young adult has the same severity rating for a domain
under a part A listing as he or she had as a child under a similar
functional equivalence domain. For example, absent medical improvement
or new evidence demonstrating that the prior finding was in error, a
young adult who had an extreme limitation in the ability to interact and
relate with others as a child will probably have extreme limitation in
social functioning as an adult. Similarly, unless the impairment(s) has
improved or there is new evidence indicating that the prior finding was
in error, a finding of marked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult. The broad domains of functioning we used to evaluate a child's
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination. Accordingly, it is
important to remember that the descriptions of the childhood functional
equivalence domains in the regulations include work-related functions
for adolescents, defined as children age 12-18. [47]

Determining Whether a Young Adult's Work Activity is
SGA [28]
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination. Accordingly, it is
important to remember that the descriptions of the childhood functional
equivalence domains in the regulations include work-related functions
for adolescents, defined as children age 12-18. [47]

Determining Whether a Young Adult's Work Activity is
SGA [28]

When we determine a young adult's earnings for SGA purposes, we
count only those earnings that are attributable to his or her own
productivity. We assume that a young adult's reported earnings are
attributable to his or her own productivity unless there is evidence
indicating that those earnings are greater than would be attributable to
his or her productivity.

- Work activity Many young adults with disabilities have worked. The work
experience may have been (or may be, if the person is still working)
subsidized, in a sheltered setting, or performed under special
conditions. As for any adult, we exclude subsidized earnings. [29] In addition: Some young adults whose impairments arose during military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA. We will consider the actual work
activity, not the amount of pay the service person receives or the duty
status of the service person, when we determine whether the work is
SGA. [30] Young adults may have impairment-related work expenses; that is,
expenses for an item or service that directly enables a person to work
and that the person necessarily incurs because of an impairment(s)
do SGA. We will consider the actual work
activity, not the amount of pay the service person receives or the duty
status of the service person, when we determine whether the work is
SGA. [30] Young adults may have impairment-related work expenses; that is,
expenses for an item or service that directly enables a person to work
and that the person necessarily incurs because of an impairment(s). We
deduct impairment-related work expenses from a person's wages or
self-employment income before we determine whether the wages or
self-employment income constitute SGA. [31]

- Volunteer service Young adults with disabilities may participate in
government-sponsored programs for volunteer activity, such as AmeriCorps
VISTA. We do not count as earnings payments a person receives from some
of these programs. [32]

- Unsuccessful work attempts Some people have brief periods of work with earnings at the SGA
level. We will consider the possibility that a brief period of work was
an unsuccessful work attempt when we are determining whether the work
was SGA. If a period of work is an unsuccessful work attempt, we will
not consider that work to be SGA when we determine if the young adult is
under a disability. [33] However, as we noted in section III.A, covered
wages or self-employment income from an unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.

Work activity

Many young adults with disabilities have worked. The work
experience may have been (or may be, if the person is still working)
subsidized, in a sheltered setting, or performed under special
conditions. As for any adult, we exclude subsidized earnings. [29] In addition:
n unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.

Work activity

Many young adults with disabilities have worked. The work
experience may have been (or may be, if the person is still working)
subsidized, in a sheltered setting, or performed under special
conditions. As for any adult, we exclude subsidized earnings. [29] In addition:

- Some young adults whose impairments arose during military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA. We will consider the actual work
activity, not the amount of pay the service person receives or the duty
status of the service person, when we determine whether the work is
SGA. [30]

- Young adults may have impairment-related work expenses; that is,
expenses for an item or service that directly enables a person to work
and that the person necessarily incurs because of an impairment(s). We
deduct impairment-related work expenses from a person's wages or
self-employment income before we determine whether the wages or
self-employment income constitute SGA. [31]

Some young adults whose impairments arose during military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA
ring military
service continue on active duty and receive full pay while they are in
treatment for their impairments. They may also receive payments while
working in a designated therapy program or on limited duty. Active duty
status or receipt of pay (for example, sick pay) by a member of the
military does not indicate by itself that the service person has
demonstrated the ability to do SGA. We will consider the actual work
activity, not the amount of pay the service person receives or the duty
status of the service person, when we determine whether the work is
SGA. [30]

Young adults may have impairment-related work expenses; that is,
expenses for an item or service that directly enables a person to work
and that the person necessarily incurs because of an impairment(s). We
deduct impairment-related work expenses from a person's wages or
self-employment income before we determine whether the wages or
self-employment income constitute SGA. [31]

Volunteer service

Young adults with disabilities may participate in
government-sponsored programs for volunteer activity, such as AmeriCorps
VISTA. We do not count as earnings payments a person receives from some
of these programs. [32]

Unsuccessful work attempts

Some people have brief periods of work with earnings at the SGA
level. We will consider the possibility that a brief period of work was
an unsuccessful work attempt when we are determining whether the work
was SGA. If a period of work is an unsuccessful work attempt, we will
not consider that work to be SGA when we determine if the young adult is
under a disability. [33] However, as we noted in section III.A, covered
wages or self-employment income from an unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.

Determining Whether the Young Adult Has an MDI(s)
od of work is an unsuccessful work attempt, we will
not consider that work to be SGA when we determine if the young adult is
under a disability. [33] However, as we noted in section III.A, covered
wages or self-employment income from an unsuccessful work attempt may
provide work credits that establish disability insured status under
title II.

Determining Whether the Young Adult Has an MDI(s)

Young adults often have the same kinds of impairments as
children; for example, attention deficit/hyperactivity disorder,
language disorders, or learning disorders. Sometimes, the impairment
may be evident before age 18; at other times, the impairment may not be
identified until later. We will consider all MDIs the young adult has,
including MDIs that are usually found in children.

Determining Whether a Young Adult Can Do Past
Relevant Work

Many young adults have performed work that was SGA for at least
brief periods. This work will usually meet the 15-year recency test for
past relevant work. If the work also lasted long enough for the young
adult to learn to do it, it will be past relevant work. [34] We do not
consider work done during a period of entitlement to disability benefits
under title II or title XVI to be past relevant work; [35] however, we may
consider the young adult's job performance when we assess his or her
RFC.

Determining Whether a Young Adult Can Adjust to
Other Work

- As for any adult, we consider a young adult's RFC, age,
education, and work experience to determine if he or she can make an
adjustment to other work. A young adult does not need to have an
impairment(s) that meets or medically equals a listing to qualify for
disability benefits. We may find that a young adult is disabled because
of an inability to adjust to other work.
ust to
Other Work

- As for any adult, we consider a young adult's RFC, age,
education, and work experience to determine if he or she can make an
adjustment to other work. A young adult does not need to have an
impairment(s) that meets or medically equals a listing to qualify for
disability benefits. We may find that a young adult is disabled because
of an inability to adjust to other work.

- When a young adult has only exertional (strength) limitations
and has an RFC and vocational factors that match the criteria of a rule
in the Medical-Vocational Guidelines in appendix 2 of subpart P of the
Regulations No. 4 (grid rules), the grid rules always direct a decision
of "not disabled" for young adults.

- In many young adult cases, however, the grid rules will not
direct a conclusion of "disabled" or "not disabled." For example, many
young adults who qualify for disability benefits have impairments (such
as mental and neurological disorders) that cause non-exertional
limitations. These limitations may erode the occupational base at some,
or even all, levels of exertion. [36] Other young adults have solely
exertional limitations but are unable to do a full range of work in one
of the exertional categories in appendix 2. Some young adults have
limitations that prevent them from performing even the full range of
sedentary work. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply: If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule
k. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply: If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule.
In this case, the exertional capacity will always fall between two rules
(that is, a sedentary and a light rule) that direct a conclusion of "not
disabled." [37] If a young adult has solely nonexertional limitations or both
exertional and nonexertional limitations, we follow the guidance in the
regulations and the relevant SSRs to determine any erosion of the
occupational base. [38] If the occupational base is significantly eroded, we
will find the young adult disabled despite his or her young
age. [39] If a young adult has a substantial loss of one or more of the
basic mental demands of competitive, remunerative, unskilled work, the
occupational base will be significantly eroded, despite vocational
factors that we would ordinarily consider favorable (for example, young
age, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to: Understand, remember, and carry out instructions; Make simple work-related judgments typically required for unskilled
work; Respond appropriately to supervision, coworkers, and work
situations; and Deal with changes in a routine work setting. Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work.
priately to supervision, coworkers, and work
situations; and Deal with changes in a routine work setting. Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work.

- A young adult needs only basic communication abilities to do
unskilled work. [41] Basic communication abilities include the ability to
hear and understand simple oral messages, including instructions, and to
communicate simple messages orally. If the person has these basic
communication abilities, there will not be a significant impact on the
unskilled occupational base. Nevertheless, when a person has a physical or mental
impairment(s) that affects communication, it is important to consider
the nature of the impairment and whether the person has other associated
limitations. Many disorders that cause limitations in basic
communication may cause other limitations as well. For example, a
physical disorder like cerebral palsy that can affect a person's facial
muscles and limit the ability to communicate simple messages orally may
also affect the arm muscles and limit the ability to lift and carry.
Language disorders, as well as mental and neurological impairments
commonly found in young adults who allege disability, may also cause
limitations in abilities such as the ability to concentrate, persist, or
maintain pace in job tasks, and the ability to adapt to changes in a
work setting. Language disorders are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.
ers are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.

- Under the grid rules, we find younger individuals not
disabled even if we determine that their vocational factor of education
is "illiterate." However, a young adult's educational level can be an
indication of an underlying impairment(s) that affects our assessment of
RFC. [42] For example,
if a young adult, despite having attended high
school, is illiterate or has a limited reading ability, he or she may
have an MDI, such as a learning disability or language disorder. Any
such underlying MDI may affect a young adult's RFC. As we noted in
Section III.F.4.b, these types of disorders can cause limitations in
many areas. When illiteracy or limited reading ability is related to an
MDI, we consider how the underlying MDI affects the person's ability to
meet the requirements of work when we assess RFC. For example, a person
who has borderline intellectual functioning (BIF) may be limited in her
ability to understand and remember instructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]
nstructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]

As for any adult, we consider a young adult's RFC, age,
education, and work experience to determine if he or she can make an
adjustment to other work. A young adult does not need to have an
impairment(s) that meets or medically equals a listing to qualify for
disability benefits. We may find that a young adult is disabled because
of an inability to adjust to other work.

When a young adult has only exertional (strength) limitations
and has an RFC and vocational factors that match the criteria of a rule
in the Medical-Vocational Guidelines in appendix 2 of subpart P of the
Regulations No. 4 (grid rules), the grid rules always direct a decision
of "not disabled" for young adults.

In many young adult cases, however, the grid rules will not
direct a conclusion of "disabled" or "not disabled." For example, many
young adults who qualify for disability benefits have impairments (such
as mental and neurological disorders) that cause non-exertional
limitations. These limitations may erode the occupational base at some,
or even all, levels of exertion. [36] Other young adults have solely
exertional limitations but are unable to do a full range of work in one
of the exertional categories in appendix 2. Some young adults have
limitations that prevent them from performing even the full range of
sedentary work. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply:
t are unable to do a full range of work in one
of the exertional categories in appendix 2. Some young adults have
limitations that prevent them from performing even the full range of
sedentary work. In these cases, we consider the type and extent of the
young adult's limitations and the extent of the erosion of the
occupational base and other relevant factors. The following guidelines
apply:

- If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule.
In this case, the exertional capacity will always fall between two rules
(that is, a sedentary and a light rule) that direct a conclusion of "not
disabled." [37]

- If a young adult has solely nonexertional limitations or both
exertional and nonexertional limitations, we follow the guidance in the
regulations and the relevant SSRs to determine any erosion of the
occupational base. [38] If the occupational base is significantly eroded, we
will find the young adult disabled despite his or her young
age. [39]

- If a young adult has a substantial loss of one or more of the
basic mental demands of competitive, remunerative, unskilled work, the
occupational base will be significantly eroded, despite vocational
factors that we would ordinarily consider favorable (for example, young
age, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to: Understand, remember, and carry out instructions; Make simple work-related judgments typically required for unskilled
work; Respond appropriately to supervision, coworkers, and work
situations; and Deal with changes in a routine work setting.
ge, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to: Understand, remember, and carry out instructions; Make simple work-related judgments typically required for unskilled
work; Respond appropriately to supervision, coworkers, and work
situations; and Deal with changes in a routine work setting.

- Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work.

If the young adult has solely exertional limitations but is
able to do somewhat more than the full range of sedentary work, the
young adult will not be disabled based on a framework of a grid rule.
In this case, the exertional capacity will always fall between two rules
(that is, a sedentary and a light rule) that direct a conclusion of "not
disabled." [37]

If a young adult has solely nonexertional limitations or both
exertional and nonexertional limitations, we follow the guidance in the
regulations and the relevant SSRs to determine any erosion of the
occupational base. [38] If the occupational base is significantly eroded, we
will find the young adult disabled despite his or her young
age. [39]

If a young adult has a substantial loss of one or more of the
basic mental demands of competitive, remunerative, unskilled work, the
occupational base will be significantly eroded, despite vocational
factors that we would ordinarily consider favorable (for example, young
age, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to:

- Understand, remember, and carry out instructions;

- Make simple work-related judgments typically required for unskilled
work;
gnificantly eroded, despite vocational
factors that we would ordinarily consider favorable (for example, young
age, college education, and skilled work experience). [40] The basic mental
demands of competitive, remunerative, unskilled work include the
abilities to:

- Understand, remember, and carry out instructions;

- Make simple work-related judgments typically required for unskilled
work;

- Respond appropriately to supervision, coworkers, and work
situations; and

- Deal with changes in a routine work setting.

Understand, remember, and carry out instructions;

Make simple work-related judgments typically required for unskilled
work;

Respond appropriately to supervision, coworkers, and work
situations; and

Deal with changes in a routine work setting.

Adjudicators must remember that young adults are more likely
to have recent educational experience that provides for direct entry
into skilled work; some will also have vocational experiences (see
section C. above) that provide them with skills they can use in skilled
or semiskilled work.

A young adult needs only basic communication abilities to do
unskilled work. [41] Basic communication abilities include the ability to
hear and understand simple oral messages, including instructions, and to
communicate simple messages orally. If the person has these basic
communication abilities, there will not be a significant impact on the
unskilled occupational base.
or semiskilled work.

A young adult needs only basic communication abilities to do
unskilled work. [41] Basic communication abilities include the ability to
hear and understand simple oral messages, including instructions, and to
communicate simple messages orally. If the person has these basic
communication abilities, there will not be a significant impact on the
unskilled occupational base.

- Nevertheless, when a person has a physical or mental
impairment(s) that affects communication, it is important to consider
the nature of the impairment and whether the person has other associated
limitations. Many disorders that cause limitations in basic
communication may cause other limitations as well. For example, a
physical disorder like cerebral palsy that can affect a person's facial
muscles and limit the ability to communicate simple messages orally may
also affect the arm muscles and limit the ability to lift and carry.
Language disorders, as well as mental and neurological impairments
commonly found in young adults who allege disability, may also cause
limitations in abilities such as the ability to concentrate, persist, or
maintain pace in job tasks, and the ability to adapt to changes in a
work setting.

- Language disorders are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.
ers are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.

Nevertheless, when a person has a physical or mental
impairment(s) that affects communication, it is important to consider
the nature of the impairment and whether the person has other associated
limitations. Many disorders that cause limitations in basic
communication may cause other limitations as well. For example, a
physical disorder like cerebral palsy that can affect a person's facial
muscles and limit the ability to communicate simple messages orally may
also affect the arm muscles and limit the ability to lift and carry.
Language disorders, as well as mental and neurological impairments
commonly found in young adults who allege disability, may also cause
limitations in abilities such as the ability to concentrate, persist, or
maintain pace in job tasks, and the ability to adapt to changes in a
work setting.

Language disorders are not the only kinds of impairments
that can affect communication. Some physical impairments may also
affect communication, particularly speech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.

Under the grid rules, we find younger individuals not
disabled even if we determine that their vocational factor of education
is "illiterate."
peech. For example, congenital or
acquired facial deformities may affect speech because a person cannot
use his or her facial muscles for articulation; cerebral palsy may
affect speech because of muscle spasms that make it difficult to speak
clearly.

Under the grid rules, we find younger individuals not
disabled even if we determine that their vocational factor of education
is "illiterate."

- However, a young adult's educational level can be an
indication of an underlying impairment(s) that affects our assessment of
RFC. [42] For example,
if a young adult, despite having attended high
school, is illiterate or has a limited reading ability, he or she may
have an MDI, such as a learning disability or language disorder. Any
such underlying MDI may affect a young adult's RFC. As we noted in
Section III.F.4.b, these types of disorders can cause limitations in
many areas.

- When illiteracy or limited reading ability is related to an
MDI, we consider how the underlying MDI affects the person's ability to
meet the requirements of work when we assess RFC. For example, a person
who has borderline intellectual functioning (BIF) may be limited in her
ability to understand and remember instructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]
nstructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]

However, a young adult's educational level can be an
indication of an underlying impairment(s) that affects our assessment of
RFC. [42] For example,
if a young adult, despite having attended high
school, is illiterate or has a limited reading ability, he or she may
have an MDI, such as a learning disability or language disorder. Any
such underlying MDI may affect a young adult's RFC. As we noted in
Section III.F.4.b, these types of disorders can cause limitations in
many areas.

When illiteracy or limited reading ability is related to an
MDI, we consider how the underlying MDI affects the person's ability to
meet the requirements of work when we assess RFC. For example, a person
who has borderline intellectual functioning (BIF) may be limited in her
ability to understand and remember instructions, which results in an
inability to read and write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]

Additional considerations for age-18 redeterminations
write. The BIF also affects her ability to
maintain attention on tasks that she has difficulty remembering. When
we assess her RFC, we assess limitations in maintaining attention as
well as in understanding and remembering instructions. When we
determine whether she can do other work, we consider the vocational
factor of illiteracy. [43]

Additional considerations for age-18 redeterminations

- Young adult previously found disabled as a child under a
listing. [44] Although our rules use different words to describe the
concept, "listing-level severity" is generally the same for both parts
A and B of the listings. Most of the part B listings have an equivalent
listing in part A, and many contain identical criteria. Listings that
include functioning among their criteria are generally based on a
standard of "extreme" limitation in a specific function (such as
walking) or in a broad area (domain) of functioning (such as
concentration, persistence, or pace), or on "marked" limitations in two
areas of functioning. While the areas of functioning may differ between analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]
analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]

- Young adult previously found disabled as a child based on
functional equivalence. To functionally equal the listings under title XVI, a
child's impairment(s) must result in "marked" limitations in two of the
childhood domains or an "extreme" limitation in one. [46] Although we do
not use these domains for adults, they describe aspects of functioning
that are relevant to our evaluation of a young adult's work-related
limitations. We use similar domains when we evaluate a child's mental
impairments and some physical impairments, such as immune disorders. We
may find that the young adult has the same severity rating for a domain
under a part A listing as he or she had as a child under a similar
functional equivalence domain. For example, absent medical improvement
or new evidence demonstrating that the prior finding was in error, a
young adult who had an extreme limitation in the ability to interact and
relate with others as a child will probably have extreme limitation in
social functioning as an adult. Similarly, unless the impairment(s) has
improved or there is new evidence indicating that the prior finding was
in error, a finding of marked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult. The broad domains of functioning we used to evaluate a child's
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination
ked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult. The broad domains of functioning we used to evaluate a child's
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination. Accordingly, it is
important to remember that the descriptions of the childhood functional
equivalence domains in the regulations include work-related functions
for adolescents, defined as children age 12-18. [47]

Young adult previously found disabled as a child under a
listing. [44]

- Although our rules use different words to describe the
concept, "listing-level severity" is generally the same for both parts
A and B of the listings. Most of the part B listings have an equivalent
listing in part A, and many contain identical criteria. Listings that
include functioning among their criteria are generally based on a
standard of "extreme" limitation in a specific function (such as
walking) or in a broad area (domain) of functioning (such as
concentration, persistence, or pace), or on "marked" limitations in two
areas of functioning.

- While the areas of functioning may differ between analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]
analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]

Although our rules use different words to describe the
concept, "listing-level severity" is generally the same for both parts
A and B of the listings. Most of the part B listings have an equivalent
listing in part A, and many contain identical criteria. Listings that
include functioning among their criteria are generally based on a
standard of "extreme" limitation in a specific function (such as
walking) or in a broad area (domain) of functioning (such as
concentration, persistence, or pace), or on "marked" limitations in two
areas of functioning.

While the areas of functioning may differ between analogous listings
in parts A and B, we intend for these criteria to be equally severe.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]

Young adult previously found disabled as a child based on
functional equivalence.
vere.
Therefore, a child's impairment(s) that met or medically equaled a part
B listing will often meet or medically equal a part A listing at age 18
unless the impairment(s) has medically improved. Note though that we do
not use the medical improvement review standard for CDRs in age-18
redeterminations. [45]

Young adult previously found disabled as a child based on
functional equivalence.

- To functionally equal the listings under title XVI, a
child's impairment(s) must result in "marked" limitations in two of the
childhood domains or an "extreme" limitation in one. [46] Although we do
not use these domains for adults, they describe aspects of functioning
that are relevant to our evaluation of a young adult's work-related
limitations. We use similar domains when we evaluate a child's mental
impairments and some physical impairments, such as immune disorders. We
may find that the young adult has the same severity rating for a domain
under a part A listing as he or she had as a child under a similar
functional equivalence domain. For example, absent medical improvement
or new evidence demonstrating that the prior finding was in error, a
young adult who had an extreme limitation in the ability to interact and
relate with others as a child will probably have extreme limitation in
social functioning as an adult. Similarly, unless the impairment(s) has
improved or there is new evidence indicating that the prior finding was
in error, a finding of marked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult.
ion in
social functioning as an adult. Similarly, unless the impairment(s) has
improved or there is new evidence indicating that the prior finding was
in error, a finding of marked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult.

- The broad domains of functioning we used to evaluate a child's
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination. Accordingly, it is
important to remember that the descriptions of the childhood functional
equivalence domains in the regulations include work-related functions
for adolescents, defined as children age 12-18. [47]

To functionally equal the listings under title XVI, a
child's impairment(s) must result in "marked" limitations in two of the
childhood domains or an "extreme" limitation in one. [46] Although we do
not use these domains for adults, they describe aspects of functioning
that are relevant to our evaluation of a young adult's work-related
limitations. We use similar domains when we evaluate a child's mental
impairments and some physical impairments, such as immune disorders. We
may find that the young adult has the same severity rating for a domain
under a part A listing as he or she had as a child under a similar
functional equivalence domain. For example, absent medical improvement
or new evidence demonstrating that the prior finding was in error, a
young adult who had an extreme limitation in the ability to interact and
relate with others as a child will probably have extreme limitation in
social functioning as an adult
for a domain
under a part A listing as he or she had as a child under a similar
functional equivalence domain. For example, absent medical improvement
or new evidence demonstrating that the prior finding was in error, a
young adult who had an extreme limitation in the ability to interact and
relate with others as a child will probably have extreme limitation in
social functioning as an adult. Similarly, unless the impairment(s) has
improved or there is new evidence indicating that the prior finding was
in error, a finding of marked limitation in the ability to attend and
complete tasks as a child is likely to translate to a marked limitation
in the ability to concentrate, persist, or maintain pace in work-related
task completion as an adult.

The broad domains of functioning we used to evaluate a child's
impairment-related limitations may also provide guidance for findings
about a young adult's RFC on redetermination. Accordingly, it is
important to remember that the descriptions of the childhood functional
equivalence domains in the regulations include work-related functions
for adolescents, defined as children age 12-18. [47]

V. Continued payments for young adults participating
in a vocational rehabilitation or similar
program [48] ("Section 301") [49]

- When we determine that a young adult is no longer disabled due
to medical improvement, we will continue payments if : (1) He or she is participating in the Ticket to Work and
Self-Sufficiency program or another appropriate program of vocational
rehabilitation (VR), employment, or other support services; [50] and (2) Completion of the program or continued participation
for a specified period will increase the likelihood that he or she will not
return to the disability or blindness benefit rolls. [51] The title XVI provision for Section 301 payments also applies to a
person age 18 or older whose disability has ended as a result of a title
XVI age-18 redetermination. [52]
ther support services; [50] and (2) Completion of the program or continued participation
for a specified period will increase the likelihood that he or she will not
return to the disability or blindness benefit rolls. [51] The title XVI provision for Section 301 payments also applies to a
person age 18 or older whose disability has ended as a result of a title
XVI age-18 redetermination. [52]

- Likelihood Determination When a young adult is a student age 18 through 21
participating in an IEP under the provisions of the IDEA, we will find
that completion of or continuation in the IEP will increase the
likelihood that he or she will not return to the disability or blindness
benefit rolls. [53] In this circums

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_11_2p. Check the current official text before relying on it. Not legal advice.