Residual Functional Capacity Childhood Mental Disorders (Page 2 of 7) in pdf

Residual Functional Capacity Childhood Mental Disorders Page 2

(6) Health and physical well-being.

The SSA Medical Listing which describes Attention Deficit Hyperactivity Disorder has been

consulted and reviewed on conjunction with the preparation of this RFC form. Specifically:

112.11 Attention Deficit Hyperactivity Disorder: Manifested by developmentally inappropriate

degrees of inattention, impulsiveness, and hyperactivity.

The required level of severity for these disorders is met when the requirements in both A and B

are satisfied.

A. Medically documented findings of all three of the following:

1. Marked inattention; and

2. Marked impulsiveness; and

3. Marked hyperactivity;

AND

B. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of

the appropriate age-group criteria in paragraph B1 of 112.02; or, for children (age 3 to

attainment of age 18), resulting in at least two of the appropriate age-group criteria in

paragraph B2 of 112.02.

MEDICAL AND FUNCTIONAL CAPACITY ASSESSMENT (CHILD)

SSI/SSD Review of Child’s Medical Impairments

How long have you treated the child and how often do you see him/her?

What is/are your diagnoses, and provide your estimated date of onset?

Mental Functional Assessment – Page Number 2

Residual Functional Capacity Childhood Mental Disorders Page 2