Residual Functional Capacity Childhood Mental Disorders Page 2

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(6) Health and physical well-being.
The SSA Medical Listing which describes Anxiety Disorders have been consulted and reviewed
in conjunction with the preparation of this RFC form. Specifically:
112.06 Anxiety Disorders: In these disorders, anxiety is either the predominant disturbance or is
experienced if the individual attempts to master symptoms; e.g., confronting the dreaded object
or situation in a phobic disorder, attempting to go to school in a separation anxiety disorder,
resisting the obsessions or compulsions in an obsessive compulsive disorder, or confronting
strangers or peers in avoidant disorders.
The required level of severity for these disorders is met when the requirements in both A and B
are satisfied.
Indicate which of these findings is present in your answers below:
A. Medically documented findings of at least one of the following:
1. Excessive anxiety manifested when the child is separated, or separation is
threatened, from a parent or parent surrogate; or
2. Excessive and persistent avoidance of strangers; or
3. Persistent unrealistic or excessive anxiety and worry (apprehensive
expectation), accompanied by motor tension, autonomic hyperactivity, or
vigilance and scanning; or
4. A persistent irrational fear of a specific object, activity, or situation which
results in a compelling desire to avoid the dreaded object, activity, or situation; or
5. Recurrent severe panic attacks, manifested by a sudden unpredictable onset of
intense apprehension, fear, or terror, often with a sense of impending doom,
occurring on the average of at least once a week; or
6. Recurrent obsessions or compulsions which are a source of marked distress; or
7. Recurrent and intrusive recollections of a traumatic experience, including
dreams, which are a source of marked distress;
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.
Mental Functional Assessment – Page Number 2

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