Intellectual disability can affect every aspect of a person’s life, including their ability to work. If this condition prevents you or someone you love from holding down a job, Social Security Disability benefits may provide the financial support you need. However, getting approved takes more than just filing an application. The SSA has specific criteria for evaluating mental disorder claims, and meeting those criteria requires the right evidence, presented the right way.
That’s where Wambach Disability Law comes in. Attorney Joe Wambach has spent his career representing disability claimants nationwide, and he knows what it takes to build a strong intellectual disability case from the ground up. Whether you’re filing for the first time or dealing with a denial, our disability lawyer can review your situation and help you move forward. Contact us today to arrange a free consultation with an SSA lawyer for intellectual disability in Evansville, Indiana.
Intellectual disability is a clinically diagnosed condition marked by significant limitations in both intellectual functioning and “adaptive functioning,” which is the everyday conceptual, social, and practical behavior people use to manage daily life. For Social Security Disability (SSD) purposes, the condition must also have manifested before age 22 to qualify. If someone meets all of these diagnostic criteria, they may qualify for SSD benefits under Listing 12.05 of the SSA’s Blue Book.
The Social Security Administration (SSA) recognizes that intellectual disability exists on a spectrum. Some people with the condition live and work with relatively modest support needs, while others require substantial assistance with basic daily tasks. The SSA’s evaluation process accounts for this range and offers two distinct pathways to eligibility under Listing 12.05. One is for claimants with profound limitations, the other is for claimants whose functioning can be assessed through standardized testing.
The first pathway, 12.05A, applies to claimants whose intellectual limitations are severe enough to prevent them from participating in standardized intelligence testing altogether. Under this pathway, claimants can demonstrate adaptive functioning deficits by providing evidence of their dependence on others for basic personal care, such as eating, bathing, dressing, and toileting. This pathway applies to a small subset of claimants with the most profound limitations.
The second pathway, 12.05B, covers claimants who can participate in standardized testing. It requires claimants to meet two main criteria. The first is a full-scale IQ score of 70 or below, or a full-scale score of 71 to 75 paired with a verbal or performance score of 70 or below. The second is evidence of marked limitation in two, or extreme limitation in one, of the four following areas of mental functioning:
Most adult claimants pursue benefits through this second pathway. Both pathways also require evidence that the disorder began before age 22.
The requirement that a claimant’s intellectual disability began before age 22 is unique to Listing 12.05 among the mental disorder listings. It’s also often the criterion that requires the most careful evidence-building. However, there are two key aspects of this requirement worth noting.
First, the SSA doesn’t require proof that a claimant met the full criteria of 12.05A or 12.05B before age 22. Just evidence that’s consistent with the conclusion that the disorder itself began before then.
Second, if records from before age 22 aren’t available, the SSA will accept current evidence of the claimant’s intellectual and adaptive limitations combined with historical accounts. This historical evidence can include school records of special education services, IEPs, transition plans, reports from teachers or academic evaluators, and statements from people who knew the claimant before age 22.
Our law firm in Evansville, Indiana, regularly helps clients locate and organize this kind of evidence, including by reaching out to school districts or former employers on your behalf.
Two misconceptions come up frequently in intellectual disability claims, and both can discourage claimants from pursuing benefits they may legitimately qualify for. The first is that having worked at some point disqualifies them. The second is that being able to perform everyday tasks means their adaptive functioning deficits aren’t significant enough to qualify.
The SSA addresses both of these directly in its Blue Book. It states that, when evaluating a claimant’s work history, the SSA looks at the full picture to get a sense of functional capacity. For example, the SSA might consider factors like:
When evaluating the ability to perform daily activities, the SSA looks at whether the claimant can complete tasks independently, consistently, and without significant support from others. A claimant may be able to drive a car or prepare simple meals and still have qualifying deficits in adaptive functioning. Strengths in one area don’t cancel out deficits in another. If you’re concerned about how work history or evidence of daily functioning might affect your claim, a disability lawyer can walk you through how the SSA is likely to weigh that evidence.
Claimants can still qualify for disability benefits even if they don’t meet the Blue Book listing criteria exactly. If a claimant’s intellectual disability doesn’t satisfy the requirements of 12.05A or 12.05B, the SSA moves to an assessment of their residual functional capacity (RFC). This is an evaluation of what work-related activities the claimant can still perform despite their limitations.
An RFC assessment evaluates how the claimant’s condition affects their ability to do things like follow instructions, interact with supervisors and coworkers, handle day-to-day changes, and maintain reliable attendance. Many claimants with intellectual disability struggle with these basic work-related requirements even if their IQ scores or adaptive functioning deficits fall short of listing-level criteria. An Evansville disability lawyer can present a claimant’s intellectual disability, any co-occurring conditions, and their symptoms in a way that maximizes their weight in the SSA’s evaluation process.
Intellectual disability claims live or die based on the quality of the evidence behind them. An attorney who knows what the SSA is looking for can make the difference between a claim that tells your full story and one that falls short. Joe Wambach is that attorney.
Before opening Wambach Disability Law in Evansville, Joe spent a decade at one of Indianapolis’s busiest disability law firms. There, he represented claimants in more than 1,000 ALJ hearings across Indiana, Illinois, Kentucky, and New Mexico. That depth of experience shapes how he builds cases, prepares clients, and advocates before the SSA, whether you’re in Evansville, Indiana, or anywhere else in the US. And when you work with our law firm, you work with Joe directly, not someone passing along messages while you wait for the answers you need.
Our law firm handles intellectual disability claims with no upfront costs. Joe’s fee comes only from any back pay you receive if the SSA approves your claim, so you don’t have to worry about affordability getting between you and the representation you need. If you or someone you love is pursuing SSD benefits based on intellectual disability, contact our Evansville law firm today to get started.
Social Security Disability benefits can make a real difference for people whose intellectual disability prevents them from working, and our Evansville disability lawyer is here to help you pursue them. Contact us today to get started with your free initial consultation with attorney Joe Wambach.
