Notice2026-17814
Social Security Ruling, SSR 26-2p; Titles II and XVI: Documenting and Evaluating Disability in Young Adults
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 1, 2026
Issuing agencies
Social Security Administration
Abstract
We are providing notice of SSR 26-2p. This SSR explains our policies and consolidates information from our regulations on documenting and evaluating disability in young adults. This ruling rescinds and replaces SSR 11-2p.
Full Text
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<title>Federal Register, Volume 91 Issue 168 (Tuesday, September 1, 2026)</title>
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[Federal Register Volume 91, Number 168 (Tuesday, September 1, 2026)]
[Notices]
[Pages 56262-56269]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-17814]
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SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA-2024-0053]
Social Security Ruling, SSR 26-2p; Titles II and XVI: Documenting
and Evaluating Disability in Young Adults
AGENCY: Social Security Administration (SSA).
ACTION: Notice of Social Security Ruling (SSR).
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SUMMARY: We are providing notice of SSR 26-2p. This SSR explains our
policies and consolidates information from our regulations on
documenting and evaluating disability in young adults. This ruling
rescinds and replaces SSR 11-2p.
DATES: We will apply this notice on October 1, 2026.
FOR FURTHER INFORMATION CONTACT: Michael J. Goldstein, Disability
Policy, Social Security Administration, 6401 Security Boulevard,
Baltimore, MD 21235-6401, telephone: (410) 965-1020.
SUPPLEMENTARY INFORMATION: Although 5 U.S.C. 552(a)(1) and (a)(2) do
not require it, we are publishing this SSR in accordance with 20 CFR
402.160(b)(1). Although SSRs do not have the same force and effect as
statutes or regulations, they are binding on all components of SSA (20
CFR 402.160(b)(1)).
We use SSRs to make available to the public precedential final
opinions, orders, and statements of policy and interpretation relating
to the federal old-age, survivors, disability, Supplemental Security
Income, and Special Veteran Benefits programs. We may base SSRs on
determinations or decisions made at all levels of our administrative
review process, federal court decisions, decisions of our Commissioner,
opinions from our Office of the General Counsel, or other
interpretations of the law and regulations.
This SSR will remain in effect until we publish a notice in the
Federal Register that rescinds it, or we publish a new SSR that
replaces or modifies it.
(Catalog of Federal Domestic Assistance, Program Nos. 96.001,
Social Security--Disability Insurance; 96.002, Social Security--
Retirement Insurance; 96.004--Social Security--Survivors Insurance;
96.006--Supplemental Security Income.)
Mark Steffensen,
General Counsel, Social Security Administration.
Policy Interpretation Ruling
SSR 26-2p: Titles II and XVI: Documenting and Evaluating Disability in
Young Adults
This SSR rescinds and replaces SSR 11-2p but retains much of its
substantive information. We are publishing this SSR to update certain
content based on changes to our program rules since 2011. Additionally,
we are clarifying some of the examples, adding new examples, and
refining some content to emphasize information unique to young adult
claims. Furthermore, we are reorganizing some sections to clearly
identify information that is helpful to young adult claimants during
the initial claims process and to young adult beneficiaries and
recipients undergoing a continuing disability review (CDR) or age-18
redetermination. We are publishing these updates and revisions with the
goal of improving our customer service to young adults. As a final
note, we added a few new sections clarifying evidentiary
considerations.
Purpose: This SSR explains our policies for evaluating disability
in young adults between the ages of 18 to approximately 25.
Specifically, we provide information about how we apply our policies
when we determine whether a young adult is disabled under our rules and
discuss considerations for developing evidence in young adult cases.
This SSR also provides information about continued payments for young
adults participating in vocational rehabilitation (VR) plans.
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 (Act), as amended; Regulations 20 CFR 404.130;
404.316, 404.327, 404.328, 404.330, 404.348, 404.350-404.354; 404.1502,
404.1503, 404.1505, 404.1509-404.1510, 404.1512-404.1513, 404.1520-
404.1522, 404.1525-404.1526, 404.1529-404.1530, 404.1545-404.1546,
404.1560, 404.1563-404.1569a, 404.1571-404.1576, 404.1584, 404.1589,
404.1590, 404.1593, 404.1594; 416.902, 416.903, 416.905, 416.909-
416.910, 416.912-416.913, 416.920-416.922, 416.924a, 416.925-416.926a,
416.929-416.930, 416.945-416.946, 416.960, 416.963-416.969a, 416.971-
416.976, 416.987, 416.989-416.989a; 416.990, 416.994; 416.1181;
416.1331, and 416.1338.
[[Page 56263]]
DATES: We will apply this notice on October 1, 2026.\1\
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\1\ We will use this SSR beginning on its applicable date. We
will apply this SSR to new applications filed on or after the
applicable date of the SSR and to claims that are pending on and
after the applicable date. This means that we will use this SSR on
and after its applicable date in any case in which we make a
determination or decision. We expect that Federal courts will review
our final decisions using the policies that were in effect at the
time we issued the decisions. If a court reverses our final decision
and remands a case for further administrative proceedings after the
applicable date of this SSR, we will apply this SSR to the entire
period at issue in the decision we make after the court's remand.
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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 of disability as we do for
other adults.\2\ Thus, we use the adult rules to make disability
determinations or decisions for young adults in situations \3\
including:
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\2\ See 20 CFR 404.1505 and 416.905.
\3\ Under title II, we sometimes use the adult definition of
disability to make disability determinations or decisions for people
under age 18, see 20 CFR 404.1520. In these situations, we will use
the content in this SSR to help us make our determination or
decision.
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<bullet> When a young adult files a claim for title II child \4\
benefits on a parent's record based on a disability that began before
they attained age 22;
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\4\ For purposes of title II entitlement, a child is a person
who has the required relationship to the insured person. See
generally 20 CFR 404.350 and 404.354.
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<bullet> When a child \5\ who is receiving title XVI childhood
disability benefits attains age 18 and must undergo a disability
redetermination; \6\ and
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\5\ For purposes of determining disability under title XVI, a
child is a person who has not attained age 18. See 20 CFR
416.902(c).
\6\ See 20 CFR 416.987.
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<bullet> When a young adult receiving disability benefits under
title II or XVI undergoes a CDR to determine whether they are still
disabled.\7\
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\7\ See 20 CFR 404.1590 and 416.990.
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As in all adult disability claims, a young adult who applies for
disability benefits under title II or XVI \8\ is disabled if they have
a medically determinable physical or mental impairment(s) (MDI) \9\
that results in an inability to engage in any substantial gainful
activity (SGA).\10\
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\8\ For simplicity, we refer in this SSR only to initial claims
for benefits. However, the policy interpretations in this SSR also
apply, with some exceptions, to age-18 redeterminations under
section 1614(a)(3)(H)(iii) of the Act and 20 CFR 416.987, and to
CDRs under sections 223(f) and 1614(a)(4) of the Act and 20 CFR
404.1594 and 416.994. When there is a difference in how the policy
applies to age-18 redeterminations or to CDRs, we explain how the
policy differs.
\9\ See 20 CFR 404.1521 and 416.921 for the definition of MDI.
We use the term impairment(s) in this SSR to refer to an
``impairment or a combination of impairments.''
\10\ See sections 223(d)(1)(A) and 1614(a)(3)(A) of the Act. The
impairment(s) must also satisfy the duration requirement in sections
216(i)(1), 223(d)(1)(A), and 1614(a)(3)(A) of the Act; that is, it
must be expected to result in death or must have lasted or be
expected to last for a continuous period of not less than 12 months.
See also 20 CFR 404.1505, 404.1509, 416.905, and 416.909.
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We use a sequential evaluation process \11\ to determine disability
in adult claims, which considers the individual's work activity,\12\
the severity \13\ and duration of physical or mental MDIs,\14\ whether
any impairment or combination of impairments meets or medically equals
a listing in the Listing of Impairments (listings),\15\ the
individual's residual functional capacity (RFC),\16\ and whether the
individual has the ability to do their past relevant work or other work
that exists in significant numbers in the national economy.\17\
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\11\ See 20 CFR 404.1520 and 416.920 for information about the
sequential evaluation process.
\12\ If the individual is doing SGA, we will find them not
disabled. 20 CFR 404.1520(a)(4)(i), 416.920(a)(4)(i). For the
definition of SGA and the rules for how we determine whether work
shows that a person has the ability to do SGA, see 20 CFR 404.1510,
404.1571-404.1576, 404.1584, 416.910, and 416.971-416.976. For the
specific monthly earnings amounts we generally consider to be SGA,
see: <a href="https://www.ssa.gov/oact/COLA/sga.html">https://www.ssa.gov/oact/COLA/sga.html</a>.
\13\ An impairment(s) is severe if it significantly limits the
person's physical or mental ability to do basic work activities. 20
CFR 404.1520(c) and 416. 920(c).
\14\ See 20 CFR 404.1509 and 416.909.
\15\ The rules for how we determine whether an impairment(s)
meets or medically equals a listing are in 20 CFR 404.1525,
404.1526, 416.925, and 416.926. The listings are at 20 CFR part 404,
subpart P, appendix 1.
\16\ For more information about the rules we use to assess RFC,
see 20 CFR 404.1545-404.1546, and 416.945-416.946.
\17\ For more information about the rules we use to determine
whether a person can perform past work or other work, see 20 CFR
404.1560-404.1569a and 416.960-416.969a.
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This SSR identifies and explains issues relevant to determining
disability for young adults, ages 18 to approximately 25, including the
evidence we need to document a young adult's impairment-related
limitations; considerations for evaluating limitations; issues
regarding disability insured status; issues related to the sequential
evaluation process; and considerations for resolving inconsistencies in
the evidence. We also discuss issues related to continued payments for
young adults participating in VR or an Individualized Education Program
(IEP).
Policy Interpretation
Sources of Evidence About a Young Adult's Ability To Do Basic Work
Activities
Once we have objective medical evidence \18\ from an acceptable
medical source \19\ that establishes the existence of an 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, other medical sources, and nonmedical sources.\20\
Although we always need objective medical evidence from an acceptable
medical source, we will determine what other evidence we need based on
the facts of the case.
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\18\ See 20 CFR 404.1502(f) and 416.902(k).
\19\ See 20 CFR 404.1502(a) and 416.902(a).
\20\ 20 CFR 404.1502(a), (d) and (e), 416.902(a), (i) and (j).
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Medical Sources
In addition to providing evidence establishing an MDI, acceptable
medical sources can provide information about how a young adult's
impairments affect their ability to perform work-related activities.
For example, a licensed physician, licensed advanced practice
registered nurse, or a licensed physician assistant who has examined or
treated a young adult for asthma might discuss the impact of asthma on
the young adult's participation in physical activities. A qualified
speech-language pathologist might discuss how a language disorder
contributes to limited attention and difficulty communicating in a work
setting. A licensed or certified school psychologist might discuss how
conditions such as intellectual disability, learning disabilities, or
borderline intellectual functioning impact a young adult's ability to
remember and carry out instructions.
Additionally, we may receive evidence from other medical sources
who we do not consider acceptable medical sources, such as
chiropractors, occupational therapists (OT), or physical therapists
(PT). We cannot use evidence from these sources to establish that a
young adult has an MDI. However, we may use evidence from these sources
to evaluate 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:
<bullet> A psychiatric social worker (PSW) might comment on the
young adult's ability to deal with changes in a routine
[[Page 56264]]
work setting or on how they get along with others.\21\
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\21\ A ``medical source'' is ``an individual who is licensed as
a healthcare worker by a State and working within the scope of
practice permitted under State or Federal law, or an individual who
is certified by a State as a speech-language pathologist or a school
psychologist and acting within the scope of practice permitted under
State or Federal law.'' 20 CFR 404.1502(d), 416.902(i). State
healthcare practice and licensure laws differ. A certain type of
practitioner, e.g., a naturopath or PSW, might qualify as a medical
source under one State's laws but not under another's.
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<bullet> 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 their ability to stand and walk.
<bullet> An OT might comment on the young adult's ability to use
fine motor skills to use a computer.
Nonmedical Sources
An individual who knows and has contact with the young adult, but
is a nonmedical source, can also provide evidence to help us evaluate
the severity and impact of a young adult's impairment(s). These sources
include the young adult, 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
nonmedical 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). We will consider any evidence from
school programs that the young adult participated in that had
psychosocial supports, extra help, accommodations, or were in
structured settings or living arrangements.\22\ For example:
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\22\ Similar to childhood disability claims under title XVI, we
may consider accommodations or one-to-one assistance in a school or
work setting when evaluating function in young adults. We use this
information when evaluating the degree of functional limitations for
adults when evaluating mental impairments in 20 CFR 404.1520a(c),
404.1545(c), 416.920a(c), and 416.945(c).
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<bullet> Some young adults who received special education
(including transition services) or related services \23\ 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.\24\
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\23\ In this context, special education is defined as
instructional services provided to students through age 21 in
primary and secondary education under the Individuals with
Disabilities Education Improvement Act of 2004 (IDEA).
Transition services are a coordinated set of special education
services designed to facilitate the student's movement from school
to post-school activities, including postsecondary education,
vocational education, integrated employment (including supported
employment), independent living, or community participation. Such
services include instruction, related services, community services,
the development of employment and other post-school adult living
objectives, and, if appropriate, acquisition of daily living skills
and provision of a functional vocational evaluation.
Related services include transportation and developmental,
corrective, and other supportive services (for example, occupational
therapy) as are required to assist a student with a disability, as
defined by IDEA, to benefit from special education. A student who
does not qualify for special education may qualify for related
services under section 504 of the Rehabilitation Act of 1973 to
ensure a free, appropriate public education.
\24\ The Higher Education Opportunity Act of 2008 authorizes
postsecondary educational services for students with disabilities.
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<bullet> Young adults who receive special education services at age
16 or older will have an IEP, including an IEP transition plan.\25\ 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.
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\25\ IEP transition plans are discussed in 34 CFR 300.320(b).
The first IEP a child receives by the time they turn 16 must include
transition assessments related to training, education, and
employment, as well as the transition services the child needs to
reach identified goals. The IEP may be established at a younger age
if determined appropriate by the IEP team. IEPs are discussed in SSR
09-2p, 74 FR 7625 (February 2009), available at: <a href="https://www.ssa.gov/OP_Home/rulings/ssi/02/SSR2009-02-ssi-02.html">https://www.ssa.gov/OP_Home/rulings/ssi/02/SSR2009-02-ssi-02.html</a>. (For the
complete titles of all SSRs cited in this footnote and those
following, see the CROSS-REFERENCES section at the end of this SSR).
The information about IEPs applies equally to people age 18-22 who
are still in special education. We may also consider IEPs from a
period before the person attained age 18 (for example, senior year
of high school) if they are relevant to the period we are
considering in connection with an application, age-18
redetermination, or CDR. Recent IEPs will frequently be relevant in
age-18 redeterminations. Also see 34 CFR 300.320, available at:
<a href="https://www.ecfr.gov/current/title-34/subtitle-B/chapter-III/part-300/subpart-D/subject-group-ECFR28b07e67452ed7a/section-300.320">https://www.ecfr.gov/current/title-34/subtitle-B/chapter-III/part-300/subpart-D/subject-group-ECFR28b07e67452ed7a/section-300.320</a>.
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<bullet> 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).
<bullet> 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.
Regarding IEP goals, a young adult who achieves a goal may or may
not have limitations in performing basic work activities. We will not
equate achievement of an IEP goal with the ability to perform basic
work activities without considering if achievement of the goal was in
whole or in part due to psychosocial supports and highly structured or
supportive settings, or extra help and accommodations.\26\
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\26\ Similar to childhood disability claims, see 20 CFR
416.924a(b)(5) and (b)(7), we may consider special education
programs and accommodations in school settings when evaluating
function in young adults.
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A young adult who does not achieve a goal may have an impairment-
related limitation(s) in their ability to perform work activity.
However, a young adult's failure to achieve a goal does not, by itself,
establish that the impairment(s) is disabling.
In addition to information about special support services, we will
also consider results of standardized tests (such as intelligence tests
and standardized tests of adaptive functioning We will consider any
available testing in the context of all the evidence in the file,
including information about developmental history and daily functioning
in a variety of settings.
Considerations in Developing Evidence in Young Adult Cases
We also clarify in this SSR that before we determine that a young
adult is not disabled, we will make every reasonable effort to develop
a complete medical history for the following periods:
<bullet> Initial-level claims: Generally, at least 12 months
preceding the young adult's application.\27\
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\27\ We will develop evidence for a different period if there is
a reason to believe that development of an earlier period is
necessary or unless the young adult states their disability began
less than 12 months before the application was filed. See 20 CFR
404.1512(b)(1) and 416.912(b)(1).
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<bullet> Age-18 redeterminations: Generally, at least 12 months
preceding the date of the interview or the month the form Disability
Report-Adult (SSA-3368) \28\ is completed.
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\28\ The standard for requesting evidence for an age-18
redetermination aligns with the process for initial claims in 20 CFR
416.912(b)(1). Also see 20 CFR 416.987. The Disability Report--Adult
form is available for viewing at: <a href="https://www.ssa.gov/forms/ssa-3368-bk.pdf">https://www.ssa.gov/forms/ssa-3368-bk.pdf</a>.
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[[Page 56265]]
<bullet> CDRs: Generally, at least 12 months preceding the month
the form Continuing Disability Review Report (SSA-454) \29\ or the
internet Continuing Disability Review Report (i454) is completed.
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\29\ See 20 CFR 404.1589, 416.989, and 416.989a; and 20 CFR
404.1593(b) and 416.993. The Continuing Disability Review Report is
available for viewing at: <a href="https://www.ssa.gov/forms/ssa-454-bk.pdf">https://www.ssa.gov/forms/ssa-454-bk.pdf</a>.
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In addition, we may develop the following types of evidence
identified by the young adult or their parent or legal guardian and
nonmedical sources:
<bullet> Evidence from school programs as discussed above, if the
young adult is receiving special education services or received these
services from age 16 forward.
<bullet> Evidence from community experiences discussed above.
<bullet> Evidence from a prior claim file if the young adult
previously filed for disability benefits. We will copy relevant medical
records and school records to the current file. Some examples of
relevant records may include information relevant to a young adult's
participation in school programs and community experiences, including
work settings.
<bullet> Evidence that the young adult is participating in a VR or
similar program (such as Section 301) \30\ as described below.
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\30\ Section 301 of the Social Security Disability Amendments of
1980 (Pub. L. 96-265) provides for continuation of disability
benefits to certain individuals whose disability medically ceases
while the individual is engaged in a VR program.
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<bullet> Longitudinal evidence (medical and nonmedical) if the
young adult participated in school programs or has had community
experiences including work from age 16 on, or if the impairment(s) or
case facts warrant establishing a history that extends beyond the 12-
month period of development. For example, intelligence tests
administered by a licensed or certified school psychologist after a
young adult has attained 16 years of age are relevant to assessing the
young adult's general intellectual functioning. Some impairments have
periods of fluctuating severity in terms of symptoms and functional
effects over time as part of the ongoing disease process, for example,
mental disorders or seizure disorders. In such cases, we may develop
longitudinal evidence that extends beyond the 12-month period to assist
us in evaluating the severity of a young adult's impairment(s) and
resulting functional limitations.
Considerations Related To Evaluating a Young Adult's Impairment-Related
Limitations
We evaluate a young adult's impairment-related limitations,
including symptoms, in the sequential evaluation process to:
<bullet> Determine whether their MDI or combination of MDI(s) is
severe and meets the duration requirement (i.e., an MDI(s) that is
expected to result in death within 12 months of the onset of disability
or has lasted or is expected to last a continuous period of at least 12
months);
<bullet> Determine whether their MDI(s) meets or medically equals a
listed impairment; and
<bullet> Assess their RFC and determine if the young adult has the
ability to perform past relevant work or other work that exists in
significant numbers in the national economy.
The examples in the sections below do not necessarily establish
that a young adult is disabled, only that the individual may have
limitations affecting their ability to work. We will consider the
context for any skills or abilities that are demonstrated when
evaluating the ability to function. For example, we will consider
whether the individual had psychosocial supports, a highly structured
or supportive setting, extra help, or accommodations.
Evidence Regarding Functioning From Educational Programs
As discussed above, we may have evidence about a young adult's
functioning from school programs, including their IEP. This evidence
may provide insight as to how well a young adult can perform the mental
and physical demands of work. The following examples of school-reported
difficulties might suggest limitations in work activities:
<bullet> Difficulty in understanding, remembering, and carrying out
simple instructions and work procedures during a school-sponsored work
experience;
<bullet> Difficulty communicating spontaneously and appropriately
in the classroom or educational setting; \31\
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\31\ Educational setting means any school-type activities or
educational programs that take place outside of a traditional
classroom setting.
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<bullet> Difficulty with maintaining attention for extended periods
in a classroom or educational setting;
<bullet> Difficulty relating to authority figures and responding
appropriately to correction or criticism during school or a work-study
experience;
<bullet> Difficulty using motor skills to move between classrooms;
<bullet> Difficulty functioning outside a supported or highly
structured classroom or educational setting;
<bullet> Difficulty with hyperfocus (an intense focus on things
that interest an individual, such as video games), along with a
limitation in their ability to focus on other tasks, sustaining focus,
or transitioning from one task to another in the educational setting;
<bullet> Difficulty independently and appropriately initiating,
sustaining, and completing assignments within the classroom or
educational setting; and,
<bullet> Difficulty sustaining attendance due to illness, treatment
of medical conditions, or disciplinary action(s) related to medical
conditions.
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 VR agency. These services may include:
<bullet> 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).
<bullet> 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).
<bullet> Work experience or supervised part-time or full-time
employment to assist a young adult in acquiring job skills and
professional work attitudes and habits.
<bullet> VR services, or services provided by states and local
areas through the Workforce Innovation and Opportunity Act (WIOA),\32\
which provide eligible students (in-school youth) aged 14 to 21 the
opportunity to receive tutoring, mentoring, alternative secondary
school opportunities, paid and unpaid work experiences, counseling, and
related supports. The WIOA also provides services for eligible out-of-
school youth (aged 16 to 24).\33\
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\32\ The WIOA was signed into law on July 22, 2014. The
intention of the WIOA is help job seekers access employment,
education, training, and support services to succeed in the labor
market and to match employers with skilled workers needed to compete
in the global economy. See Pub. L. 113-128; 128 Stat. 1425, 29
U.S.C. 3164, 81 FR 56072 (August 2016), available at: <a href="https://www.congress.gov/113/plaws/publ128/PLAW-113publ128.pdf">https://www.congress.gov/113/plaws/publ128/PLAW-113publ128.pdf</a>.
\33\ See 20 CFR 681.210.
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A young adult may participate in OJT or work experience placements
that are unpaid, paid at less than SGA levels, or
[[Page 56266]]
paid at SGA levels. Some young adults have multiple placements as part
of a transition plan that exposes them to a variety of work settings.
Other young adults may have multiple placements because of
unsatisfactory performance.
Regardless of whether the work was SGA, information about how well
a young adult performed in job 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 learn and
remember information or to maintain attention to carry out 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.
The evidence might show that the claimant missed time from work. We
will not consider the missed time from work in itself to reflect
difficulties with function in the work place or the ability to sustain
work activities on a continual basis. However, this evidence may be
relevant when evaluating impairment-related limitations.
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
them 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 type and extent of support or assistance and the
characteristics of any structured setting in which the young adult
spends their time when we evaluate the effects of their impairment(s)
on functioning.
Extra Help and Accommodations
Working requires an individual 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.\34\ If a young adult
with an impairment(s) needs or would need greater supervision,
assistance, or some other type of accommodation because of the
impairment(s) than an employee who does not have an impairment, the
young adult has a work-related limitation that should be considered in
the RFC. For example, a young adult with an intellectual development
disorder or a severe anxiety disorder may need additional supports to
stay on task or transition from one task to another; we would consider
that when assessing the young adult's RFC.
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\34\ See 20 CFR 416.924a(b)(5)(ii).
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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 daily activities.
We evaluate the degree of help, the use of any special devices or
medications that enable the young adult to function, and if the extra
help or support can be used effectively on a sustained basis. If there
are adverse side effects or continuing limitations, we will evaluate
limitations that nevertheless persist.\35\
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\35\ Additional information that may provide insight to function
and limitations or special support is in the Adult Listings for
Mental Disorders, see 12.00C4; available at:
<a href="https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm">https://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm</a>.
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Accommodations
Accommodations are adjustments or modifications to tasks or an
environment that allow an individual with an impairment 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.\36\ The fact that a young adult receives
or has received accommodations as a part of their IEP or Section 504
plan \37\ may be an indication that they have a limitation in the work
setting.
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\36\ We provide more detail about accommodations in IEPs in SSR
09-2p.
\37\ Section 504 of the Rehabilitation Act of 1973 prohibits
discrimination on the basis of disability in programs and activities
that receive Federal financial assistance. Public Law 93-112,
section 504; 29 U.S.C. 794(a), as amended. Under this section,
schools must provide a free, appropriate public education to each
student with a disability. See 34 CFR 104.33(a). When a student has
a disability that limits his or her access to the educational
setting, the school will conduct an evaluation of specific areas of
educational need and, if necessary, have a written plan for the aids
and services that will be provided.
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Some accommodations may indicate or provide evidence to support
that a young adult's impairment(s) meets or medically equals a listing.
For example, a young adult's need for an augmentative or alternative
communication (AAC) device (e.g., an electronic picture board accessed
via an app on a smartphone or electronic tablet) may indicate a speech
impairment that meets listing 2.09 or might provide evidence to support
impairment severity that meets one of the neurological listings in
section 11.00 of the listings or the autism spectrum disorder listing
12.10.
When we determine whether an individual can perform their PRW, we
do not consider potential accommodations or whether an individual would
be eligible for or require a particular workplace accommodation. We
cannot find that a young adult can do their PRW with accommodations
unless we find the young adult actually performed that PRW with those
accommodations.\38\ If their employer made the accommodation, the young
adult performed PRW with the accommodation, and the young adult's RFC
supports they can do PRW with those accommodations, we will find the
young adult can do PRW as they actually performed it.
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\38\ As described below, work may not be SGA due to a special
employment situation, an impairment-related work expense, or
extensive subsidy and therefore it would not be considered PRW.
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When we determine whether an individual can adjust to other work
that exists in significant numbers in the national economy, we do not
consider whether the individual could do so with accommodations, even
if an employer would be required to provide reasonable accommodations
under a statute, including the Americans with Disabilities Act of
1990.\39\
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\39\ The Americans with Disabilities Act of 1990 requires an
employer to provide reasonable accommodations to a qualified person
with a disability. See 42 U.S.C. 12112; SSR 00-1c.
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Effects of Treatment, Including Medications
Treatment, including medications, can have a positive effect on an
individual'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. However,
treatment 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. Common side
[[Page 56267]]
effects of medication causing symptoms such as fatigue, dizziness, and
impaired motor function are considered in the medical evaluation.\40\
The nature and frequency of a young adult's treatment may preclude them
from maintaining a work schedule of 8 hours a day for 5 days a week, on
a sustained basis.\41\
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\40\ For more information about how we consider the nature and
severity of symptoms, see 20 CFR 404.1529 and 416.929.
\41\ See 20 CFR 404.1545 and 416.945.
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The record might include evidence that the individual failed to
follow prescribed treatment. If the individual would otherwise be
entitled to benefits, but we have evidence that (1) the individual's
own medical source(s) prescribed treatment for the MDI(s) upon which
the disability finding is based and (2) the individual did not follow
the prescribed treatment, we will determine whether the individual has
failed, without good cause, to follow prescribed treatment.\42\
Examples of good cause include incapacity and circumstances where the
individual's own medical sources disagree about whether the individual
should follow a prescribed treatment.\43\
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\42\ See 20 CFR 404.1530 and 416.930.
\43\ See SSR 18-3p.
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Work-Related Stress
Working involves many factors and demands that can be stressful.
For example, some individuals 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, five days per
week on a sustained basis. Moreover, one individual's reaction to
stress associated with the demands of work may be different from that
of another individual, even among individuals with the same
impairment(s). Evaluating functional limitations based on the reaction
to the demands of work is highly individualized.\44\
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\44\ See 20 CFR 404.1545(c) and 416.945(c).
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Evidence provided by nonmedical sources, including information
contained in school records, may provide insight about the effect of
stress on a young adult's physical or mental functioning and what, if
any, psychosocial supports, or structure they would need when
experiencing work-related stress.\45\ We consider impairment-related
limitations created by an individual's response to the demands of work
on an individualized basis when we evaluate symptoms and assess RFC.
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\45\ See 20 CFR 404.1545 and 416.945.
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We consider the consistency of the young adult's statements about
the effects of stress and determine whether they can be reasonably
related to an MDI. If so, we consider the degree to which the
intensity, persistence, and limiting effects of the individual's
symptom(s) are consistent with and supported by the objective signs,
laboratory findings, and other medical and nonmedical evidence.\46\
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\46\ See 20 CFR 404.1529 and 416.929.
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Insured Status Issues for Young Adults
When a young adult has worked, we consider whether they are insured
for purposes of establishing a period of disability or becoming
entitled to disability insurance benefits under title II of the Act.
While the 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 they have 6 quarters of coverage in the 12-quarter
period ending with the quarter in which the disability began.\47\
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\47\ Claimants age 24 to the attainment of age 31 meet the
disability insured status requirement when they have quarters of
coverage in at least one-half of the quarters beginning with the
quarter after the quarter they attained age 21 and ending with the
quarter in which disability began. For example, a claimant who
becomes disabled in the quarter in which they attain age 25 needs 8
quarters of coverage during the 16 quarters ending in the quarter in
which they became disabled. If the number of quarters in the period
we are considering is an odd number, we reduce it by one to
determine how many quarters of coverage the young adult needs. See
20 CFR 404.130(c).
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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 to apply towards establishing insured status.
Determining Disability: Specific Issues That May Arise During the
Sequential Evaluation Process
Determining Whether a Young Adult's Work Activity is SGA \48\
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\48\ The SGA step of the sequential evaluation process applies
only to applications under titles II and XVI and to CDRs under title
II. We do not consider the SGA step in age-18 redeterminations or in
title XVI CDRs. See 20 CFR 416.987(b) for the rules on determining
disability in age-18 redeterminations. See 20 CFR 416.994(b)(5) for
the sequential evaluation process for title XVI CDRs for adults.
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We primarily consider a young adult's earnings to determine if
their work activity was SGA unless there is evidence that indicates
that the earnings are greater than the reasonable value of the work.
Work Activity: Many young adults with mental or physical
impairments have worked or are working. The work experience may have
been (or may be, if the individual is still working) subsidized, in a
sheltered setting, or performed under special conditions. As for any
adult, we subtract the value of any subsidized earnings and the
reasonable cost of any impairment-related work expenses from a young
adult's gross earnings to determine if the work is SGA.\49\ In
addition, some young adults whose impairments arose during military
service remain 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.\50\
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\49\ See 20 CFR 404.1574 and 416.974 for evaluating work as an
employee and 20 CFR 404.1575 and 416.975 for work in self-
employment. For monthly SGA amounts by disability type, see <a href="https://www.ssa.gov/oact/COLA/sga.html">https://www.ssa.gov/oact/COLA/sga.html</a>.
\50\ See 20 CFR 404.1574(a)(3) and 416.974(a)(3) and SSR 84-24.
Additionally, when calculating SGA, impairment-related work expenses
may be considered and subtracted from the SGA amount, see 20 CFR
404.1576 and 416.976.
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Volunteer Service: Young adults with disabilities may participate
in government-sponsored programs for volunteer activity, such as
AmeriCorps VISTA. We do not count payments an individual receives from
some of these programs as earnings.\51\
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\51\ See 20 CFR 404.1574(d) and 416.974(d); see also SSR 84-24.
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Considering Illiteracy When Evaluating MDI(s), RFC, and Vocational
Factors
Under the vocational rules, we may find young adults not disabled
even if we determine that their educational level is illiterate.\52\
However, a young adult's illiteracy can be an indication of an
underlying impairment(s) that affects our assessment of RFC. For
example, if a young adult, despite having attended high school, is
illiterate or has a limited reading ability, they may have an MDI, such
as a learning disability or language disorder. Any such MDI may affect
a young adult's RFC. As we noted above, these types of disorders can
cause limitations in more than one area.
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\52\ See 20 CFR, Part 404, Subpart P, Appendix 2, 201.00(h).
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[[Page 56268]]
When illiteracy or limited reading ability is related to an MDI, we
consider how the MDI affects the individual's ability to meet the
requirements of work when we assess RFC.\53\ For example, a young adult
who has an intellectual disorder may be limited in their ability to
understand and remember instructions, which results in an inability to
read and write. The intellectual disorder may also affect their ability
to maintain attention on tasks that they have difficulty remembering.
When we assess the young adult's RFC, we assess limitations in
maintaining attention as well as in understanding and remembering
instructions. When we determine whether they can do other work, we
assess an individual's vocational factor of education, including
consideration of illiteracy as an educational category.\54\
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\53\ See 20 20 CFR 404.1545 and 416.945.
\54\ See 20 CFR 404.1564(b)(1) and 416.964(b)(1).
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Additional Considerations for Age-18 Redeterminations
Young Adult Previously Found Disabled as a Child Under a Listing \55\
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\55\ See 20 CFR 404.1525(b) and 416.925(b). When we are making a
disability determination or decision under title II for a person
under age 18, we consider part B childhood listings until the person
attains age 18. We may also consider part A adult listings for the
period before the person attains age 18, if there is no appropriate
part B listing and the disease processes have a similar effect on
adults and children. As for all adults, we use only part A of the
Listing of Impairments when we determine whether a young adult's
impairment(s) meets or medically equals a listing. We never use part
B childhood listings for people who are at least 18 years old.
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Although our rules use different words to describe the concept,
listing-level severity is generally the same for both the adult
listings (part A) and the childhood listings (part B). Most of the part
B childhood listings have an equivalent adult 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 balance while standing or
walking) or in a broad area (domain) of functioning (such as
concentrating, persisting, or maintaining pace), or 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.
[cir] NOTE: We only use the medical improvement review standard in
CDRs. In age-18 redeterminations, we evaluate the young adult's
impairment(s) under the adult standard for disability used for initial
claims.
Resolving Inconsistencies in the Evidence
We evaluate all the case evidence for relevancy, sufficiency, and
consistency, and to resolve any inconsistencies.
After reviewing all relevant evidence, we determine whether there
is sufficient evidence to make a finding about disability. The evidence
we review may include: \56\
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\56\ See 20 CFR 404.1512, 404.1520, 416.912, and 416.920.
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<bullet> A complete medical history;
<bullet> Evidence that establishes an MDI;
<bullet> Evidence (medical or functional) to evaluate impairment
severity;
<bullet> Evidence to determine the duration of an MDI; and
<bullet> Evidence to support establishing the onset date of
disability.
If the evidence is sufficient and there are no inconsistencies in
the case record, we will make a determination or decision. We consider
evidence to be inconsistent when it conflicts with other evidence,
contains an internal conflict, is ambiguous, or when the medical
evidence does not appear to be based on medically acceptable clinical
or laboratory diagnostic techniques. If there are inconsistencies in
the record, but the evidence is nevertheless sufficient, we will
proceed to make a determination or decision, addressing and explaining
the inconsistencies, as appropriate.\57\
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\57\ See 20 CFR 404.1520b(b)(1) and 416.920b(b)(1).
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For example, a young adult with vision loss had two visual acuity
tests, one indicating best corrected visual acuity in both eyes was 20/
200 and another indicating a best corrected visual acuity of 20/200 in
one eye and 20/400 in the other eye. Despite the inconsistency in the
visual acuity measurements, a visual acuity of 20/200 (or less) meets
the listing criteria for 2.02. Thus, the evidence is sufficient despite
the inconsistency.
A finding might appear inconsistent but may be a normal variation
in function or reflect the impact of treatment on functioning. For
example, the record for a young adult with attention-deficit/
hyperactivity disorder (ADHD) may include longitudinal evidence of
minimal hyperactivity at home, in the classroom, and on work experience
placements, but at a consultative examination (CE) the young adult has
great difficulty staying focused, cannot sit still, and leaves the room
several times. The observations during the CE may represent increased
symptoms or limitations on a particular day, rather than the overall
level of functioning or the effect of an unfamiliar situation or
setting.\58\ In this case, the evidence is not inconsistent but
documents a variation in functioning during a one-time event.
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\58\ See section 12.00C.6 of the adult listings at 20 CFR part
404, subpart P, appendix 1. Accepting the observation of the young
adult's behavior or performance in an unusual setting, like a CE,
without considering the rest of the evidence could lead to an
erroneous conclusion about the young adult's overall functioning.
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As another example, for a young adult with ADHD, their ability to
play video games for extended periods may not be evidence of their
ability to engage in work because of the difference in context. A young
adult with ADHD may be able to play video games independently and
maintain attention for several hours without being distracted at home,
but the same individual may be unable, due to their impairment, to
maintain attention in a task such as scanning items at a cash register
in a work setting. The difference in the young adult's ability to
maintain attention may be related to the context of each activity;
these tasks may not demonstrate an inconsistency in the ability to
maintain attention related to the ability to work. Additionally, the
game play does not address how well a young adult would respond
appropriately to others in the workplace, focus attention on work
activities and stay on task at a sustained rate, and deal with changes
in a routine work setting.
If the evidence of record is inconsistent and insufficient to make
a determination or decision, or if the evidence is consistent but
insufficient to make a determination or decision, we will determine the
best way to resolve the inconsistency or insufficiency, e.g., by
requesting additional evidence or asking the claimant to attend a
consultative examination.\59\
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\59\ See 20 CFR 404.1520b(b)(2) and 416.920b(b)(2).
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Continued Payments for Young Adults Participating in a VR or Similar
Program (Section 301) \60\
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\60\ We commonly refer to this provision as ``Section 301''
because the initial legislative authority for continued payment of
benefits was provided in Section 301 of the Social Security
Disability Amendments of 1980 (Pub. L. 96-265).
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When we determine that a young adult is no longer disabled due to
medical improvement, we will continue payments if:
<bullet> The young adult is participating in an appropriate program
of VR,
[[Page 56269]]
employment, or other support services; \61\
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\61\ See 20 CFR 404.316(c)(1)(i), 404.327(a), and
416.1338(a)(1), (c).
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<bullet> The young adult began participating in the program before
the date their disability or blindness ended; \62\ and
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\62\ 20 CFR 404.316(c)(1)(ii) and 416.1338(a)(2).
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<bullet> Completion of the program or continued participation for a
specified period will increase the likelihood that the young adult will
not receive benefits based on disability or blindness once again in the
future.\63\
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\63\ See 20 CFR 404.316(c)(1)(iii), 404.328 and 416.1338(a)(3),
(e).
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This consideration for continued payment applies under title II and
title XVI when an individual's disability or blindness ends for medical
reasons while they are participating in an appropriate program,
including when a young adult's disability has ended as a result of a
title XVI age-18 redetermination.\64\
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\64\ See 20 CFR 416.1338(a).
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Appropriate programs include but are not limited to: The Ticket to
Work and Self-Sufficiency Program, an individualized plan for
employment (IPE) with a State VR agency, Plan to Achieve Self-Support
(PASS) under title XVI,\65\ and an IEP (ages 18-21) under the
provisions of the IDEA.
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\65\ See 20 CFR 416.1181.
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To ensure that Section 301 benefits are applied to all eligible
individuals, we will inquire whether a young adult is participating in
an appropriate program and request evidence of that participation
before we determine whether or not their disability ended for medical
reasons. If we determine that they are no longer medically disabled and
are participating in an appropriate program, we will issue a notice to
the young adult containing language that their case is being referred
to another office for a decision about continued payments based on
their participation in a VR, employment, training, or educational
program.
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 they
will not receive benefits based on disability or blindness once again
in the future.\66\ In this circumstance, we will continue benefit
payments until the IEP is completed or the person stops participating
in the IEP for any reason. When a young adult is participating in
another appropriate program, we will find that completion of or
continuation in that program will increase the likelihood that the
individual will not receive benefits based on disability or blindness
once again in the future if the program provides the individual with:
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\66\ See 20 CFR 404.328(b) and 416.1338(e)(2).
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[cir] Work experience that will increase the likelihood of being
able to perform PRW; or
[cir] Education or work experience that will increase the
likelihood of adjusting to other work.\67\
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\67\ See 20 CFR 404.328(a) and 416.1338(e)(1).
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For example, if a young adult successfully completed a VR-sponsored
training program to become a certified computer technician, she has
acquired computer skills that will permit direct entry into semiskilled
or skilled occupations, thus increasing her overall ability to adjust
to other work. We would determine that the training program would
increase the likelihood that she will not return to the disability or
blindness benefit rolls.
Effective Date: We will apply this SSR on October 1, 2026.
Cross-References: SSR 84-24: Titles II and XVI: Determination of
Substantial Gainful Activity for Persons Working in Special
Circumstances--Work Therapy Programs in Military Service--Work Activity
in Certain Government-Sponsored Programs; SSR 00-1c: Sections 222(c)
and 223(a), (d)(2)(a), and (e)(1) of the Social Security Act (42 U.S.C.
422(c) and 423(a), (d)(2)(A), and (e)(1)) Disability Insurance
Benefits--Claims Filed Under Both the Social Security Act and the
Americans with the Disabilities Act; SSR 09-2p: Title XVI: Determining
Childhood Disability--Documenting a Child's Impairment-Related
Limitations; SSR 09-3p: Title XVI: Determining Childhood Disability--
The Functional Equivalence Domain of ``Acquiring and Using
Information''; SSR 09-4p: Title XVI: Determining Childhood Disability--
The Functional Equivalence Domain of ``Attending and Completing
Tasks''; SSR 09-5p: Title XVI: Determining Childhood Disability--The
Functional Equivalence Domain of ``Interacting and Relating with
Others''; SSR 09-6p: Title XVI: Determining Childhood Disability--The
Functional Equivalence Domain of ``Moving About and Manipulating
Objects''; SSR 09-7p: Title XVI: Determining Childhood Disability--The
Functional Equivalence Domain of ``Caring for Yourself''; SSR 09-8p:
Title XVI: Determining Childhood Disability--The Functional Equivalence
Domain of ``Health and Physical Well-Being''; SSR 18-3p: Titles II and
XVI: Failure to Follow Prescribed Treatment; SSR 24-2p: Titles II and
XVI: How We Evaluate Past Relevant Work.
[FR Doc. 2026-17814 Filed 8-31-26; 8:45 am]
BILLING CODE 4191-02-P
</pre></body>
</html>Indexed from Federal Register on September 1, 2026.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.