Can Problems With Memory and Following Instructions Help Me Qualify for Social Security Disability?

Can Problems With Memory and Following Instructions Help Me Qualify for Social Security Disability?

How Social Security Evaluates Your Ability to Understand, Remember, and Apply Information

You may be physically capable of going to work.

But what if you cannot remember what your supervisor tells you?

What if someone explains a task and, a few minutes later, you have forgotten part of the instructions?

What if you need things repeated?

What if you can follow a simple one-step direction but become confused when several steps are involved?

Or maybe you performed the same type of work for years, but depression, anxiety, PTSD, a brain injury, medication side effects, chronic pain, or another medical condition now makes it difficult to think and remember the way you once did.

You may wonder:

“Can problems with my memory and ability to follow instructions help qualify me for Social Security Disability?”

Yes.

Social Security specifically evaluates your ability to understand, remember, or apply information when deciding how a mental impairment affects your ability to function.  But Social Security is not asking whether you occasionally forget something-everyone does that.

The more important question is: Are your problems understanding, remembering, learning, or using information serious enough to interfere with your ability to perform work activities reliably and on a sustained basis?

That distinction can be extremely important in an SSDI or SSI claim.

Recommended Reading: Can Mental Illness Qualify Me for Social Security Disability Benefits? Social Security does not decide mental-health claims based only on the name of a diagnosis. It also considers how the condition affects the abilities needed to function in a real work setting.

What Does “Understand, Remember, or Apply Information” Actually Mean?

This is Social Security’s terminology.  Most people would say it much more simply:

Can you learn what you are supposed to do, remember it, and then use that information to perform the job?

Social Security looks at abilities such as:

• Understanding instructions and procedures;
• Remembering what you have been told;
• Following one- or two-step directions;
• Learning new tasks;
• Sequencing several steps in the correct order;
• Asking and answering questions appropriately;
• Recognizing mistakes;
• Correcting mistakes;
• Solving ordinary problems; and
• Using judgment to make work-related decisions.

These are not just “mental health” skills, they are basic abilities used in almost every workplace.

Understanding Something Once Is Not the Same as Remembering It Later

Suppose a supervisor tells you: “Take these invoices, match them with the purchase orders, enter the amounts into the computer, flag any differences, and bring the exceptions to me.”

You may understand every word while the supervisor is standing in front of you.  But what happens ten minutes later?  Can you remember all of the steps?  Can you perform them in the correct order?  Do you have to go back and ask what you were supposed to do?  Do you forget what you were doing halfway through the task?  Do you need written instructions for things you once remembered easily?

A person can appear to understand a conversation and still have significant difficulty retaining and using the information afterward; that can matter in a disability claim.

Simple Instructions and Detailed Instructions Are Not the Same Thing

A person may be able to follow “Put this box on that shelf” and still have serious difficulty with:

“Check this shipment against the purchase order, separate the damaged items, update the inventory, prepare the return paperwork, and notify your supervisor of any discrepancy.”

Both involve instructions, but they require very different levels of memory, organization, sequencing, and judgment.

That is why a statement such as: “I can follow instructions” may not tell Social Security enough.

The better questions are:

What kind of instructions?

How many steps?

How often do they need to be repeated?

Can you remember them without supervision?

Can you apply them correctly once the supervisor walks away?

Why Does This Matter in a Real Job?

Almost every job requires some ability to learn, remember, and use information.

A mechanic may need to remember diagnostic procedures and the steps already performed.

A nurse may need to remember instructions, medications, patient information, and safety procedures.

A warehouse employee may need to remember product locations, shipping rules, inventory procedures, and equipment instructions.

An office worker may need to remember passwords, appointments, procedures, deadlines, and assignments from several different people.

A cashier may need to learn a register system, remember store procedures, respond to customer questions, and recognize when something is wrong.

Different jobs require different levels of mental functioning.  The issue is not simply whether you have memory problems, it is whether those problems interfere with your ability to perform the actual mental demands of work.

What Medical Conditions Can Cause These Problems?

Many conditions can affect understanding, memory, learning, or judgment.  Examples may include:

• Depression;
• Anxiety disorders;
• PTSD;
• Bipolar disorder;
• Schizophrenia and other psychotic disorders;
• Autism spectrum disorder;
• Neurodevelopmental disorders;
• Neurocognitive disorders;
• Traumatic brain injuries;
• Neurological conditions;
• Severe chronic pain; and
• Other medically determinable physical or mental impairments.

Medication side effects may also affect alertness, concentration, processing speed, or memory.  The limitation does not have to come from a condition labeled “mental illness.”

A physical condition can create cognitive limitations too.

What If My Memory Problems Come From Pain or Medication?

That can still matter.  Suppose chronic pain makes it difficult to focus long enough to absorb instructions.  Or medication causes sedation, slowed thinking, or forgetfulness.

The resulting limitation may be relevant even though the original medical condition is physical.

Social Security considers the functional effects of medically determinable impairments, including the effects of treatment and medication when supported by the evidence.  So the question is not simply:

“What diagnosis causes my memory problem?”

The question is also:

“How does that problem affect what I can actually do at work?”

“I Have to Write Everything Down.”

That can be meaningful, but context matters.  Lots of people make lists.  The important question is why you need the list.  There is a difference between:

“I write down my errands because it is convenient.”

and:

“If I do not immediately write down what someone tells me, I will probably forget it.”

There is also a difference between independently using notes as an organizational tool and being unable to complete ordinary tasks without repeated written prompts.

Ask:

• Do you need written instructions for routine tasks?
• Do you still make mistakes despite having notes?
• Do you forget where you put the notes?
• Do you need another person to create reminders for you?
• Can you independently organize and use the information?

Those details describe functioning much better than simply saying, “I make lists.”

What If I Can Remember Things I Enjoy?

That does not automatically mean you can meet the mental demands of work.  Memory is not an all-or-nothing ability.

You may remember events from years ago but have difficulty retaining new information.  You may remember the names of family members but forget what a supervisor told you fifteen minutes ago.  You may remember the plot of a television show you enjoy but struggle to learn a new procedure.  You may perform a familiar household activity from habit but become confused by a new multi-step task.

The relevant issue is not whether you can remember anything.  It is whether your medically determinable impairments interfere with your ability to learn, retain, and use information needed for work.

What If I Can Drive?

Driving can be relevant, but it should be considered in context.  There is a difference between:

“I drive wherever I need to go.”

and:

“I drive only to familiar places within a few miles of home.”

Ask:

• Do you drive unfamiliar routes?
• Do you rely heavily on GPS?
• Have you gotten lost?
• Do you avoid complicated traffic?
• Does someone usually accompany you?
• Can you independently plan and complete an unfamiliar trip?

The simple statement “I can drive” does not necessarily tell Social Security much about your ability to understand, remember, and apply information throughout a workday.

What If I Can Pay Bills?

The same principle applies.  Social Security may consider whether you can manage money, but “I pay bills” can mean very different things.

One person may independently track income, expenses, due dates, bank accounts, and investments.  Another may occasionally write a check after a spouse reminds them which bill is due and how much to pay.

Those are not equivalent levels of functioning.  The important questions include:

• Do you remember when bills are due?
• Have bills gone unpaid?
• Have you made financial mistakes?
• Do you need reminders?
• Has someone else taken over responsibilities you previously handled?

Your Doctor’s Records May Not Use the Exact Words Social Security Uses

Medical records are usually written to document treatment; they are not written primarily to answer Social Security’s vocational questions.

Your records may contain observations such as:

• “Forgetful”;
• “Poor recent memory”;
• “Difficulty concentrating”;
• “Slowed thought process”;
• “Requires redirection”;
• “Cognitive complaints”;
• “Impaired short-term memory”; or
• “Difficulty following conversation.”

Those observations can be important.

But your records may never say: “This patient cannot understand, remember, or apply work-related information.”  That does not necessarily mean the limitation does not exist.  Social Security considers the record as a whole, including medical evidence, your statements, reports from people who know you, and evidence concerning how you function in daily life.

“Alert and Oriented” Does Not Automatically Mean You Can Work

This deserves special attention.

Mental-status examinations often contain statements such as: “Alert and oriented times three” or “Memory grossly intact.”

Those findings are evidence and should not be ignored, but they must be understood in context.  Being able to identify who you are, where you are, and approximately what day it is does not necessarily establish that you can:

• Learn new work procedures;
• Remember instructions throughout an eight-hour day;
• Sequence several tasks correctly;
• Recognize mistakes;
• Make repeated work decisions;
• Switch between assignments; and
• Do those things reliably five days a week.

A ten- or twenty-minute medical appointment is not the same thing as competitive employment.  Social Security evaluates whether you can function independently, appropriately, effectively, and on a sustained basis.

Supportive Environments Can Hide the Severity of a Limitation

Suppose you function fairly well at home.  But your spouse:

Organizes your medications.

Maintains the calendar.

Reminds you of appointments.

Pays the bills.

Writes down instructions.

Drives you to unfamiliar places.

Handles important paperwork.

Makes sure you complete necessary tasks.

If Social Security looks only at the end result, it might appear that you are functioning independently, but you may not be.

That is why it is important to explain how much help you need to accomplish ordinary activities.  The ability to function in a structured and supportive home environment does not necessarily establish the ability to function independently in a competitive workplace.

Social Security Rates the Severity of the Limitation

When evaluating adult mental impairments, Social Security considers four broad areas of functioning and rates the degree of limitation:see 20 C.F.R. Part 404, Subpart P, Appendix 1, § 12.00F(2):

• None: You are able to function in the area independently, appropriately, effectively, and on a sustained basis.
• Mild: Your ability to function that way is slightly limited.
• Moderate: Your ability to function that way is fair.
• Marked: Your ability to function that way is seriously limited.
• Extreme: You are not able to function in that area independently, appropriately, effectively, and on a sustained basis.

For understanding, remembering, or applying information, a marked limitation means the ability to function independently, appropriately, effectively, and on a sustained basis is seriously limited.

An extreme limitation means the person is unable to function in that area independently, appropriately, effectively, and on a sustained basis, but even a limitation that does not satisfy a Listing can still matter significantly when Social Security assesses Residual Functional Capacity.

Does a Serious Memory Problem Automatically Mean I Am Disabled?

No.  Social Security evaluates the entire claim.

For many adult mental-health Listings, the paragraph B criteria generally require an extreme limitation in one of the four broad areas or marked limitations in two.  So a marked limitation in understanding, remembering, or applying information by itself does not automatically establish disability under a Listing, but that does not make the limitation unimportant.

If you do not meet or medically equal a Listing, Social Security generally moves on to determine your Residual Functional Capacity, or RFC.

That is where the exact nature of your limitations may become even more important.

Recommended Reading: What Is Residual Functional Capacity and Why Does It Matter in My Social Security Disability Claim?

The Listing Analysis and the Mental RFC Are Different

This distinction is important.  The four broad areas of mental functioning help Social Security determine the severity of a mental impairment and whether a Listing may be met.

The mental RFC assessment is more detailed; it asks what specific work-related mental abilities remain.  For example:

Can you understand and remember simple instructions?

Can you understand detailed instructions?

Can you carry out multi-step tasks?

Can you learn new procedures?

Can you make ordinary work decisions?

Can you perform independently without repeated supervision?

Can you adapt when instructions or procedures change?

A person might not meet a mental-health Listing and still have an RFC that eliminates the person’s past work—or possibly all competitive work.

What Happens If I Cannot Perform My Past Work?

Suppose your old job required detailed instructions, complex decision-making, extensive recordkeeping, or the ability to independently learn and remember complicated procedures.  Your current limitations may prevent you from returning to that job, but Social Security may then consider whether you can perform other work.

That is why the difference between:

“Cannot perform complex work”

and:

“Cannot reliably understand, remember, and carry out even simple instructions”

can be extremely important.

The more basic the mental ability that is impaired, the more significantly the occupational base may be affected.

Recommended Reading: What is Past Relevant Work?

Memory Problems Often Overlap With Concentration Problems

Real people do not experience symptoms according to regulatory categories.  Suppose a supervisor gives you an instruction and later you cannot remember it.

Did you forget?  Or were you so distracted that you never absorbed the information?

Suppose you lose your place halfway through a task.

Is that memory?  Concentration?  Persistence?  Possibly all three.

That overlap is one reason mental-health disability claims must be evaluated functionally rather than by labels alone.

Recommended Reading: How Do Problems With Concentration, Persistence, and Pace Affect a Social Security Disability Claim? The next article in this series looks at whether you can stay focused, continue working, and complete tasks at an acceptable pace—not merely whether you understand what you were asked to do.

Practical Questions That May Help Describe Your Limitations

Instead of simply saying: “My memory is bad,” think about what actually happens.

Can you remember verbal instructions?

How many steps can you reliably follow?

Do instructions need to be repeated?

Do you have to write everything down?

Can you learn a new procedure?

Can you remember appointments without help?

Can you independently manage medication?

Can you complete multi-step activities in the proper order?

Can you recognize when you have made a mistake?

Can you determine how to correct it?

Can you make ordinary decisions without assistance?

Have family members taken over responsibilities you once handled?

Did you perform these activities successfully before your medical condition became worse?

Those answers tell Social Security far more about your functional capacity than the statement “I have memory problems.”

The Law

Under 20 C.F.R. §§ 404.1520a and 416.920a, Social Security evaluates mental impairments using four broad areas of functioning:

1. Understand, remember, or apply information;
2. Interact with others;
3. Concentrate, persist, or maintain pace; and
4. Adapt or manage oneself.

Section 12.00E1 of the Adult Listing of Impairments explains that understanding, remembering, or applying information refers to the ability to learn, recall, and use information to perform work activities.  Examples include understanding and learning instructions and procedures, following one- or two-step oral directions, asking and answering questions, recognizing and correcting mistakes, solving problems, sequencing multi-step activities, and using reason and judgment to make work-related decisions.

Social Security evaluates the evidence as a whole and considers whether the person can function independently, appropriately, effectively, and on a sustained basis.

If a severe mental impairment does not meet or medically equal a Listing, Social Security generally proceeds to a more detailed assessment of the claimant’s mental Residual Functional Capacity.

The Bottom Line

Problems with memory, understanding, learning, judgment, and following instructions can be extremely important in an SSDI or SSI claim.

But Social Security needs more than:  “I forget things.”

The real questions are:

Can you learn what a job requires?

Can you remember instructions after they are given?

Can you carry them out correctly?

Can you follow several steps in the right order?

Can you recognize and correct mistakes?

Can you make ordinary work decisions?

Can you do these things independently without repeated prompting or supervision?

And most importantly:

Can you do them reliably throughout a normal workday and workweek?

A person does not need to have completely lost the ability to remember before memory limitations become vocationally significant.  The issue is whether medically determinable impairments interfere with the ability to learn, retain, and use the information necessary to sustain competitive employment.

Experience With Social Security Disability Claims

At Powell & Denny, P.C., we have extensive experience representing people whose physical conditions, mental-health conditions, or combination of impairments prevent them from maintaining employment. In claims involving mental limitations, identifying the diagnosis is only the beginning. The evidence must also explain how the condition affects the abilities employers actually require—including learning instructions, remembering information, making decisions, maintaining concentration, interacting appropriately with others, adapting to change, and functioning reliably over a normal workweek.

A diagnosis identifies what condition you have.

The disability analysis asks what that condition prevents you from doing.

Recommended Reading: How Do Problems With Concentration, Persistence, and Pace Affect a Social Security Disability Claim? In the next article in this series, we will examine another basic requirement of competitive employment: whether a person can stay focused, continue performing a task, maintain an acceptable pace, and do so consistently throughout the workday.

An experienced Social Security Disability attorney can evaluate your medical evidence together with your vocational factors to determine how the law applies to your specific situation.  At Powell & Denny, we have represented injured and disabled workers throughout Alabama for more than 30 years. We understand that serious claims are rarely decided by a diagnosis alone. They are decided by how the injury affects the person’s ability to function, work, and earn a living.

If you have questions about an Alabama Workers’ Compensation claim, or a claim for Social Security Disability benefits, don’t hesitate to contact the experienced attorneys at Powell and Denny today a free consultation; remember. Virtual appointments are available through Zoom so you can meet with one of the attorneys of Powell and Denny from wherever you live, and remember-there is no fee unless you win.

Powell & Denny: We Work When You Can’t.

Offices in Birmingham, Alabama and Huntsville, AL