Can You Understand, Remember, and Carry Out Instructions?

Can You Understand, Remember, and Carry Out Instructions?

Why Memory and Cognitive Limitations Matter in Social Security Disability and Alabama Workers’ Compensation Cases

One of the most misunderstood aspects of disability law has nothing to do with lifting, standing, walking, or sitting.  Instead, it involves something most of us take for granted until we lose it:

The ability to understand, remember, and carry out instructions.

Every job, whether it involves working in an office, a factory, a hospital, a retail store, or on a construction site, requires employees to receive information, remember it, and use it correctly.

For some individuals, however, an injury or illness makes those seemingly simple tasks much more difficult.  Memory problems, slowed thinking, poor concentration, confusion, and difficulty learning new information can make returning to work impossible—even when a person still appears physically capable of performing the job.

Both Social Security Disability and Alabama workers’ compensation recognize that these limitations may significantly affect a person’s ability to maintain employment, although each system evaluates them under different legal standards.

Understanding Instructions Involves More Than Intelligence

Many people mistakenly believe that memory problems only affect individuals with dementia or Alzheimer’s disease-Nothing could be further from the truth.

A person may be intelligent, motivated, and eager to return to work, yet still struggle to:

• remember verbal instructions;
• follow multi-step directions;
• learn new procedures;
• retain information from one day to the next;
• remember safety protocols;
• complete tasks without repeated reminders; or
• make appropriate decisions when unexpected situations arise.

These problems are not necessarily a reflection of intelligence.  Instead, they often result from medical conditions affecting the brain’s ability to process and retain information.

Many Medical Conditions Can Affect Memory and Learning

Memory problems may arise from a wide variety of physical and psychological conditions.

Some of the more common examples include:

• traumatic brain injuries (TBI);
• strokes;
• chronic pain;
• post-traumatic stress disorder (PTSD);
• depression;
• anxiety disorders;
• multiple sclerosis;
• Parkinson’s disease;
• epilepsy;
• sleep disorders;
• medication side effects; and
• chemotherapy-related cognitive impairment (“chemo brain”).

Even individuals suffering from severe orthopedic injuries sometimes develop significant cognitive difficulties because persistent pain, poor sleep, and prescribed medications interfere with normal brain function.  In other words, memory problems do not always begin in the brain itself.

Sometimes they develop because the body is constantly coping with pain, fatigue, or emotional stress.

Recommended Reading: Mental Functional Limitations Matter in Social Security Disability and Alabama Workers’ Compensation Cases

Why Employers Depend on Employees Who Can Learn and Remember

Virtually every occupation requires employees to remember information.

A cashier must remember procedures for handling money.

A nurse must remember medication protocols.

A mechanic must follow repair procedures.

A truck driver must remember delivery instructions and safety regulations.

A machine operator must follow production requirements while remaining alert to changing conditions.

Even jobs classified as unskilled work require employees to learn and consistently remember basic work procedures.

Workers who frequently forget instructions, require repeated supervision, or cannot retain recently learned information often struggle to maintain competitive employment.  That is true regardless of whether the job is sedentary, light, medium, or heavy.

Recommended Reading: What Do Sedentary, Light, Medium, and Heavy, Work Really Mean?

How Social Security Evaluates Memory and Understanding

When evaluating disability claims, Social Security looks beyond medical diagnoses and considers how mental limitations affect a person’s ability to function in a work setting.  One important question is whether the claimant can:

• understand instructions;
• remember instructions;
• carry out instructions accurately;
• learn new job tasks;
• make work-related decisions; and
• complete tasks independently.

For some individuals, these limitations are mild-for others, they may require repeated reminders, frequent supervision, or additional time to complete even simple tasks.

These limitations become part of the claimant’s Residual Functional Capacity (RFC) and may significantly affect the types of jobs Social Security believes the individual can perform.

For example, someone may retain the ability to perform only simple, routine tasks because more detailed work exceeds his or her cognitive abilities.  In more severe cases, memory limitations may substantially reduce the number of jobs available—or eliminate competitive employment altogether.

Recommended Reading: What is My Residual Functional Capacity (RFC)?

Chronic Pain Can Affect Memory

Anyone who has experienced severe, persistent pain understands how difficult it can become to think clearly.  Pain continuously competes for the brain’s attention.

Instead of focusing entirely on the task at hand, the brain is simultaneously attempting to process ongoing pain signals.

The result may include:

• forgetting instructions;
• losing track of conversations;
• difficulty completing tasks;
• slower thinking; and
• increased mental fatigue.

These difficulties often become even worse when combined with poor sleep or medications prescribed to manage chronic pain.

This is one reason physicians frequently evaluate the combined effects of pain, medication, fatigue, and emotional distress rather than considering each condition separately.

Recommended Reading: Can Pain Alone Keep Me from Working?

Recommended Reading: Can the Side Effects of Prescribed Medication Affect My Workers’ Compensation and Social Security Disability Claims?

Recommended Reading: Chronic Pain and Resulting Psychological Issues

How These Limitations May Affect an Alabama Workers’ Compensation Claim

Memory and cognitive limitations may also play an important role in Alabama workers’ compensation cases.  Consider an employee who suffered a traumatic brain injury after a fall from scaffolding.

Even after recovering physically, the worker may struggle to remember safety procedures or follow detailed instructions.

Likewise, an employee with chronic pain may have difficulty remembering work assignments because pain and medication interfere with concentration.  These limitations may affect important questions such as:

• Can the employee safely return to the former job?
• Can the employee be retrained for different work?
• Can the employee perform other reasonably suitable employment?
• Has the injury reduced the employee’s earning capacity?

In many body-as-a-whole injury cases, vocational experts consider these functional limitations when evaluating whether an injured worker has sustained a permanent loss of earning capacity.

Mental and cognitive limitations may therefore become just as important as physical restrictions.

Recommended Reading: What Do Permanent Work Restrictions Mean in Workers’ Compensation and Social Security Disability Cases?

Recommended Reading: What is “Suitable” Employment?

The Bottom Line

The ability to understand, remember, and carry out instructions is fundamental to almost every job.  When illness or injury interferes with those abilities, the effects may be just as disabling as the inability to lift, stand, or walk.

That is why both Social Security Disability and Alabama workers’ compensation frequently examine how memory and cognitive limitations affect an individual’s ability to perform work safely, consistently, and productively.

Although the legal standards differ, both systems recognize that successful employment depends upon much more than physical strength.  It also depends upon the ability to learn, remember, and apply information day after day in a real-world work environment.

Coming Next…

In our next article, we’ll examine another critical mental work function:

Why Concentration, Persistence, and Pace Matter in Social Security Disability and Alabama Workers’ Compensation Cases

We’ll explain why being able to perform a task for a few minutes is very different from maintaining attention, productivity, and reliability throughout an eight-hour workday—and why chronic pain, fatigue, PTSD, depression, medication side effects, migraines, and other medical conditions often make that impossible for many disabled workers.