What is Intellectual Disability?

Written by: Gayle Gonzalez Conner

Intellectual disability (ID) is a developmental condition characterized by significant limitations in both intellectual functioning and adaptive behavior. These limitations affect a person’s ability to reason, learn, and solve problems, as well as their capacity to communicate, care for themselves, and interact socially.

Children with intellectual disabilities typically experience delays in reaching developmental milestones such as speaking, walking, and performing basic self-care tasks. They may struggle with academic learning and often require more time and support to grasp new concepts. In some cases, certain skills may not be acquired at all.

Intellectual disabilities originate before the age of 22 and may result from a variety of factors, including genetic conditions, prenatal complications, birth defects, or exposure to harmful substances. Common causes include Down syndrome, fetal alcohol syndrome, and other chromosomal or metabolic disorders. Intellectual disability can also result from events occurring after birth, such as traumatic brain injury, stroke, or severe infections affecting the brain.

Intellectual Disability and Winning Disability Benefits

The Social Security Administration maintains a list of qualifying impairments, and individuals with low intellectual functioning may be eligible for disability benefits if they meet the criteria outlined in the Social Security Administration’s medical listings. Social Security Listing 12.05 governs how claims involving intellectual disability, learning disorders, low IQ, or special needs are evaluated. To meet this listing, a claimant must demonstrate both significantly subaverage intellectual functioning and deficits in adaptive functioning that began before age 22.

Eligibility requires:

• A formal diagnosis of intellectual disability;
• Documentation of significant limitations in adaptive functioning (e.g., communication, self-care, social skills);
• IQ testing results demonstrating cognitive impairment;
• Evidence that the condition began before age 22.

If an individual is unable to complete standardized IQ testing due to the severity of their condition, they may still be eligible for benefits if documentation shows they rely on others—such as family members or caregivers—for daily personal care and decision-making.

Both Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs may be available, depending on the individual’s work history and financial circumstances.

Social Security Listing 12.05 for Intellectual Disability Claims

12.05 Intellectual disorder (satisfied by A or B):

1. Satisfied by 1, 2, and 3:
   1. Significantly subaverage general intellectual functioning evident in your cognitive inability to function at a level required to participate in standardized testing of intellectual functioning; and
   2. Significant deficits in adaptive functioning currently manifested by your dependence upon others for personal needs (for example, toileting, eating, dressing, or bathing); and
   3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.

OR

2. Satisfied by 1, 2, and 3:
   1. Significantly subaverage general intellectual functioning evidenced by a or b:
      1. A full scale (or comparable) IQ score of 70 or below on an individually administered standardized test of general intelligence; or
      2. A full scale (or comparable) IQ score of 71-75 accompanied by a verbal or performance IQ score (or comparable part score) of 70 or below on an individually administered standardized test of general intelligence; and
   2. Significant deficits in adaptive functioning currently manifested by extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
      1. Understand, remember, or apply information; or
      2. Interact with others; or
      3. Concentrate, persist, or maintain pace; or
      4. Adapt or manage oneself; and
   3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.

Supporting Evidence for Listing 12.05 Claims

To effectively support a claim under Listing 12.05 for intellectual disability, it is beneficial to compile the following types of evidence:

1. Formal IQ Test Results
   • While the Social Security Administration does not mandate the use of a specific intelligence test, it generally accepts widely recognized assessments such as the Wechsler Adult Intelligence Scale (WAIS-IV) and the Stanford-Binet Intelligence Scales. The key requirement is that the test be a valid, reliable, and individually administered measure of intellectual functioning. Group-administered tests are not acceptable.
   • The Social Security Administration also considers various subtest scores, including verbal comprehension, perceptual reasoning, working memory, and processing speed. These scores contribute to the Full-Scale IQ, which plays a significant role in determining whether an individual meets the Social Security Administration’s criteria for an intellectual disorder.
   • If the claimant is unable to complete such testing, get detailed psychological reports explaining why, plus another objective indicators of severe intellectual limitations.
2. Developmental and School Records
   • Educational records demonstrating placement in special education programs or consistent academic challenges. Individualized Education Program (IEP) documents, or earlier IQ tests can show onset before age 22.
3. Adaptive Functioning Assessments
   • Vineland Adaptive Behavior Scales or Adaptive Behavior Assessment System (ABAS) results can quantify deficits in daily living and social skills.
4. Third-Party Statements
   • Family members, caregivers, or group home staff familiar with the claimant’s daily functioning and support needs can detail how much help the claimant needs for personal care, meal prep, or even simple travel.
   • Vocational documentation from former employers outlining work-related limitations and accommodations.
5. Clinical Observations
   • Notes from treating psychologists or psychiatrists describing the claimant’s communication ability, comprehension, and behavioral responses in everyday settings.
6. Consistency Over Time
   • Demonstrate a consistent pattern of intellectual and adaptive functioning deficits across multiple sources of evidence, rather than relying on a single point-in-time assessment.

Unlike many medical impairments that involve ongoing treatment and clinical documentation, intellectual disability may lack extensive medical records. As such, non-medical evidence can play a critical role in establishing the severity and functional impact of the condition. In certain cases, requesting a psychological medical expert at the hearing may be advisable to provide expert testimony and further substantiate the claim.

Clarifying Key Medical and Technical Concepts Relevant to Listing 12.05

• Significantly Subaverage General Intellectual Functioning: Generally characterized by an IQ score of approximately 70 or below. However, Listing 12.05 allows for flexibility in interpretation, recognizing that standardized testing may not always be feasible or conclusive. In such cases, clinical observations and alternative indicators may be considered.
• Adaptive Functioning: Refers to an individual’s capacity to perform age-appropriate daily activities and responsibilities, including personal hygiene, communication, social interaction, and basic household tasks. Deficits in adaptive functioning are central to evaluating intellectual disability. Do you require excessive reliance on caregivers for basic tasks (e.g., feeding, dressing, bathing)?  Are you unable to follow directions, stay safe independently, or handle routine daily living tasks?
• Individually Administered Standardized Test of General Intelligence: These are formal assessments conducted one-on-one by a qualified psychologist to measure intellectual functioning. Common examples include the Wechsler Adult Intelligence Scale (WAIS) and the Stanford-Binet Intelligence Scales.
• Dependence on Others: Involves a level of assistance that exceeds what is typical for the individual’s age. This may include supervision for personal care, reminders for basic tasks such as eating, or step-by-step guidance for dressing and other routine activities.

Key Takeaways

• Listing 12.05 focuses on intellectual disability with significant limitations in daily functioning.
• The listing has two subsections (A or B), either of which can qualify the claimant at Step 3 of the sequential evaluation.
• Evidence must support both low intellectual functioning and marked deficits in adaptive behavior—with onset before adulthood (age 22).

Distinguishing Intellectual Disorder from Acquired Loss of Mental Functioning

Not all individuals with low intellectual functioning meet the criteria for intellectual disability under Social Security Administration guidelines, particularly if the impairment developed after age 22. These conditions may result in significant cognitive decline and functional limitations, but they are assessed under different medical criteria than those used for developmental intellectual disabilities. In such cases, the Social Security Administration evaluates the condition under its listing for neurocognitive disorders. 

Older applicants who previously maintained substantial gainful employment and earned sufficient work credits may be eligible for SSDI. When the loss of mental functioning occurs after age 22, such as in cases involving traumatic brain injury (TBI) or other acquired cognitive impairments, the claim is evaluated under the appropriate neurocognitive disorder listing in the Social Security Administration’s Blue Book.

Common causes of acquired intellectual impairments include:

• Traumatic brain injury (TBI)
• Multiple sclerosis (MS)
• Early-onset dementia or Alzheimer’s disease
• Amyotrophic lateral sclerosis (ALS)
• Early-onset Parkinson’s disease

This evaluation often requires evidence of a significant decline in cognitive functioning, typically defined as a 15-point reduction in IQ compared to pre-impairment levels. However, because many individuals lack formal cognitive testing prior to the onset of their condition, it is often necessary to work with a qualified disability attorney to establish a credible baseline for comparison. This may involve gathering educational, vocational, or third-party evidence to demonstrate the extent of functional decline.

Neurocognitive Disorders (Acquired Loss of Mental Functioning)

• Onset Requirement: Develops after a period of typical cognitive development; does not begin during the developmental years.
• Key Features: Represents a clinically significant decline from previous cognitive abilities in one or more areas, such as:
  • Memory
  • Attention and executive functioning (e.g., planning, judgment, decision-making)
  • Language
  • Perceptual abilities
• SSDI/SSI Eligibility Criteria: Must demonstrate that the cognitive decline substantially impairs mental functioning in areas recognized by Social Security Administration, such as:
  • Understanding and remembering information
  • Interacting appropriately with others
  • Maintaining concentration and persistence

What to Expect at the Hearing?

Although the language of Listing 12.05 is relatively straightforward, it is often challenging to qualify as disabled under this provision. The assistance of an experienced Social Security attorney can be invaluable when pursuing claims of this nature. Administrative Law Judges frequently determine that the requirement for significant deficits in adaptive functioning is not satisfied when an individual did not attend resource or special education classes, cannot provide evidence of such attendance, or has engaged in any form of employment—whether minimal, part-time, or simple—during adulthood. The reason judges appear more reluctant to approve claims based on intellectual disability compared to other impairments remains uncertain; however, under the law, claims should be granted when the criteria of this listing are met.

During disability hearings, Administrative Law Judges often ask questions to assess cognitive functioning, even when IQ scores suggest disability. These questions may include:

• Do you have a driver’s license?
• Are you capable of living independently?
• Do you need reminders for medical appointments or medications?
• Can you read, write, or do basic math?
• Were you in special education classes?

These inquiries aim to evaluate the severity of adaptive functioning deficits. Because adaptive functioning is a nuanced concept, it’s highly beneficial to have an experienced Social Security Disability attorney assist in demonstrating these deficits.

How to Obtain the Social Security Disability Benefits You Deserve?

Cognitive impairment—regardless of its cause—can significantly affect your daily functioning and ability to maintain employment. If you are no longer able to work, or if your physician has advised you to apply for Social Security Disability benefits, our experienced attorneys at LaBovick Law group can provide the legal guidance you need. 

LaBovick Law Group can help you by

• Preparing and filing your initial Social Security Disability application.
  The application process can be complex and is often structured in a way that leads to mistakes—mistakes that can delay or even result in the denial of your claim.
• Appealing an unjust denial or Request for Reconsideration.
  If your claim has been wrongfully denied, we will take prompt action to protect your rights and pursue the benefits you deserve.
• Filing a Hearing Request and representing you before an Administrative Law Judge.
  LaBovick Law Group will ensure that your treating physician, when possible, completes the appropriate Residual Functional Capacity (RFC) forms, prepare you thoroughly for your hearing, submit a detailed legal brief, and skillfully cross-examine the vocational expert.

The Social Security Administration often denies legitimate claims and looks for reasons to reject applications. Your chances of success increase significantly when you are represented by an experienced Social Security Disability attorney, who knows how to navigate the process and advocate effectively on your behalf.