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6412 Federal Register / Vol. 62, No. 28 / Tuesday, February 11, 1997 / Rules and Regulationscauses no more than minimal functionallimitations, we will find that the childdoes not have a severe impairment and,therefore, is not disabled. The phrase‘‘minimal functional limitations’’replaces the phrase from our prior rules‘‘minimal limitation in your ability tofunction, independently, appropriately,and effectively in an age-appropriatemanner,’’ which, as noted above, wasderived from the prior statutorydefinition of disability.Final paragraph (d) ‘‘Yourimpairment(s) must meet, medicallyequal, or functionally equal in severitya listed impairment in appendix 1,’’explains that an impairment(s) causesmarked and severe functionallimitations if it meets, medically equalsor functionally equals the severity of alisted impairment. Thus, if a child’simpairment(s) meets, medically equals,or functionally equals in severity alisting (and meets the durationrequirement), we will find the childdisabled. If a child’s impairment(s) doesnot meet or medically equal orfunctionally equal in severity anylisting, or does not meet the durationrequirement, we will find the child notdisabled. We have removed thelanguage from prior paragraph (e) thatsaid a child’s claim would not be deniedbecause his or her impairment(s) wasnot of listing-level severity.We added a new paragraph (e), ‘‘Ifyou attain age 18 after you file yourdisability application but before wemake a determination or decision,’’ toexplain what we will do in such cases.We will use the rules for determiningdisability in adults when an individualwhom we found disabled prior toattaining age 18 attains age 18. (We havealways used the adult disability rulesbeginning at age 18 when we find thatan individual was not disabled prior toattaining age 18 to see if the individualbecame disabled at a later date.)Therefore, final paragraph (e) explainsthat, for the period during which theindividual is under age 18, we will usethe disability rules in § 416.924, but forthe period starting with the day theindividual attains age 18, we will usethe disability rules for adults filing newclaims in § 416.920.Except for redesignating priorparagraph (g) as final paragraph (f),‘‘Basic considerations,’’ has not beenchanged. We will continue to considerall relevant medical and nonmedicalevidence in a child’s case record.Finally, we have added a newparagraph (g) to explain that, when wemake an initial or reconsidereddetermination whether you are disabledor when we make an initialdetermination about whether yourdisability continues under section416.994a, we will complete a standardform, Form SSA–538, ChildhoodDisability Evaluation Form. The newform is designed to guide ouradjudicators through the new sequentialevaluation process and emphasizes therequirements for establishing functionalequivalence. In new paragraph (g), wealso explain that disability hearingofficers, administrative law judges, andthe administrative appeals judges on theAppeals Council (when the AppealsCouncil makes a decision) will notcomplete the form. This is because theseadjudicators issue decisions withdetailed rationales and findings thatwill already reflect the steps of the newsequential evaluation process.Section 416.924a Age as a Factor ofEvaluation in Childhood DisabilityMost of the guidance in our priorrules on consideration of age inchildhood disability cases has not beenchanged by Public Law 104–193. Wehave revised this section to conform tothe ‘‘marked and severe functionallimitations’’ disability standard. Asunder our prior rules, we will considerthe child’s age in determining whetherhe or she has a severe impairment(s).When evaluating whether theimpairment(s) meets, medically equals,or functionally equals the severity of alisting, we will consider the child’s ageif the listing we consider uses agecategories. We have deleted priorparagraphs (a)(4) and (b), whichaddressed issues related to the IFA.We redesignated prior paragraph (c),‘‘Correcting chronological age ofpremature infants,’’ and prior paragraph(d), ‘‘Age and the impact of severeimpairments on younger children andolder adolescents,’’ as final paragraphs(b) and (c) and made changes to conformto the new definition of disability; wedeleted prior paragraph (d)(4)(ii)because it was based on the prior‘‘comparable severity’’ standard.Section 416.924bChildrenFunctioning inThis section discusses some of theterms we use to describe or evaluatefunctioning in children, including ageappropriateactivities, developmentalmilestones, activities of daily living, andwork-related activities. We retained thediscussions of these terms withappropriate conforming changes. Wealso clarified the explanations of the lastthree terms, which were described inour prior rules as ‘‘the most importantindicators of functional limitations’’ in,respectively, infants up to attainment ofage 3, children aged 3 to attainment ofage 16, and older adolescents aged 16 toattainment of age 18. In the interim finalrules, we describe these functions asbeing ‘‘most important as indicators offunctional limitations,’’ because theemphasis should be on whatever agegroups for which these indicators offunctional limitations are mostappropriate.Although we deleted prior paragraph(b)(5) because it described the domainsand behaviors used in performing anIFA under our prior rules, considerationof functional limitations remains anintegral part of the childhood disabilityevaluation process. For example, final§ 416.926a describes areas offunctioning we will consider when weevaluate whether a child’simpairment(s) is functionally equivalentin severity to a listing.Section 416.924cWill ConsiderOther Factors WeAs under our prior rules, when weevaluate whether a child’simpairment(s) is disabling, we willconsider all relevant factors, such as theeffects of medications, the setting inwhich the child lives, the child’s needfor assistive devices, and the child’sfunctioning in school. However, asthroughout these interim final rules, wehave revised this section to conform tothe statutory ‘‘marked and severefunctional limitations’’ standard.Section 416.924d IndividualizedFunctional Assessment for ChildrenSection 416.924e Guidelines forDetermining Disability Using theIndividualized Functional AssessmentWe deleted both of these sections asrequired by section 211(b)(2) of PublicLaw 104–193.Section 416.925 Listing ofImpairments in Appendix 1 of SubpartP of Part 404 of This ChapterWe have revised paragraph (a) of thissection, ‘‘Purpose of the Listing ofImpairments,’’ to explain that, forchildren, the Listing of Impairmentsdescribes impairments that areconsidered severe enough to result inmarked and severe functionallimitations. We revised paragraph (b)(2),which explains the purpose of thechildhood listings in part B of theListing, to explain that the level ofseverity of the impairments listed inpart B is intended to be the same as thatexpressed in the functional severitycriteria of the childhood mentaldisorders listings (see 112.01 ff.).Therefore, in general, a child’simpairment(s) is of ‘‘listing-levelseverity’’ if it results in markedlimitations in two broad areas offunctioning, or extreme limitations in