1. (1) "Severity rating" is a rating of the extent of your impairment and how it impacts your ability to perform basic work activities. The following chart provides a description of limitations on work activities and the severity ratings assigned to each.

   Effect on Work Activities	Degree of Impairment	Numerical Value
   (a) There is no effect on your performance of one or more basic work-related activities.	None	1
   (b) There is no significant limit on your performance of one or more basic work-related activities.	Mild	2
   (c) There are significant limits on your performance of one or more basic work-related activities.	Moderate	3
   (d) There are very significant limits on your performance of one or more basic work-related activities.	Marked	4
   (e) You are unable to perform basic work-related activities.	Severe	5

2. (2) We use the description of how your condition impairs your ability to perform work activities given by the acceptable medical source or your treating provider, and review other evidence you provide, to establish severity ratings when the impairments are supported by, and consistent with, the objective medical evidence.

3. (3) A contracted doctor reviews your medical evidence and the ratings assigned to your impairment when:

   1. (a) The medical evidence indicates functional limitations consistent with at least a moderate physical or mental health impairment;
   2. (b) Your impairment has lasted or is expected to last, twelve months or more with available medical treatment; and
   3. (c) You are not an active ABD recipient previously determined likely to be disabled as defined in WAC 388-449-0010 through 388-449-0100.

4. (4) The contracted doctor reviews your medical evidence, severity rating, and functional assessment to determine whether:

   1. (a) The medical evidence is objective and sufficient to support the findings of the provider;
   2. (b) The description of the impairment(s) is supported by the medical evidence; and
   3. (c) The severity rating, duration, and assessment of functional limitations assigned by DSHS are consistent with the medical evidence.

5. (5) If the medical provider's description of your impairment(s) is not consistent with the objective evidence, we will:

   1. (a) Assign a severity rating, duration, and functional limitations consistent with the objective medical evidence; and
   2. (b) Clearly describe why we rejected the medical evidence provider's opinion; and
   3. (c) Identify the medical evidence used to make the determination.

[Statutory Authority: 2014 c 218, 2011 1st sp.s. c 15, RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.08A.100, 74.04.770, 74.62.030, 41.05.021, 74.09.035, and 74.09.530. WSR 15-03-031, § 388-449-0035, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.08.090, 74.08A.100, 74.04.770, 74.62.030, and 2013 2nd sp.s. c 10. WSR 13-24-040, § 388-449-0035, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.04.510, 74.08.090, 74.08A.100, 74.04.770, 74.04.0052, 74.04.655, 74.08.043, 74.08.335, and 2011 1st sp.s. c 36. WSR 12-10-042, § 388-449-0035, filed 4/27/12, effective 6/1/12.]