60RRBH25R0009 CMOS SSA-2506-BK and SSA-4734-F4-SUP Attachment 5.pdf

This document is a Mental Residual Functional Capacity Assessment form, which evaluates an individual's mental capabilities across four key domains: Understanding and Memory, Sustained Concentration and Persistence, Social Interaction, and Adaptation. The assessment rates the individual's functional limitations using a 5-point scale for various cognitive and interpersonal abilities.

The functional capacity narrative indicates that the claimant has significant residual limitations. Specifically, the individual can understand and remember simple instructions but struggles with detailed tasks, has moderately limited ability to sustain attention, experiences difficulty working within a schedule, has reduced energy, and requires 12 hours of sleep due to illness. The assessment notes challenges in interacting with the public, maintaining hygiene, traveling alone, and being dependent on family for support. The overall evaluation suggests moderate functional impairments across multiple areas of mental and social functioning.