Form SSA-2506-BK: Psychiatric Review Technique Form (PRTF)

LINK HERE : Psychiatric Review Technique Form (PRTF)

Lee Ann Torrans:  I no longer practice law.  Please see terms of use regarding this website.

Form SSA_2506-BK – “Psychiatric Review Technique Form” is provided by the SSA and is used in the Disability Determination Services of the SSA.  This is a data driven form.  Look for the data in the form to support any conclusions drawn.

This form is recognized and understood by the SSA.  You are speaking their language.  They are familiar with this form and know what to expect.




A DDS psychiatrist or psychologist makes an evaluation as to whether you are disabled and in doing so considers all information regarding your mental impairment.

This includes:

  1. Review of medical records provided by the DDS
  2. Face-to-face psychiatric evaluation of the applicant
  3. Written report with summary and discussion

The Disability Determination Services outline for child psychiatric evaluations is more complex than the adult format.

The SSA is interested in facts and evidence based conclusions as they bear upon impairments of specific functional capabilities.

Specific observations and reporting of the claimant’s Activities of Daily Living, along with relevant psychiatric history, and a fact based Mental Status Examination are crucial to the exam’s utility.

The DSM-IV is used as a basis for evaluation and diagnostic criteria.

Link Here: The Psychiatric Review Technique Form SSA-2506-BK (9-2000)

Specific symptoms and behaviors will be addressed as delineated by the SSA and are to be checked as present or absent.

Psychiatric Review Technique Form (PRTF)

Read this form carefully (or have someone read it for you) to see if the MC considered all the pertinent information in your file.

About the PRTF

The PRTF contains the following:

• Section I:  Medical summary.

• Section II: Record of pertinent signs, symptoms, findings, functional limitations, and effects of treatment that have a significant bearing on your case.

A full report should include the basis for the application of these medical determinations to your case.

• Section III : Record of signs, symptoms, and findings that show the presence of the categories of mental disorders in the

• Section IV: Based upon the data above the medical consultant will provide a rating of your functional limitations, which are relevant to your ability to work.

Medical Consultants Notes

These notes support the medical consultant’s opinion and basis for that opinion based upon the date of Sections One through Sections Three.  If you are denied, be sure to look to see if the Medical Consultant did in fact sign your denial.  Know whether the Medical Consultant’s opinion was made a part of or basis of your decision.

RFC Form

You have the right to have a medical determination by a Medical Consultant.  Be certain that a medical consultant did IN FACT review your claim.  You may contact your DDS Director and pose this question.  It may take a significant period of time and determination to confirm this issue.  You might want to start with BOTH a letter and a  phone call and schedule a follow up until you have your response.

If there is a diagnoses be certain it is supported by formal psychological testing.

Form SSA-2506-BK: Psychiatric Review Technique Form (PRTF)

Form SSA_2506-BK – Psychiatric Review Technique Form is provided by the SSA and is used in the Disability Determination Services of the SSA.  This is a data driven form.  Look for the data in the form to support any conclusions drawn.  IT MUST BE THERE.

This form is recognized and understood by the SSA.  You are speaking their language.  They are familiar with this form and know what to expect.

Child Psychiatric Evaluation

The Disability Determination Services outline for child psychiatric evaluations is more complex than the adult format.

The SSA is interested in facts and evidence based conclusions as they bear upon impairments of specific functional capabilities.




Specific observations and reporting of the claimant’s Activities of Daily Living, along with relevant psychiatric history, and a fact based Mental Status Examination are crucial to the exam’s utility.

  • The DSM-V is used as a basis for evaluation and diagnostic criteria
  • The Psychiatric Review Technique Form SSA-2506-BK (9-2000) is used
  • Specific symptoms and behaviors will be addressed as delineated by the SSA and are to be checked as present or absent

Medical Consultants Notes

These notes support the medical consultant’s opinion and basis for that opinion based upon the date of Sections One through Sections Three.  If you are denied, be sure to look to see if the Medical Consultant did in fact sign your denial.  Know whether the Medical Consultant’s opinion was made a part of or basis of your decision.

RFC Form

You have the right to have a medical determination by a Medical Consultant.  Be certain that a medical consultant did IN FACT review your claim.  You may contact your DDS Director and pose this question.  It may take a significant period of time and determination to confirm this issue.  You might want to start with BOTH a letter and a  phone call and schedule a follow up until you have your response.

 

If there is a diagnoses be certain it is supported by formal psychological testing.