DI 24508: Medical Evaluation at Step 3 of Sequential Evaluation
A. Listing of Impairments
1. Where is the Listing of Impairments?
The Listing of Impairments (Listings) is located in the Program Operations Manual System (POMS) subchapter DI 34000; and, 20 CFR Part 404, Subpart P, Appendix 1.
2. What is the purpose of the Listings?
When a claimant’s impairment meets, or medically equals, the criteria of a listed impairment, and the claimant is not performing substantial gainful activity (SGA,) we find him or her disabled. We group the impairments in the Listings by each of the major body systems.
The Listings describe impairments that we consider severe enough to:
prevent an adult from doing any gainful activity, regardless of his or her age, education, or work experience, or
cause a child under age 18 marked and severe functional limitations.
3. What does consideration of the Listings include?
Consideration of the Listings includes both the introductory text at the beginning of each body system and the specific listing. Under the Listings, we do not consider the vocational factors of age, education, or work experience.
4. Why do the Listings have a Part A and Part B?
The effects of impairments may be different for children and adults.
Part A of the Listings contains medical criteria that apply to adults – claimants age 18 and over.
Part B of the Listings contains medical criteria that apply to children only - claimants under age 18. We may use Part A for claimants under age 18 if the impairment does not meet a Part B listing and the Part A criteria are appropriate.
DI 34001.001 - Listing of Impairments -- Purpose, Parts and Use
B. How do we find a claimant’s impairment(s) meet a listing?
An impairment(s) meets a listing when the claimant has a severe, medically determinable impairment (MDI) that:
satisfies all relevant criteria in the introductory text and in the specific listing criteria; and
meets the 12 month duration requirement as described in DI 24508.005B.3. in this section.
EXCEPTION: Under Title XVI, blindness does not have to meet the duration requirement to meet a listing. See DI 26005.005 Title XVI Statutory Blindness Evaluation Issues.
1. The introductory text
The introductory text in each body system contains:
information relevant to the use of the Listings in that body system;
examples of common impairments in the body system; and
definitions used in the Listings for that body system.
The introductory text may also include specific criteria for:
establishing an MDI,
confirming the existence of an impairment(s), or
establishing an impairment(s) satisfies the criteria of a particular listing in the body system.
IMPORTANT: If the introductory text does not include specific criteria for establishing an MDI or confirming the existence of an impairment(s), the medical evidence must still show that the claimant has a severe MDI(s) as defined in DI 24505.001. The introductory text also provides guidance for actions when an impairment does not meet a listing.
2. Specific criteria
The specific listing criteria follow the introductory text in each body system, below the heading, “Category of Impairments.” Within each listing, we specify the objective medical and other findings needed to satisfy the criteria of that listing. The specified findings may refer to specific items in the introductory text.
Most of the listed impairments are permanent or expected to result in death.
Nevertheless, the evidence must show the claimant’s impairment(s) has lasted, or we expect it to last, for a continuous period of at least 12 months, or we can expect it to result in death.
For some listings, we state a specific period of time for which an impairment(s) will meet the listing prior to the need for a continuing disability review (CDR).
C. Can an impairment(s) meet a listing based only on a diagnosis?
To meet a listing, the MDI(s) must satisfy all of the criteria in the listing. Although we have a few listings that only require a claimant have a particular condition (for example, listing 11.10 for Amyotrophic lateral sclerosis), we must have clinical findings, laboratory findings, or both that establish the condition(s). An impairment cannot meet a listing based on a diagnosis only.
D. How do we consider symptoms when we determine whether an impairment(s) meets a listing?
Some listed impairments include symptoms as criteria, such as pain. For information about evaluating symptoms, see DI 24501.021.
E. Articulating the medical evaluation content when an impairment(s) meets a listing
The requirements for meeting listings differ based on the body system and the specific disorder.
1. All claim types
For all claim types, you must:
Identify the listing the impairment meets; and,
Discuss symptom evaluation, onset, duration, closed period, and drug addiction and alcoholism materiality, as applicable.
2. Title XVI child claims
For Title XVI child claims, see DI 25230.001 Explaining Title XVI Childhood Disability Evaluation Determinations.
3. Physical evaluation
For claims other than Title XVI child claims, if the impairment meets a physical listing, use the SSA-416-UF (Medical Evaluation) to address meeting the listing. For instructions on how to complete the 416, see DI 24501.006 SSA-416-UF Medical Evaluation.
4. Mental evaluation
For claims other than Title XVI child claims, if the impairment meets a mental listing, use a SSA-2506-BK Psychiatric Review Technique (PRT) to evaluate the impairment(s). For instructions on how to complete the PRT see, DI 24505.025 Evaluation of Mental Impairments.
DI 22001.001 Sequential Evaluation of Title II and Title XVI Adult Disability Claims
DI 24501.006 SSA-416 Medical Evaluation
DI 24501.020 Establishing a Medically Determinable Impairment (MDI)
DI 24501.021 Evaluating Symptoms
DI 25220.005 Determining if a Child Has a Severe Impairment(s)
DI 25220.010 Meets or Medical Equals
DI 34000.000 Listing of Impairments – Current -Table of Contents