TN 10 (04-09)

A. Title II

When Item 15 is checked and the claimant's impairment meets or equals the level of severity of the Listing of Impairments at the time of adjudication, enter up to 7 positions of the appropriate medical listing number. The first three positions (to the left of the decimal point) must be numeric, with values of 001-114. Fill in with leading zeroes if the medical listing number has fewer than 3 positions before the decimal. Positions 4-5 (the first two positions to the right of the decimal point) must be numeric; with values, 02-30 (must show leading zeroes). Position 6 (the third position to the right of the decimal point) must be alpha with values A-O, or blank). Position 7 (the last position) can have values A-O (alpha), 1-9 (numeric, no zeroes), or be blank.

For example:

Medical listing “112.09” should be coded as “112.09”

Medical listing “4.02A2” should be coded as “004.02A2”

NOTE: These coding instructions coincide with the requirements for entering medical listing codes to the National Disability Determination Services System.

B. Title XVI

1. Adult (individual age 18 or older)

When Item 15 or 18B is checked, complete Item 23 as in DIB cases.

2. Child (individual under age 18)

1. When the impairment(s) meets or medically equals a listing, complete Item 23 as in DIB cases.

2. When the impairment(s) functionally equals the listings, make no entry in Item 23.