The Listing of Impairments Under Federal Disability Law
The sequential evaluation process for Social Security disability benefits consists of five steps. If a claimant is not performing substantial gainful activity, they will pass the first step. Next, they will pass the second step if they are suffering from a severe impairment that is likely to last for at least 12 months or result in death. This brings the sequential evaluation to the third step, which involves consulting a manual known as the Listing of Impairments. A claim for benefits usually will succeed at this step if the claimant meets the criteria of an entry in the Listing. If they do not, the process will continue to a residual functional capacity assessment and the fourth and fifth steps. This discussion focuses on the third step and the Listing of Impairments.
The Structure of the Listing of Impairments
The Social Security Administration has divided the Listing into two parts. Part A generally covers medical impairments in adults, who are 18 or older. It describes impairments that are severe enough to inherently prevent a claimant from performing substantial gainful activity. Meanwhile, Part B of the Listing provides medical criteria that should be used when evaluating impairments in children, who must have marked and severe functional limitations. Part B is relevant only to children pursuing SSI benefits, since SSDI benefits are not available to children under 18 except as auxiliary benefits based on a parent’s benefits.
Medical conditions in Part A of the Listing are grouped according to the body systems that are affected:
- Musculoskeletal disorders
- Special senses and speech
- Respiratory disorders
- Cardiovascular system
- Digestive system
- Genitourinary disorders
- Hematological disorders
- Skin disorders
- Endocrine disorders
- Congenital disorders that affect multiple body systems
- Neurological disorders
- Mental disorders
- Cancer (malignant neoplastic diseases)
- Immune system disorders
Generally, an impairment in the Listing is permanent or expected to result in death, or the entry for the impairment specifically describes its duration. If an impairment is not necessarily permanent or terminal, and there is no durational statement in its entry, the evidence must show that the impairment has lasted or is expected to last for at least 12 months.
Medical Equivalence to Listed Impairments
Each impairment in the Listing is defined very precisely, which makes it harder for any given person to meet all of the applicable criteria. As an alternative, a claimant likely will be eligible for benefits if their impairment is medically equal to a listed impairment. This means that it is at least equal in severity and duration to the criteria of a listed impairment.
First, if a claimant has an impairment described in the Listing but does not exhibit all the findings in that entry, their impairment is medically equivalent if there are other findings related to the impairment that have medically equal significance to the required criteria. A claimant with an impairment described in the Listing who exhibits all the findings in that entry, but not to the level of severity required by the entry, also has an impairment that is medically equivalent if there are other findings related to their impairment that have medically equal significance to the required criteria.
When a claimant has an impairment that is not covered in the Listing, but there is a closely analogous impairment in the Listing, their impairment is considered medically equivalent to that impairment if the findings related to their impairment have equal medical significance to the analogous impairment. Finally, when a claimant has a combination of impairments, and none of them meets the criteria of an entry in the Listing, their combination of impairments is medically equivalent to a closely analogous impairment in the Listing if findings related to their impairments have equal medical significance to those of the analogous impairment.
