1. These listings include only examples of mental disorders that we consider serious
enough to result in marked and severe functional limitations. If your severe mental
disorder does not meet the criteria of any of these listings, we will consider whether
you have an impairment(s) that meets the criteria of a listing in another body system.
You may have another impairment(s) that is secondary to your mental disorder. For
example, if you have an eating disorder and develop a cardiovascular impairment because
of it, we will evaluate your cardiovascular impairment under the listings for the
cardiovascular body system.
2. If you have a severe medically determinable impairment(s) that does not meet a
listing, we will determine whether your impairment(s) medically equals a listing (see § 416.926 of this chapter).
3. If your impairment(s) does not meet or medically equal a listing, we will consider
whether you have an impairment(s) that functionally equals the listings (see § 416.926a
of this chapter).
4. Although we present these alternatives in a specific sequence above, each represents
listing-level severity, and we can evaluate your claim in any order. For example,
if the factors of your case indicate that the combination of your impairments may
functionally equal the listings, we may start with that analysis. We use the rules
in § 416.994a of this chapter, as appropriate, when we decide whether you continue
to be disabled.
112.01 Category of Impairments, Mental Disorders
112.02 Neurocognitive disorders (see 112.00B1), for children age 3 to attainment of age 18, satisfied by A and B,
or A and C:
A. Medical documentation of a clinically significant deviation in normal cognitive
development or by significant cognitive decline from a prior level of functioning
in one or more of the cognitive areas:
1. Complex attention;
2. Executive function;
3. Learning and memory;
4. Language;
5. Perceptual-motor; or
6. Social cognition.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that
is, you have a medically documented history of the existence of the disorder over
a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly
structured setting(s) that is ongoing and that diminishes the symptoms and signs of
your mental disorder (see 112.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in
your environment or to demands that are not already part of your daily life (see 112.00G2c).
112.03 Schizophrenia spectrum and other psychotic disorders (see 112.00B2), for children age 3 to attainment of age 18, satisfied by A and B,
or A and C:
A. Medical documentation of one or more of the following:
1. Delusions or hallucinations;
2. Disorganized thinking (speech); or
3. Grossly disorganized behavior or catatonia.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that
is, you have a medically documented history of the existence of the disorder over
a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly
structured setting(s) that is ongoing and that diminishes the symptoms and signs of
your mental disorder (see 112.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in
your environment or to demands that are not already part of your daily life (see 112.00G2c).
112.04 Depressive, bipolar and related disorders (see 112.00B3), for children age 3 to attainment of age 18, satisfied by A and B, or
A and C:
A. Medical documentation of the requirements of paragraph 1, 2, or 3:
1. Depressive disorder, characterized by five or more of the following:
a. Depressed or irritable mood;
b. Diminished interest in almost all activities;
c. Appetite disturbance with change in weight (or a failure to achieve an expected
weight gain);
d. Sleep disturbance;
e. Observable psychomotor agitation or retardation;
f. Decreased energy;
g. Feelings of guilt or worthlessness;
h. Difficulty concentrating or thinking; or
i. Thoughts of death or suicide.
2. Bipolar disorder, characterized by three or more of the following:
a. Pressured speech;
b. Flight of ideas;
c. Inflated self-esteem;
d. Decreased need for sleep;
e. Distractibility;
f. Involvement in activities that have a high probability of painful consequences
that are not recognized; or
g. Increase in goal-directed activity or psychomotor agitation.
3. Disruptive mood dysregulation disorder, beginning prior to age 10, and all of the following:
a. Persistent, significant irritability or anger;
b. Frequent, developmentally inconsistent temper outbursts; and
c. Frequent aggressive or destructive behavior.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that
is, you have a medically documented history of the existence of the disorder over
a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly
structured setting(s) that is ongoing and that diminishes the symptoms and signs of
your mental disorder (see 112.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in
your environment or to demands that are not already part of your daily life (see 112.00G2c).
112.05 Intellectual disorder (see 112.00B4), for children age 3 to attainment of age 18, satisfied by A or B:
A. Satisfied by 1 and 2 (see 112.00H):
1. Significantly subaverage general intellectual functioning evident in your cognitive
inability to function at a level required to participate in standardized testing of
intellectual functioning; and
2. Significant deficits in adaptive functioning currently manifested by your dependence
upon others for personal needs (for example, toileting, eating, dressing, or bathing)
in excess of age-appropriate dependence.
OR
B. Satisfied by 1 and 2 (see 112.00H):
1. Significantly subaverage general intellectual functioning evidenced by a or b:
a. A full scale (or comparable) IQ score of 70 or below on an individually administered
standardized test of general intelligence; or
b. A full scale (or comparable) IQ score of 71-75 accompanied by a verbal or performance
IQ score (or comparable part score) of 70 or below on an individually administered
standardized test of general intelligence; and
2. Significant deficits in adaptive functioning currently manifested by extreme limitation
of one, or marked limitation of two, of the following areas of mental functioning:
a. Understand, remember, or apply information (see 112.00E1); or
b. Interact with others (see 112.00E2); or
c. Concentrate, persist, or maintain pace (see 112.00E3); or
d. Adapt or manage oneself (see 112.00E4).
112.06 Anxiety and obsessive-compulsive disorders (see 112.00B5), for children age 3 to attainment of age 18, satisfied by A and B,
or A and C:
A. Medical documentation of the requirements of paragraph 1, 2, 3, or 4:
1. Anxiety disorder, characterized by one or more of the following:
a. Restlessness;
b. Easily fatigued;
c. Difficulty concentrating;
d. Irritability;
e. Muscle tension; or
f. Sleep disturbance.
2. Panic disorder or agoraphobia, characterized by one or both:
a. Panic attacks followed by a persistent concern or worry about additional panic
attacks or their consequences; or
b. Disproportionate fear or anxiety about at least two different situations (for example,
using public transportation, being in a crowd, being in a line, being outside of your
home, being in open spaces).
3. Obsessive-compulsive disorder, characterized by one or both:
a. Involuntary, time-consuming preoccupation with intrusive, unwanted thoughts; or;
b. Repetitive behaviors that appear aimed at reducing anxiety.
4. Excessive fear or anxiety concerning separation from those to whom you are attached.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that
is, you have a medically documented history of the existence of the disorder over
a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly
structured setting(s) that is ongoing and that diminishes the symptoms and signs of
your mental disorder (see 112.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in
your environment or to demands that are not already part of your daily life (see 112.00G2c).
112.07 Somatic symptom and related disorders (see 112.00B6), for children age 3 to attainment of age 18, satisfied by A and B:
A. Medical documentation of one or both of the following:
1. Symptoms of altered voluntary motor or sensory function that are not better explained
by another medical or mental disorder; or
2. One or more somatic symptoms that are distressing, with excessive thoughts, feelings,
or behaviors related to the symptoms.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
112.08 Personality and impulse-control disorders (see 112.00B7), for children age 3 to attainment of age 18, satisfied by A and B:
A. Medical documentation of a pervasive pattern of one or more of the following:
1. Distrust and suspiciousness of others;
2. Detachment from social relationships;
3. Disregard for and violation of the rights of others;
4. Instability of interpersonal relationships;
5. Excessive emotionality and attention seeking;
6. Feelings of inadequacy;
7. Excessive need to be taken care of;
8. Preoccupation with perfectionism and orderliness; or
9. Recurrent, impulsive, aggressive behavioral outbursts.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
112.09 [Reserved]
112.10 Autism spectrum disorder (see 112.00B8), for children age 3 to attainment of age 18), satisfied by A and B:
A. Medical documentation of both of the following:
1. Qualitative deficits in verbal communication, nonverbal communication, and social
interaction; and
2. Significantly restricted, repetitive patterns of behavior, interests, or activities.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
112.11 Neurodevelopmental disorders (see 112.00B9), for children age 3 to attainment of age 18, satisfied by A and B:
A. Medical documentation of the requirements of paragraph 1, 2, or 3:
1. One or both of the following:
a. Frequent distractibility, difficulty sustaining attention, and difficulty organizing
tasks; or
b. Hyperactive and impulsive behavior (for example, difficulty remaining seated, talking
excessively, difficulty waiting, appearing restless, or behaving as if being “driven
by a motor”).
2. Significant difficulties learning and using academic skills; or
3. Recurrent motor movement or vocalization.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
112.12 [Reserved]
112.13 Eating disorders (see 112.00B10), for children age 3 to attainment of age 18, satisfied by A and B:
A. Medical documentation of a persistent alteration in eating or eating-related behavior
that results in a change in consumption or absorption of food and that significantly
impairs physical or psychological health.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
112.14 Developmental disorders in infants and toddlers (see 112.00B11, 112.00I), satisfied by A and B:
A. Medical documentation of one or both of the following:
1. A delay or deficit in the development of age-appropriate skills; or
2. A loss of previously acquired skills.
AND
B. Extreme limitation of one, or marked limitation of two, of the following developmental
abilities (see 112.00F):
1. Plan and control motor movement (see 112.00I4b(i)).
2. Learn and remember (see 112.00I4b(ii)).
3. Interact with others (see 112.00I4b(iii)).
4. Regulate physiological functions, attention, emotion, and behavior (see 112.00I4b(iv)).
112.15 Trauma- and stressor-related disorders (see 112.00B11), for children age 3 to attainment of age 18, satisfied by A and B,
or A and C:
A. Medical documentation of the requirements of paragraph 1 or 2:
1. Posttraumatic stress disorder, characterized by all of the following:
a. Exposure to actual or threatened death, serious injury, or violence;
b. Subsequent involuntary re-experiencing of the traumatic event (for example, intrusive
memories, dreams, or flashbacks);
c. Avoidance of external reminders of the event;
d. Disturbance in mood and behavior (for example, developmental regression, socially
withdrawn behavior); and
e. Increases in arousal and reactivity (for example, exaggerated startle response,
sleep disturbance).
2. Reactive attachment disorder, characterized by two or all of the following:
a. Rarely seeks comfort when distressed;
b. Rarely responds to comfort when distressed; or
c. Episodes of unexplained emotional distress.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas
of mental functioning (see 112.00F):
1. Understand, remember, or apply information (see 112.00E1).
2. Interact with others (see 112.00E2).
3. Concentrate, persist, or maintain pace (see 112.00E3).
4. Adapt or manage oneself (see 112.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that
is, you have a medically documented history of the existence of the disorder over
a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly
structured setting(s) that is ongoing and that diminishes the symptoms and signs of
your mental disorder (see 112.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in
your environment or to demands that are not already part of your daily life (see 112.00G2c).