TN 3 (09-21)

DI 28090.040 Rationale Content - Meets or Equals

A. Meets a listing

The rationale must reflect the specific listing, including any subsection identification (for example, Listing 14.02A or B) in the rationale if a listing is met. Include the specific findings that meet the listing’s requirements. For a rationale example, see DI 28090.300A.

B. Equals a listing

When the impairment(s) is medically equivalent to a listed impairment in the Listing of Impairments, the rationale must identify the elements that support this finding and identify the listed impairment number, including any subsection identification that is equaled. The adjudicator must explain why the signed statement of the reviewing medical or psychological consultant (MC/PC) concluded that severity and duration equivalent to a listed impairment is present. The adjudicator must incorporate the entire analysis, as to equivalency provided by the reviewing MC/PC, into the rationale. The rationale must also document medical equivalency in the following situations:

1. Specified medical finding(s) missing

When an impairment is listed, and one or more of the specified medical findings is missing from the evidence (but other medical findings of greater or equal significance that relate to the same impairment are present in the evidence), the MC/PC or adjudicator should identify the equivalent finding (or finding of greater or equal significance).The MC/PC or adjudicator should explain the basis(es) for the equivalency.

2. Unlisted impairment

When there is an unlisted impairment, identify the most closely analogous listed impairment. The analysis must identify those medical findings of the unlisted impairment and explain why the findings or manifestations are equivalent to the severity reflected in the identified listed impairment.

3. Combination of impairments

When the MC/PC or adjudicatorbases equivalency on a combination of impairments, the MC/PC or adjudicator will cite the listed impairment number most closely related to the most severe impairment. In these situations, the MC or PC will provide a medical explanation to show how the interaction of the combined impairments equates with the intended severity of a listed impairment(s).

For more information on medical equivalence, see DI 24508.010. For a rationale example, see DI 28090.300B.

C. Impairment does not meet or equal

When the individual's impairment(s) does not meet or equal the Listings, the adjudicator will include the statement: “The individual's impairment(s) does not meet or equal the level of severity described in, or intended by, the Listing of Impairments.”

To Link to this section - Use this URL:
DI 28090.040 - Rationale Content - Meets or Equals - 08/26/2015
Batch run: 09/22/2021