608.What if your condition does not meet or medically equal a listing?

608.1What happens in adult claims?

If you apply for disabled worker's benefits, widow(er)'s benefits based on disability, childhood disability benefits (“disabled adult child”), a “period of disability,” or adult SSI disability payments and have a severe impairment (see §606), we will decide if your condition meets or medically equals an impairment in Part A of the Listing of Impairments. (See §§607 and §§608.) However, if we decide that your condition is not a listed impairment and is not medically equal to a listed impairment, we may still decide that you are disabled under the definition in §507.1.

We will do this by assessing your residual functional capacity for work. That means we will look at how your condition affects your ability to do work-related activities and determine what you can still do despite your impairment(s). We will also consider your vocational background, including your age, education, and work experience.

1. First, we determine if your impairment prevents you from doing your past relevant work. Usually we consider past relevant work to be any substantial gainful work you did in the past 15 years that lasted long enough for you to have learned to do the work.

2. If you have no past relevant work or cannot do your past relevant work, we then look for other work you can do considering your impairment, age, education, and work experience. By “other work,” we mean jobs that exist in significant numbers in the national economy.

608.2What happens in children's SSI claims?

If you apply for SSI based on disability, and we decide that you have a severe impairment(s), we will decide if your condition meets or medically equals an impairment in Part B of the Listing of Impairments. If the listings in part B do not apply, and your specific disease process(es) has a similar effect on adults and children, we use the listings in part A to decide if your condition meets or medically equals a listed impairment. (See §607.) However, if we decide that your condition is not a listed impairment and is not medically equal to a listed impairment, we may still decide that you are disabled under the definition in §517.

We will do this by considering whether your condition(s) "functionally equals the listings"; that is, we will consider what you cannot do, have difficulty doing, need help doing, or are restricted from doing because of your condition. We will consider how your condition(s) affects you in your daily activities at home, at school, and in your neighborhood. Your activities are the things you do when you are acquiring and using information; attending and completing tasks; interacting and relating with others; moving about and manipulating objects; and caring for yourself. We will also consider your health and physical well-being.

To decide whether your condition(s) functionally equals the listings, we will compare your daily activities to the daily activities of other children your age who do not have impairments, and we will compare how you do your activities to how those children do theirs

When we evaluate your claim, these are some of the things we will think about:

1. How well you can initiate, sustain, and complete your activities (for example, the range and pace of your activities; how much prompting you need to begin, carry through, and finish them).

2. How independently you are able to function compared to children your age who do not have impairments (for example, how much extra help or supervision you need in your activities).

3. Whether you spend some or all of your time in a structured or supportive setting, beyond what a child who does not have an impairment typically needs.

4. Whether symptoms such as pain, fatigue, decreased energy, or anxiety, as well as the effects of medication limit your functioning.