Mental Disorder Listings 12.05-12.07

Understanding SSA’s mental disorder listings is critical to successful SSI/SSDI applications. In this article, we will review the key medical criteria required for listings 12.05 through 12.07. You can also find the listings on SSA’s website here.

12.05 Intellectual disorder
Meeting Listing 12.05
To meet the listing in (12.05), the applicant must meet the criteria outlined in Parts A or B. This criteria is different and unique from Parts A and B that you will find in other mental disorder listings.
 
  1. Used when cognitive impairment prevents taking IQ test
  2. Used for those able to take a standardized test
Overview
This disorder is characterized by significantly subaverage general intellectual functioning, significant deficits in current adaptive functioning, and manifestation of the disorder before age 22.
Symptoms may include (but are not limited to)
For SSA purposes, this generally involves having a full scale IQ of 70 or less, or a full scale IQ of 71 through 75 and a verbal or performance IQ of 70 or below, along with marked impairments in functioning.
 
Individuals who do not have the cognitive ability to take a standardized IQ test and who depend upon others for personal needs (eating, bathing, etc.) may also meet the criteria for this listing.
Examples of disorders evaluated in this listing
Intellectual disability or intellectual developmental disorder
 
This category does not include the mental disorders evaluated under neurocognitive disorders (12.02), autism spectrum disorder (12.10), or neurodevelopmental disorders (12.11) The Listing for Down Syndrome is found in 10.00.

To meet the criteria for this listing, the applicant must meet all three criteria in either A or B:

Criteria A Criteria B
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
1. Significantly subaverage general intellectual functioning evidenced by a or b:
  1. A full scale (or comparable) IQ score of 70 or below on an individually administered standardized test of general intelligence; or
  2. 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 your dependence upon others for personal needs (for example, toileting, eating, dressing, or bathing); 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:
  1. Understand, remember, or apply information
  2. Interact with others
  3. Concentrate, persist, or maintain pace
  4. Adapt or manage oneself
3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.
3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.
Cartoon of the male Super SOAR figure SOAR Tip: It is helpful to check with the applicant’s previous schools, as many schools keep educational records, Individual Education Plans (IEPs), and IQ test results on file years after the applicant completed school. Do not assume that the records do not exist because they are old.  You may be pleasantly surprised!
12.06 Anxiety and obsessive-compulsive disorders
Meeting Listing 12.06
To meet the listing in (12.06), the applicant must meet the criteria outlined in Parts A or B or Parts A and C. This article will cover the criteria required for Part A. Articles 5.2-5.8 cover the criteria required for Part B and Article 4.2 covers the criteria required for Part C.
 
  1. Medical criteria that must be present in the medical evidence
  2. Functional criteria that is assessed on a five-point rating scale from “none” to “extreme”
  3. Criteria used to evaluate “serious and persistent mental disorders”
Overview
These disorders are characterized by excessive anxiety, worry, apprehension, and fear, or by avoidance of feelings, thoughts, activities, objects, places, or people.
Symptoms may include (but are not limited to)
  • Restlessness
  • Difficulty concentrating
  • Hyper-vigilance
  • Muscle tension
  • Sleep disturbance
  • Fatigue
  • Panic attacks
  • Obsessions and compulsions
  • Constant thoughts and fears about safety
  • Frequent physical complaints
Examples of disorders evaluated in this listing
  • Social anxiety disorder
  • Panic disorder
  • Generalized anxiety disorder
  • Agoraphobia
  • Obsessive-compulsive disorder
 
*This category does not include the mental disorders evaluated under trauma- and stressor-related disorders, such as PTSD
To meet the medical criteria for this listing (Part A), there must be medical documentation of columns 1, 2, or 3:
1. Anxiety disorder, characterized by three or more:
2. Panic disorder or agoraphobia, characterized by one or both:
3. Obsessive-compulsive disorder, characterized by one or both:
  • Restlessness
  • Easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance
  • Panic attacks followed by a persistent concern or worry about additional panic attacks or their consequences
  • Disproportionate fear/anxiety about at least two different situations (e.g. using public transportation, being in a crowd or in a line, being outside of your home, being in open spaces)
  • Involuntary, time-consuming preoccupation with intrusive, unwanted thoughts
  • Repetitive behaviors aimed at reducing anxiety.
12.07 Somatic symptom and related disorders
Meeting Listing 12.07
To meet the listing in (12.07), the applicant must meet the criteria outlined in Parts A and B. This article will cover the criteria required for Part A. Articles 5.2-5.8 cover the criteria required for Part B There is no Part C for this Listing.
 
  1. Medical criteria that must be present in the medical evidence
  2. Functional criteria that is assessed on a five-point rating scale from “none” to “extreme”
Overview
These disorders are characterized by physical symptoms or deficits that are not intentionally produced or feigned, and that, following clinical investigation, cannot be fully explained by a general medical condition, another mental disorder, the direct effects of a substance, or a culturally sanctioned behavior or experience.
 
These disorders may also be characterized by a preoccupation with having or acquiring a serious medical condition that has not been identified or diagnosed.
Symptoms may include (but are not limited to)
  • Pain and other abnormalities of sensation
  • Gastrointestinal symptoms
  • Fatigue
  • High level of anxiety about personal health status
  • Abnormal motor movement
  • Pseudoseizures
  • Pseudoneurological symptoms, such as blindness or deafness
Examples of disorders evaluated in this listing
  • Somatic symptom disorder
  • Illness anxiety disorder
  • Conversion disorder
Key Terms Image of a book
Somatic symptom
Physical symptom, such as pain, weakness, shortness of breath.
Somatic symptom disorder
Involves a person having excessive thoughts, feelings and behaviors relating to physical symptoms that results in major distress and/or problems functioning. The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick.
Illness anxiety disorder
Involves a person preoccupied with having an illness or getting an illness and constantly worrying about their health. They may frequently check themselves for signs of illness, focus on health behaviors and take extreme precautions to avoid health risks. Unlike somatic symptom disorder, the person may not experience symptoms.
Conversion disorder
A condition in which symptoms affect a person’s perception, sensation or movement with no evidence of a physical cause. A person may have numbness, blindness or trouble walking. The symptoms tend to come on suddenly and may last for a while or may go away quickly. People with conversion disorder also frequently experience depression or anxiety disorders.
To meet the medical criteria for this listing (Part A), there must be medical documentation of one or more of the following:
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Symptoms of altered voluntary motor or sensory function that are not better explained by another medical or mental disorder;
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One or more somatic symptoms that are distressing, with excessive thoughts, feelings, or behaviors related to the symptoms; or
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Preoccupation with having or acquiring a serious illness without significant symptoms present.
Cartoon image of female super SOAR figure
SOAR Tip: Be aware that a history of trauma may be associated with somatic disorders. Focus on documenting the maladaptive behavior that the individual is exhibiting.