Mental Disorder Listings 12.08-12.11

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 12.08 through 12.11. You can also find the listings on SSA’s website here.*Listing 12.09 has been reserved and is not currently in use.

Meeting Listings 12.08, 12.10, and 12.11
To meet these listings, 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.
 
  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”
12.08 Personality and impulse-control disorders
Overview
These disorders are characterized by enduring, inflexible, maladaptive, and pervasive patterns of behavior.
 
Onset typically occurs in adolescence or young adulthood.
Symptoms may include (but are not limited to)
  • Patterns of distrust, suspiciousness, and odd beliefs
  • Social detachment, discomfort, or avoidance
  • Hypersensitivity to negative evaluation
  • Excessive need to be taken care of
  • Difficulty making independent decisions
  • Preoccupation with orderliness, perfectionism, and control
  • Inappropriate, intense, impulsive anger and behavioral expression grossly out of proportion to any external provocation or psychosocial stressors
Examples of disorders evaluated in this listing
  • Paranoid, schizoid, schizotypal, borderline, avoidant, dependent, obsessive-compulsive personality disorders
  • Intermittent explosive disorder
To meet the medical criteria (Part A) for this listing, there must be 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.

 

Diving Deeper: Understanding Personality Disorders
Personality disorders may fall under the following types, classified by certain behavior patterns:
Paranoid
Distrust and suspiciousness such that others’ motives are interpreted as malevolent
Schizoid
Detachment from social relationships and a restricted range of emotional expression
Schizotypal
Acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior
Antisocial
Disregard for, and violation of, the rights of others
Borderline
Instability in interpersonal relationships, self-image, and affects, and marked impulsivity
Histrionic
Excessive emotionality and attention seeking
Narcissistic
Grandiosity, need for admiration, and lack of empathy
Avoidant
Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
Dependent
Submissive and clinging behavior related to an excessive need to be taken care of
Obsessive-compulsive
Preoccupation with orderliness, perfectionism, and control
Intermittent explosive disorder
Repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which the reaction is grossly out of proportion to the situation
SOAR Tips: Individuals with personality disorder may display extreme limitations in their ability to interact with others, which is a component of section B criteria.
          
Remember that an individual may be resistant to engagement or treatment and seem difficult to work with at times, but this does not necessarily mean they have a personality disorder. Look for enduring and pervasive patterns of behavior.
12.09 Listing for Substance Addiction Disorders Removed
SSA removed this listing, effective January 17th, 2017, as individuals cannot be approved for SSI/SSDI based solely on a substance addiction disorder. Other listings consider the physical and mental health effects of substance use (e.g. cirrhosis of the liver due to chronic alcohol use or epilepsy), so this listing was considered to be redundant as it referred users to other parts of the Listings. More information on how SSA considers substance use and materiality is covered in the article Co-Occurring Substance Use: Material to Disability?
 
12.10 Autism spectrum disorder
Overview
These disorders are characterized by qualitative deficits in the development of reciprocal social interaction, verbal and nonverbal communication skills, and symbolic or imaginative activity; restricted repetitive and stereotyped patterns of behavior, interests, and activities; and stagnation of development or loss of acquired skills early in life.
Symptoms may include (but are not limited to)
  • Abnormalities and unevenness in the development of cognitive skills
  • Unusual responses to sensory stimuli
  • Behavioral difficulties, including hyperactivity, short attention span, impulsivity, aggressiveness, or self-injurious actions
Examples of disorders evaluated in this listing
  • Autism spectrum disorder with or without accompanying intellectual impairment
  • Autism spectrum disorder with or without accompanying language impairment
 
This category does not include the mental disorders evaluated under neurocognitive disorders (12.02), intellectual disorder (12.05), and neurodevelopmental disorders (12.11)
To meet the medical criteria (Part A) for this listing, there must be 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.
 
Quick Facts on Autism Spectrum Disorder from the DSM-5
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Symptoms are typically recognized between 12 and 24 months of age
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Only a minority of individuals with autism spectrum disorder live and work independently in adulthood; those who do tend to have superior language and intellectual abilities and are able to find a niche that matches their special interests and skills.
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In general, individuals with lower levels of impairment may be better able to function independently. However, even these individuals may remain socially naive and vulnerable, have difficulties organizing practical demands without aid, and are prone to anxiety and depression.
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Many adults report using compensation strategies and coping mechanisms to mask their difficulties in public but suffer from the stress and effort of maintaining a socially acceptable facade.
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Scarcely anything is known about old age in autism spectrum disorder.
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SOAR Tip: Diagnostic categories change over time. You may find that someone was diagnosed with ADHD 10 years ago who would not get that diagnosis today. Focus on the symptoms that led to the diagnosis to help meet the medical criteria required.
12.11 Neurodevelopmental disorders
*This listing is new, effective January 17th, 2017
Overview
These disorders are characterized by onset during the developmental period, that is, during childhood or adolescence, although sometimes they are not diagnosed until adulthood.
Symptoms may include (but are not limited to)
  • Underlying abnormalities in cognitive processing (e.g. deficits in learning and applying verbal or nonverbal information, visual perception, memory, or a combination of these)
  • Deficits in attention or impulse control
  • Low frustration tolerance
  • Excessive or poorly planned motor activity
  • Difficulty with organizing (time, space, materials, or tasks)
  • Deficits in social skills
  • Symptoms and signs specific to tic disorders include sudden, rapid, recurrent, non-rhythmic, motor movement or vocalization.
Examples of disorders evaluated in this listing
  • Specific learning disorder
  • Borderline intellectual functioning
  • Tic disorders (such as Tourette syndrome)
 
This category does not include the mental disorders evaluated under neurocognitive disorders (12.02), autism spectrum disorder (12.10), or personality and impulse-control disorders (12.08).
To meet the medical criteria (Part A) for this listing, there must be medical documentation of columns 1, 2, or 3:
Criteria 1
Criteria 2
Criteria 3
1. One or both of the following:
  1. Frequent distractibility, difficulty sustaining attention, and difficulty organizing tasks; or
  2. Hyperactive and impulsive behavior (e.g. 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
3. Recurrent motor movement or vocalization
SOAR Tips: Individuals who have learning disorders or who have an IQ score that is low, but do not meet the criteria in 12.05 Intellectual disorders, may meet the criteria in this listing.