Mental Disorder Listings 12.12-12.15

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 12.12 through 12.15. You can also find the full Listings on SSA’s website here.

12.12 Reserved Listing
Currently, there is no listing 12.12; SSA is reserving this space in the event they add more listings at a later date.
 
12.13 Eating disorders
*This listing is new, effective January 17, 2017
 
Meeting Listing 12.13
To meet the eating disorders listing the applicant must meet the criteria outlined in Parts A and B. Articles 5.2-5.8 cover the criteria required for Part B. There is no C section 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 disturbances in eating behavior and preoccupation with, and excessive self-evaluation of, body weight and shape.
Symptoms may include (but are not limited to)
  • Restriction of energy consumption when compared with individual requirements
  • Recurrent episodes of binge eating or behavior intended to prevent weight gain, such as self-induced vomiting, excessive exercise, or misuse of laxatives
  • Mood disturbances
  • Social withdrawal, or irritability
  • Amenorrhea
  • Dental problems
  • Abnormal laboratory findings
  • Cardiac abnormalities
 
*A person with an eating disorder can be underweight, within a healthy weight range, or overweight.
Examples of disorders evaluated in this listing
  • Anorexia nervosa
  • Bulimia nervosa
  • Binge-eating disorder
  • Avoidant/restrictive food disorder
Key Points to Keep in Mind
cartoon image of a light bulb
People in all age groups, genders and socio-economic and cultural backgrounds can be affected by eating disorders.
cartoon image of a light bulb
You may not be able to tell if the person has an eating disorder based simply on their appearance. So it is important to know the warning signs, which include behavioral, physical and psychological signs.
cartoon image of a light bulb
A person does not have to be underweight to require emergency medical assistance for an eating disorder.
To meet the medical criteria (Part A) for this listing, there must be medical documentation of:
 
  1. 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.
 
cartoon male super SOAR figure
SOAR Tip: Individuals who have an eating disorder may also experience other physical and mental health conditions related to their eating disorder, such as depression, anxiety, cardiovascular problems, or dental issues. These conditions may meet the criteria for other Listings.
12.14 Reserved Listing
Currently, there is no listing 12.14; SSA is reserving this space in the event they add more listings at a later date.
 
12.15 Trauma- and stressor-related disorders
*This listing is new, effective January 17, 2017
 
Meeting Listing 12.15
To meet the listing for trauma and stressor-related disorders, the applicant must meet the criteria outlined in Parts A and B or Parts A and C. This article covered 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 experiencing or witnessing a traumatic or stressful event, or learning of a traumatic event occurring to a close family member or close friend, and the psychological aftermath of clinically significant effects on functioning.
Symptoms may include (but are not limited to)
  • Distressing memories, dreams, and flashbacks related to the trauma or stressor
  • Avoidant behavior
  • Diminished interest or participation in significant activities
  • Persistent negative emotional states (for example, fear, anger) or persistent inability to experience positive emotions (for example, satisfaction, affection)
  • Anxiety
  • Irritability
  • Aggression
  • Exaggerated startle response
  • Difficulty concentrating
  • Sleep disturbance
Examples of disorders evaluated in this listing
  • Posttraumatic stress disorder
  • Other specified trauma- and stressor-related disorders (such as adjustment-like disorders with prolonged duration without prolonged duration of stressor)
 
This category does not include the mental disorders evaluated under anxiety and obsessive-compulsive disorders (12.06), and cognitive impairments that result from neurological disorders, such as a traumatic brain injury, which SSA evaluates under neurocognitive disorders (12.02).
cartoon female super SOAR figure
SOAR Tip:  For more information on PTSD, view the short, informative videos produced by the U.S. Department of Veterans Affairs
To meet the medical criteria (Part A) for this listing, there must be medical documentation of all of the following:
 
  1. Exposure to actual or threatened death, serious injury, or violence;
  2. Subsequent involuntary re-experiencing of the traumatic event (for example, intrusive memories, dreams, or flashbacks);
  3. Avoidance of external reminders of the event;
  4. Disturbance in mood and behavior; and
  5. Increases in arousal and reactivity (for example, exaggerated startle response, sleep disturbance).
 
cartoon male super SOAR figure
SOAR Tip: When you begin to work with applicants, look back at the Listings criteria in these articles to ensure that you are providing all the documentation that DDS needs to show how the applicant meets the medical criteria for SSI/SSDI.