Appendix 1 to Subpart P of Part 404--Listing of Impairments
Part A
Criteria applicable to individuals age 18 and over and to children under age 18 where criteria are appropriate.
Sec.
1.00 Musculoskeletal System.
2.00 Special Senses and Speech.
3.00 Respiratory System.
4.00 Cardiovascular System
5.00 Digestive System.
6.00 Genito-Urinary System.
7.00 Hemic and Lymphatic System.
8.00 Skin.
9.00 Endocrine System.
10.00 Multiple Body Systems.
11.00 Neurological.
12.00 Mental Disorders.
13.00 Neoplastic Diseases, Malignant.
14.00 Immune System.
1.00 Musculoskeletal System
1.01 Category of Impairments, Musculoskeletal
1.02 Active rheumatoid arthritis and other inflammatory arthritis.
1.03 Arthritis of a major weight-bearing joint (due to any cause):
1.04 Arthritis of one major joint in each of the upper extremities (due to any cause):
1.05 Disorders of the spine:
C. Other vertebrogenic disorders (e.g., herniated nucleus puplosus, spinal stenosis) with the following persisting for at least 3 months despite prescribed therapy and expected to last 12 months. With both 1 and 2:
1. Pain, muscle spasm, and significant limitation of motion in the spine; and
2. Appropriate radicular distribution of significant motor loss with muscle weakness and sensory and reflex loss.
1.08 Osteomyelitis or septic arthritis (established by X-ray):
1.09 Amputation or anatomical deformity of (i.e., loss of major function due to degenerative changes associated with vascular or neurological deficits, traumatic loss of muscle mass or tendons and X-ray evidence of bony ankylosis at an unfavorable angle, joint subluxation or instability):
A. Both hands; or
B. Both feet; or
C. One hand and one foot.
1.10 Amputation of one lower extremity (at or above the tarsal region):
1.11 Fracture of the femur, tibia, tarsal bone or pelvis with solid union not evident
1.12 Fractures of an upper extremity with non-union
1.13 Soft tissue injuries of an upper or lower extremity requiring a series of staged surgical procedures
2.00 Special Senses and Speech
A. Ophthalmology
2.01 Category of Impairments, Special Senses and Speech
2.02 Impairment of central visual acuity. Remaining vision in the better eye after best correction is 20/200 or less.
2.03 Contraction of peripheral visual fields in the better eye.
2.04 Loss of visual efficiency.
2.05 Complete homonymous hemianopsia
2.06 Total bilateral ophthalmoplegia.
2.07 Disturbance of labyrinthine-vestibular function (including Meniere's disease)
2.08 Hearing impairments (hearing not restorable by a hearing aid)
2.09 Organic loss of speech
3.00 Respiratory System
3.01 Category of Impairments, Respiratory System.
3.02 Chronic pulmonary insufficiency.
A. Chronic obstructive pulmonary disease
B. Chronic restrictive ventilatory disease
C. Chronic impairment of gas exchange due to clinically documented pulmonary disease. With:
3.03 Asthma. B. Attacks, in spite of prescribed treatment and requiring physician intervention, occurring at least once every 2 months or at least six times a year.
3.04 Cystic fibrosis.
3.06 Pneumoconiosis
3.07 Bronchiectasis
3.08 Mycobacterial, mycotic, and other chronic persistent infections of the lung
3.09 Cor pulmonale
3.10 Sleep-related breathing disorders.
4.00 Cardiovascular System
4.01 Category of Impairments, Cardiovascular System
4.02 Chronic heart failure
1. Inability to perform on an exercise test at a workload equivalent to 5 METs or less due to symptoms of chronic heart failure
2. Resulting in marked limitation of physical activity, as demonstrated by fatigue, palpitation, dyspnea, or anginal discomfort on ordinary physical activity, even though the individual is comfortable at rest;
4.03 Hypertensive cardiovascular disease.
4.04 Ischemic heart disease
5. Documented reversible radionuclide "perfusion" (thallium[201]) defect at an exercise level equivalent to 5 METs or less;
1. Angiographic evidence revealing:
a. 50 percent or more narrowing of a nonbypassed left main coronary artery; or
b. 70 percent or more narrowing of another nonbypassed coronary artery; or
c. 50 percent or more narrowing involving a long (greater than 1 cm) segment of a nonbypassed coronary artery; or
d. 50 percent or more narrowing of at least 2 nonbypassed coronary arteries; or
e. Total obstruction of a bypass graft vessel; and
2. Resulting in marked limitation of physical activity, as demonstrated by fatigue, palpitation, dyspnea, or anginal discomfort on ordinary physical activity, even though the individual is comfortable at rest.
4.05 Recurrent arrhythmias,
4.06 Symptomatic congenital heart disease
4.07 Valvular heart disease or other stenotic defects, or valvular regurgitation,
4.08 Cardiomyopathies
4.09 Cardiac transplantation. Consider under a disability for 1 year following surgery; thereafter, reevaluate residual impairment under 4.02 to 4.08.
4.10 Aneurysm of aorta
4.11 Chronic venous insufficiency of a lower extremity.
4.12 Peripheral arterial disease.
5.00 Digestive System
5.01 Category of Impairments, Digestive System
5.02 Recurrent upper gastrointestinal hemorrhage
5.03 Stricture, stenosis, or obstruction of the esophagus
5.04 Peptic ulcer disease
5.05 Chronic liver disease (e.g., cirrhosis; hepatitis).
5.06 Chronic ulcerative or granulomatous colitis (Crohn's)
5.07 Regional enteritis
5.08 Weight loss due to any persisting gastrointestinal disorderTables of weight reflecting malnutrition scaled according to height and sex--To be used only in connection with 5.08.
Table I--Men
|
Height (inches) |
Weight (pounds) |
|
61 |
90 |
|
72 |
122 |
Table II--Women
|
Height (inches) |
Weight (pounds) |
|
58 |
77 |
|
72 |
117 |
6.00 Genito-Urinary System
6.01 Category of Impairments, Genito-Urinary System
6.02 Impairment of renal function, with:
A. Chronic hemodialysis or peritoneal dialysis or
B. Kidney transplant.
C. Persistent elevation of serum creatine o reduction of creatinine clearance
6.06 Nephrotic syndrome, with significant anasarca
7.00 Hemic and Lymphatic System
7.01 Category of Impairments, Hemic and Lymphatic System
7.02 Chronic anemia (hematocrit persisting at 30 percent or less due to any cause).
7.05 Sickle cell disease
7.06 Chronic thrombocytopenia
7.07 Hereditary telangiectasia
7.08 Coagulation defects (hemophilia or a similar disorder).
7.09 Polycythemia vera
7.10 Myelofibrosis.
7.11 Acute leukemia. Consider under a disability for 2½ years from the time of initial diagnosis.
7.12 Chronic leukemia.
7.13 Lymphomas.
7.14 Macroglobulinemia or heavy chain disease
7.15 Chronic granulocytopenia
7.16 Myeloma
7.17 Aplastic anemias or hematologic malignancies
8.00 Skin
8.01 Category of Impairments, Skin
8.02 Exfoliative dermatitis, ichthyosis, ichthyosiform erythroderma.
8.03 Pemphigus, erythema multiforme bullosum, bullous pemphigoid, dermatitis herpetiformis.
8.04 Deep mycotic infections. With extensive fungating, ulcerating lesions not responding to prescribed treatment.
8.05 Psoriasis, atopic dermatitis, dyshidrosis.
8.06 Hydradenitis suppurative, acne conglobata.
9.00 Endocrine System
9.01 Category of Impairments, Endocrine System
9.02 Thyroid Disorders.
9.03 Hyperparathyroidism.
9.04 Hypoparathyroidism.
9.05 Neurohypophyseal insufficiency (diabetes insipidus).
9.06 Hyperfunction of the adrenal cortex.
9.08 Diabetes mellitus. With:
A. Neuropathy demonstrated by significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movements, or gait and station; or
B. Acidosis occurring at least on the average of once every 2 months; or
C. Amputation at, or above, the tarsal region; or
D. Retinitis proliferans
Table I--Men
|
Height without shoes (inches) |
Weight (pounds) |
|
60 |
246 |
|
72 |
336 |
Table II--Women
|
Height without shoes (inches) |
Weight (pounds) |
|
60 |
230 |
|
72 |
322 |
Table III--A
[Applicable at test sites less than 3,000 feet above sea level]
|
Arterial PCO2 (mm. Hg) and |
Arterial PO2 equal to or less than (mm. Hg) |
|
30 or below |
65 |
|
40 or above |
50 |
10.00 Multiple Body Systems
10.01 Category of Impairments, Multiple Body Systems
10.06 Down syndrome (excluding mosaic Down syndrome) established by clinical and laboratory findings, as described in 10.00B. Consider the individual disabled from birth.
11.00 Neurological
11.01 Category of Impairments, Neurological
11.02 Epilepsy--major motor seizures, (grand mal or psychomotor), documented by EEG and by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once a month, in spite of at least 3 months of prescribed treatment.
11.03 Epilepsy--Minor motor seizures (petit mal, psychomotor, or focal), documented by EEG and by detailed description of a typical seizure pattern, including all associated phenomena; occurring more frequently than once weekly in spite of at least 3 months of prescribed treatment.
11.04 Central nervous system vascular accident (CVA, stroke).
11.06 Parkinsonian syndrome
11.07 Cerebral palsy. With:
A. IQ of 70 or less; or
B. Abnormal behavior patterns, such as destructiveness or emotional instability: or
C. Significant interference in communication due to speech, hearing, or visual defect; or
D. Disorganization of motor function.
11.08 Spinal cord or nerve root lesions
11.09 Multiple sclerosis.
11.10 Amyotrophic lateral sclerosis.
11.11 Anterior poliomyelitis
11.12 Myasthenia gravis.
11.13 Muscular dystrophy.
11.14 Peripheral neuropathies.
11.15 Tabes dorsalis.
11.16 Subacute combined cord degeneration (pernicious anemia) with disorganization of motor function.
11.17 Degenerative disease not elsewhere such as Huntington's chorea, Friedreich's ataxia, and spino-cerebellar degeneration.
11.18 Cerebral trauma:
Evaluate under the provisions of 11.02, 11.03, 11.04 and 12.02, as applicable.
11.19 Syringomyelia.
12.00 Mental Disorders
12.01 Category of Impairments-Mental Resulting in at least two of the following:
1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Deficiencies of concentration, persistence or pace resulting in frequent failure to complete tasks in a timely manner (in work settings or elsewhere); or
4. Repeated episodes of deterioration or decompensation in work or work-like settings which cause the individual to withdraw from that situation or to experience exacerbation of signs and symptoms (which may include deterioration of adaptive behaviors).
12.02 Organic Mental Disorders
12.03 Schizophrenic, Paranoid and Other Psychotic Disorders:
12.04 Affective Disorders
12.05 Mental Retardation and Autism: Mental retardation refers to a significantly subaverage general intellectual functioning with deficits in adaptive behavior initially manifested during the developmental period (before age 22). Autism is a pervasive developmental disorder characterized by social and significant communication deficits originating in the developmental period.
The required level of severity for this disorder is met when the requirements in A, B, C, or D are satisfied.
A. Mental incapacity evidenced by dependence upon others for personal needs (e.g., toileting, eating, dressing, or bathing) and inability to follow directions, such that the use of standardized measures of intellectual functioning is precluded;
OR
B. A valid verbal, performance, or full scale IQ of 59 or less;
OR
C. A valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing additional and significant work-related limitation of function;
12.06 Anxiety Related Disorders:
C. Resulting in complete inability to function independently outside the area of one's home.
12.07 Somatoform Disorders:
12.08 Personality Disorders:.
B. Resulting in three severe restrictions, not just two.
12.09 Substance Addiction Disorders
13.00 Neoplastic Diseases, Malignant
13.01 Category of Impairments, Neoplastic Diseases--Malignant
13.02 Head and neck
13.03 Sarcoma of skin:
13.04 Sarcoma of soft parts
13.05 Malignant melanoma.
13.06 Lymph nodes:
A. Hodgkin's disease or non-Hodgkin's lymphoma with progressive disease not controlled by prescribed therapy;
13.07 Salivary glands-.
13.08 Thyroid gland-.
13.09 Breast:
13.10 Skeletal system (exclusive of the jaw):
13.11 Mandible, maxilla, orbit, or temporal fossa:
13.12 Brain or spinal cord:
13.13 Lungs.
13.14 Pleura or mediastinum:
13.15 Abdomen:
13.16 Esophagus or stomach:
13.17 Small intestine:
13.18 Large intestine (from ileocecal valve to and including anal canal)--carcinoma or sarcoma.
13.19 Liver or gallbladder:
13.20 Pancreas:
13.21 Kidneys, adrenal glands, or ureters:
13.22 Urinary bladder
13.23 Prostate gland.
13.24 Testicles:
13.25 Uterus-
13.26 Ovaries-
13.27 Leukemia.
13.28 Uterine (Fallopian) tubes-
13.29 Penis-
13.30 Vulva-
14.00 Immune System
14.01 Category of Impairments, Immune System
14.02 Systemic lupus erythematosus..
14.03 Systemic vasculitis..
14.04 Systemic sclerosis and scleroderma.
14.05 Polymyositis or dermatomyositis.
14.06 Undifferentiated connective tissue disorder.
14.07 Immunoglobulin deficiency syndromes or deficiencies of cell-mediated immunity, excepting HIV infection.
14.08 Human immunodeficiency virus (HIV) infection.
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