11.04: Vascular Insult to the Brain

What actually decides a claim under 11.04

It is deliberately not applied immediately: SSA looks at your condition at least three months after the stroke, because early deficits often improve substantially. At that point it looks for sensory or motor aphasia resulting in ineffective speech or communication, disorganisation of motor function in two extremities, or a marked physical limitation alongside a marked mental one. Claims decided on acute-period records alone frequently miss the durable picture.

Conditions evaluated under 11.04

• StrokeHow SSA evaluates it, the evidence that decides it, and why claims are denied

Frequently asked questions

Do you have to meet 11.04 to be approved?

No. Meeting a listing is one route to approval and not the most common one. Most awards are made on residual functional capacity — what SSA concludes you can still do across a full working week, given your age, education and past work. A claim that falls short of 11.04 can still be approved that way, which is why a denial citing this listing is not the end of the matter.

What if my records do not meet 11.04 exactly?

Two things can still happen. SSA can find your condition medically equals the listing — equal in severity and duration without matching every criterion — or it can move on to the functional assessment described above. What sinks these claims is usually a gap in the file rather than a gap in the criteria: a limitation you live with that no doctor wrote down.

Which conditions are evaluated under 11.04?

Stroke. The criteria are the same; what differs is the evidence each condition needs to satisfy them.