12.04: Depressive, Bipolar and Related Disorders

What actually decides a claim under 12.04

Paragraph A is the diagnosis and symptoms, but the decision is made in paragraph B: four areas of functioning — understanding and applying information; interacting with others; concentrating, persisting or maintaining pace; and adapting or managing yourself. You need an extreme limitation in one, or a marked limitation in two. Paragraph C is an alternative route for serious, persistent disorders that are only stable inside a highly structured setting, which matters for cyclical conditions assessed during a good period.

Conditions evaluated under 12.04

• DepressionHow SSA evaluates it, the evidence that decides it, and why claims are denied
• Bipolar DisorderHow SSA evaluates it, the evidence that decides it, and why claims are denied

Frequently asked questions

Do you have to meet 12.04 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 12.04 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 12.04 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 12.04?

Depression, Bipolar Disorder. The criteria are the same; what differs is the evidence each condition needs to satisfy them.