1.20: Amputation Due to Any Cause

Listing 1.20 applies when a claimant has undergone a major amputation—for instance, losing a lower or upper extremity—due to trauma, vascular disease, cancer, or any other cause. The Social Security Administration evaluates whether the amputation (and any prosthesis use) leaves the person unable to ambulate effectively or severely restricts upper-extremity function. If the criteria are met, the claimant qualifies at Step 3 of the sequential evaluation without further vocational consideration.

Listing 1.20

1.20 Amputation due to any cause (for example, vascular disease, cancer, trauma). With A or B or C:

A.
Both hands;

OR

B.
One or both lower extremities at or above the tarsal region (see 1.00C7), with an inability to ambulate effectively (see 1.00C6);

OR

C.
Pelvic amputation (hemipelvectomy), hip disarticulation, or a procedure that has the same functional effects on ambulation, resulting in an inability to ambulate effectively, as defined in 1.00C6.

(Source: 20 C.F.R. Part 404, Subpart P, Appendix 1, Listing 1.20. Effective April 2, 2021.)

Key Elements

• Major Amputation 
  • Involving both hands, or a lower extremity (or extremities) above the ankle (tarsal) region, or a pelvic/hip disarticulation.
• Inability to Ambulate Effectively (if lower limb is involved) 
  • Defined in 1.00C6, typically requiring a walker, two crutches/canes, or wheelchair for day-to-day mobility.
• Upper-Extremity Scenario (Both Hands) 
  • Automatic qualification if both hands are amputated (severely restricting the ability to perform fine and gross manipulations).
• No Short-Term Recovery Clause 
  • The listing presumes that once a major limb is gone, the question becomes whether a prosthesis can restore enough function. If it cannot, listing-level severity is met for at least 12 months.

Tips on Proving the Claimant Meets Listing 1.20

1. Operative and Hospital Records
   • Provide surgical reports or amputation summaries showing the exact level of amputation (e.g., above-knee, below-knee, hip disarticulation), along with the medical reason (trauma, peripheral artery disease, etc.).
2. Prosthetic Evaluations
   • If the claimant received a prosthesis, gather prosthetist notes detailing fit problems, pain, or inadequate functional improvement. If no prosthesis was feasible, document why (e.g., stump complications, poor healing, comorbid conditions).
3. Evidence of Ambulatory/Functional Capacity
   • For lower-limb amputations, show the claimant cannot ambulate effectively: needing two canes, a walker, or a wheelchair. A physical therapist’s statement about gait instability can bolster the claim.
4. Daily Activities Statements
   • Written or oral testimonies from the claimant or third parties illustrating how routine tasks (e.g., cooking, cleaning, personal care) remain impossible or extremely difficult even with assistive devices.
5. Specialist Opinions
   • Orthopedic or rehabilitation specialist opinions tying the level of amputation (and any unsuccessful prosthetic usage) to severe long-term limitations. If upper-extremity amputations involve both hands, clarify the drastic impact on basic daily functions.
6. Medical History of Attempted Solutions
   • Show attempts at various rehabilitation methods (e.g., physical therapy or different prosthetic fittings) that failed to restore functional ambulation or hand/arm use.

Under Listing 1.20, the amputation of one or more major limbs can be automatically disabling if it prevents effective ambulation or leaves the claimant without both hands. Documenting the exact amputation site, unsuccessful prosthetic trials, and real-world functional deficits is crucial for a Social Security Disability lawyer to help secure Step 3 approval.