Listing 12.02 is used when a medically documented decline in cognitive functioning—memory, attention, executive function, language, or social cognition—renders a person unable to perform basic work activities. Examples include traumatic brain injury (TBI), stroke-related cognitive decline, early Alzheimer’s disease, or other neurodegenerative or metabolic conditions that impair thinking and adaptive behavior. If a claimant meets or medically equals this listing at Step 3, the evaluation stops and disability is presumed.
Regulatory Text (20 C.F.R. Pt 404, Subpt P, App 1)
12.02 Neurocognitive disorders, satisfied by A and B, or A and C:
- Medical documentation of a significant cognitive decline from a prior level of functioning in one or more of the following cognitive areas:
1. Complex attention;
2. Executive function;
3. Learning and memory;
4. Language;
5. Perceptual-motor; or
6. Social cognition;
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
1. Understand, remember, or apply information;
2. Interact with others;
3. Concentrate, persist, or maintain pace;
4. Adapt or manage oneself;
OR
- The mental disorder is “serious and persistent” (see 12.00G2), with medical documentation over a period of at least 2 years, plus:
1. Ongoing treatment or structured setting that diminishes symptoms; and
2. Marginal adjustment—minimal capacity to adapt to changes not already part of daily life.
(Effective Jan 17 2017; minor technical corrections May 18 2018.)
Key Elements at a Glance
- Objective cognitive decline from prior level (neuropsychological testing, imaging, or clinical exams).
- Functional severity shown by:
- Paragraph B: Extreme limitation in one—or marked in two—of the four mental-function domains; or
- Paragraph C: ≥ 2-year documented disorder plus ongoing treatment/structured setting and marginal adjustment.
- Duration: Impairment must persist (or be expected to persist) ≥ 12 months.
Tips for Proving Listing 12.02
| Evidence Type | What To Collect | Why It Helps |
|---|---|---|
| Neuropsychological testing (e.g., WAIS-IV, RBANS, MoCA) | Full‐scale IQ, domain-specific index scores, comparison with premorbid baseline if available | Quantifies “significant cognitive decline” in A-criteria areas (memory, executive function, etc.). |
| Neuro-imaging | MRI/CT showing infarcts, TBI lesions, atrophy, hydrocephalus; PET for metabolism patterns | Corroborates organic brain pathology underlying cognitive loss. |
| Clinical notes & specialty opinions | Neurologist or neuropsychologist documenting progressive deficits, medication trials, rehab efforts | Essential for Paragraph A documentation and Paragraph C’s “ongoing treatment.” |
| Functional assessments | Mental RFCs, occupational or speech-language therapy notes, detailed ADL statements | Map objective deficits to Paragraph B functional domains (information, interaction, pace, adaptation). |
| Structured-setting proof (Paragraph C) | Adult daycare logs, assisted-living records, supervised work program notes | Shows reliance on highly structured environment and marginal adjustment to change. |
| Collateral statements | Caregiver, employer, or family reports of confusion, safety issues, social withdrawal | Real-world confirmation of marked/extreme limitations. |
Testing cues from SSA Medical-Tests Guide
- Balance Error Scoring System (BESS) or Standard Assessment of Concussion (SAC) for TBI residuals.
- Functional MRI or Diffusion Tensor Imaging when standard MRI is inconclusive.
- Blood biomarkers (e.g., neurofilament light chain) may support neurodegeneration but must be paired with functional evidence.
Document a clear, measurable drop in cognitive ability and connect it to marked/extreme functional limits or a serious-and-persistent pattern. Neuropsychological batteries, brain imaging, thorough treatment histories, and detailed third-party observations—woven together—create the strongest path to meeting Listing 12.02.
Document a clear, measurable drop in cognitive ability and connect it to marked/extreme functional limits or a serious and persistent pattern. A Social Security Disability lawyer can help gather neuropsychological batteries, brain imaging, thorough treatment histories, and detailed third-party observations—woven together to create the strongest path to meeting Listing 12.02.