Listing 12.04 covers mood-related mental disorders, ranging from major depressive disorder to bipolar disorder and similar conditions. The Social Security Administration (SSA) uses this listing to identify claimants whose mood symptoms are so severe that they meet a predefined standard of disability at Step 3 of the sequential evaluation—meaning no further vocational analysis (Steps 4 and 5) is needed.
To qualify, a claimant must:
- Provide medical documentation showing a depressive or bipolar diagnosis with specific clinical markers (paragraph A),
- Meet functional limitation requirements (paragraph B or paragraph C), which involve severe restrictions in daily functioning or a long, documented history of serious mood disorder symptoms.
Listing 12.04
12.04 Depressive, bipolar and related disorders (see 12.00B3), satisfied by A and B, or A and C:
A.
Medical documentation of the requirements of paragraph 1 or 2:
- Depressive disorder, characterized by five or more of the following:
a. Depressed mood;
b. Diminished interest in almost all activities;
c. Appetite disturbance with change in weight;
d. Sleep disturbance;
e. Observable psychomotor agitation or retardation;
f. Decreased energy;
g. Feelings of guilt or worthlessness;
h. Difficulty concentrating or thinking; or
i. Thoughts of death or suicide. - Bipolar disorder, characterized by three or more of the following:
a. Pressured speech;
b. Flight of ideas;
c. Inflated self-esteem;
d. Decreased need for sleep;
e. Distractibility;
f. Involvement in activities that have a high potential for painful consequences that are not recognized; or
g. Increase in goal-directed activity or psychomotor agitation.
AND
B.
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
C.
Your mental disorder in this listing category is “serious and persistent”; that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.
Defining Key Medical and Technical Terms
- Depressive Disorder: A persistent state of low mood, loss of interest or pleasure, and other symptoms (like changes in appetite, sleep, or self-esteem).
- Bipolar Disorder: A mood disorder with episodes of elevated mood (mania/hypomania) and often episodes of depression.
- Pressured Speech: Rapid, urgent speech that is difficult to interrupt—commonly seen in manic or hypomanic states.
- Flight of Ideas: A rapid shift from one topic to another, often based on word associations, distracting stimuli, or plays on words—typical in mania.
- Psychomotor Agitation/Retardation: Observable restlessness or slowed movements/thought processes.
- Marked Limitation: A serious, but not complete, restriction in functioning. You can still function to some degree, but it’s substantially compromised.
- Extreme Limitation: An inability to function independently in a given area. This typically signifies very little or no useful ability to carry out an activity.
- Highly Structured Setting: A supportive, supervised environment—like a group home, partial hospitalization program, or intensive outpatient treatment—that helps reduce the intensity of mental disorder symptoms.
- Marginal Adjustment: Minimal capacity to adapt to changes outside a very familiar routine or environment; even small changes can be destabilizing.
Quick-Reference Checklist for Listing 12.04
Use this checklist to ensure you cover all necessary elements at a hearing or when organizing evidence:
- Diagnosis & Paragraph A Requirements
- Depressive Disorder: At least 5 out of the 9 symptoms (e.g., depressed mood, sleep disturbance, suicidal thoughts).
- Bipolar Disorder: At least 3 out of the 7 symptoms (e.g., pressured speech, flight of ideas, decreased need for sleep).
- Paragraph B or Paragraph C
- B Criteria: Show 1 extreme or 2 marked limitations in these functional areas:
- Understanding, remembering, or applying information;
- Interacting with others;
- Concentrating, persisting, or maintaining pace;
- Adapting or managing oneself.
- C Criteria: A 2-year history of the disorder plus ongoing treatment in a highly structured setting and only marginal adjustment.
- B Criteria: Show 1 extreme or 2 marked limitations in these functional areas:
- 12-Month Duration
- The impairment must last or be expected to last at least one continuous year.
- Consistency & Severity
- Medical records should repeatedly confirm severe mood symptoms and functional limitations over time.
Tips and Recommended Medical Evidence
- Psychiatric/Psychological Evaluations
- Obtain detailed notes from psychiatrists or psychologists that describe mood symptoms, how long they’ve lasted, and how they affect daily functioning.
- Clinical Testing & Rating Scales
- Mental status exams, Beck Depression Inventory, PHQ-9, or other validated scales can document symptom intensity.
- If mania/hypomania is suspected, look for notes on high energy, racing thoughts, or decreased need for sleep.
- Therapy and Medication Records
- Show consistent use of psychotropic medications (e.g., antidepressants, mood stabilizers) and any side effects.
- If there are therapy notes (cognitive-behavioral therapy, group counseling), they can highlight ongoing symptoms and challenges.
- Functional Assessments
- Include statements from family, friends, or social workers describing how your client’s mood disorder impacts work, social interactions, and personal care.
- Employers or coworkers might testify to mistakes on the job, conflict with colleagues, or frequent absences.
- Evidence of Marginal Adjustment (Paragraph C)
- If claiming “serious and persistent” disorder, gather records showing at least 2 years of consistent psychiatric care and the need for a structured or highly supportive living arrangement.
- Document any crisis situations when even small routine changes led to a significant decline in function.
Key Takeaways
- Listing 12.04 covers both depressive disorders and bipolar disorders, each with specific symptom thresholds under Paragraph A.
- A claimant then must satisfy either the Paragraph B functional limitations or the Paragraph C “serious and persistent” criteria.
- Focus your evidence on objective clinical documentation, longitudinal treatment records, and functional impact—particularly in the four areas of mental functioning (B criteria).
By following this guide—defining terms, organizing symptoms, demonstrating functional limitations, and documenting long-term severity—a Social Security Disability lawyer can help argue that a claimant meets Listing 12.04 at Step 3, sparing them from the vocational challenges of Steps 4 and 5.
The exact text for Listing 12.04 comes from the Social Security Administration’s “Listing of Impairments,” which is found in the Code of Federal Regulations at 20 C.F.R. Part 404, Subpart P, Appendix 1. More specifically, you can locate Listing 12.04 under the heading of “Mental Disorders” in that appendix.
The most recent major revision to the adult mental disorder listings—including Listing 12.04—took effect on January 17, 2017. The final rule that introduced these changes was published in the Federal Register on September 26, 2016 (81 FR 66138). Since then, there have been no further substantive revisions specific to Listing 12.04.