Listing 12.11 covers disorders that first appear in childhood—such as attention-deficit/hyperactivity disorder (ADHD), specific learning disorders, communication disorders, developmental coordination disorder, and tic disorders (e.g., Tourette’s)—when their residual symptoms in adulthood cause marked or extreme workplace limitations. If the claimant’s documented deficits in attention, impulsivity, learning, or motor/speech function meet the criteria below, the disability evaluation stops at Step 3 with a favorable finding.
Regulatory Text
12.11 Neurodevelopmental disorders, satisfied by A and B, or A and C
- Medical documentation of the requirements of 1 or 2:
1. One or more of the following:
• Frequent distractibility, difficulty sustaining attention, and persistent impulsive behavior; or
• Hyperactive or restless behavior; or
• Recurrent motor movement or vocalization (for example, tics); or
• Significantly poor performance on standardized group achievement testing or an individually administered standardized test of academic skills; or
2. A significant developmental delay or learning deficit in communication, motor skills, or executive functioning, documented by appropriate standardized testing or clinical findings.
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (12.00 F):
1. Understand, remember, or apply information;
2. Interact with others;
3. Concentrate, persist, or maintain pace;
4. Adapt or manage oneself;
OR
- Serious and persistent disorder (12.00 G2):
• Evidence over a ≥ 2-year period, plus
1. Ongoing medical treatment, mental-health therapy, psychosocial support, or a highly structured setting that diminishes symptoms; and
2. Marginal adjustment—that is, minimal capacity to adapt to changes not already part of daily life.
(Effective Jan 17 2017; technical corrections May 18 2018.)
Key Elements
- Criterion A: Neurodevelopmental Evidence
- Document persistent deficits in attention, impulse control, motor or vocal tics, learning/academic skills, speech/language, or executive function.
- Functional Severity
- Paragraph B: Extreme in 1—or marked in 2—of the 4 mental-function domains.
- Paragraph C: Disorder present ≥ 2 years plus ongoing support/treatment and marginal adjustment.
- Duration
- Must last (or be expected to last) ≥ 12 months (B) or satisfy the 2-year standard (C).
Tips on Proving Listing 12.11
| Evidence | What to Collect | How It Satisfies Criteria |
|---|---|---|
| Childhood & school records | IEPs, report cards, psycho-educational testing, speech/OT notes | Show lifelong pattern → Criterion A + duration |
| Current neuropsychological testing | WAIS-IV indices, WIAT-IV academic scores, CPT-3 / TOVA for attention, D-KEFS for executive function | Objectively quantify distractibility, learning deficits, or executive dysfunction |
| Standardized ratings & scales | • Adult ADHD Rating Scale (ASRS-v1.1) • Barkley Functional Impairment Scale • Yale Global Tic Severity Scale |
Provide symptom severity; tie to concentrate/persist & adapt domains |
| Psychiatric/neurology notes | DSM-5 diagnosis of ADHD, SLD, tic disorder; medication trials (stimulants, alpha-agonists, SSRIs) | Establish Criterion A + ongoing treatment (Paragraph C) |
| Occupational therapy / speech-language-pathology logs | Continuing difficulty with fine-motor, coordination, pragmatic language | Map deficits to interact with others & adapt/manage |
| Functional reports & collateral statements | Supervisors, job coaches detail errors, distractibility, slow pace, social misreading, meltdowns when routines change | Document marked/extreme limitations in work-related domains |
| Structured-setting documentation | Supported-employment notes, day-program logs, coaching sessions | Proves highly structured environment & marginal adjustment (Paragraph C) |
| SSA Medical-Tests Guide cues (2024) | Continuous Performance Test (CPT-3) or QbTest for objective inattention/impulsivity; fine-motor speed via Grooved Pegboard | Supplies quantifiable metrics for Criterion A and Paragraph B |
Practical Takeaway
To qualify under Listing 12.11, a Social Security Disability lawyer can help combine objective testing (attention, academic, motor) and longitudinal treatment records with compelling evidence of marked or extreme work-domain limits—or a two-year history of structured supports with only marginal adjustment. A well-curated record linking neurodevelopmental symptoms to everyday vocational failure makes for a strong Step 3 approval.