Listing 12.15 is aimed at disabling post-traumatic and stress-related conditions—principally post-traumatic stress disorder (PTSD), acute stress disorder that becomes chronic, adjustment disorder with prolonged disturbance, or similar syndromes that arise after exposure to life-threatening or violent events. If the documented trauma response produces marked or extreme functional limitations (Paragraph B) or persists at a “serious-and-persistent” level despite treatment (Paragraph C), the claimant is found disabled at Step 3 of the sequential evaluation.
Regulatory Text
12.15 Trauma- and stressor-related disorders, satisfied by A and B, or A and C
- Medical documentation of all of the following:
1. Exposure to actual or threatened death, serious injury, or violence;
2. Subsequent involuntary re-experiencing of the traumatic event (for example, intrusive memories, dreams, or flashbacks); or marked avoidance of external reminders; or negative alterations in mood and cognition; or heightened arousal and reactivity;
3. Disturbance lasting ≥ 1 month that causes clinically significant distress or impairment.
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 of the disorder 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—minimal capacity to adapt to changes not already part of daily life.
(Source: 20 C.F.R. Pt 404, Subpt P, App 1; effective Jan 17 2017; technical corrections May 18 2018.)
Key Elements
- Criterion A – Trauma & Core Symptoms
- Proof of traumatic exposure and one or more symptom clusters—intrusion, avoidance, negative mood/cognition, hyper-arousal—lasting at least a month.
- Functional Severity
- Paragraph B: Extreme limit in 1—or marked in 2—mental-function domains.
- Paragraph C: ≥ 2-year history plus ongoing treatment/structured support and marginal adjustment.
- Duration
- ≥ 12 months of expected limitation (B) or 2-year pattern (C).
Tips on Proving Listing 12.15
| Evidence | What to Collect | Contribution |
|---|---|---|
| Trauma verification | Police reports, military DD-214 with combat citations, ER records, protective-order filings | Establish Criterion A exposure. |
| Specialized PTSD assessments | CAPS-5 interview scores; PCL-5 self-report; Clinician-Administered PTSD Scale | Quantify intrusion, avoidance, arousal—supports A-2 & severity. |
| Psychiatric progress notes | DSM-5 PTSD or adjustment-disorder diagnosis; descriptions of flashbacks, nightmares, hypervigilance | Core documentation for A-2 & A-3. |
| Medication & therapy history | SSRIs/SNRIs, prazosin, EMDR or trauma-focused CBT sessions, prolonged-exposure logs | Shows ongoing treatment (Paragraph C) and residual symptoms. |
| Mental RFCs / clinician letters | Notes on concentration lapses, startle reactions, social withdrawal, self-neglect | Map directly to Paragraph B domains. |
| Collateral statements | Spouse, coworkers, case-manager reports of panic in crowds, angry outbursts, missed workdays, isolation | Real-world proof of marked/extreme functional deficits. |
| Structured-setting documentation | VA residential PTSD program, halfway-house notes, intensive outpatient logs | Demonstrate highly structured support & “marginal adjustment” (C-criteria). |
| Medical-tests guide cues (2024) | Heart-rate variability, startle-response testing, sleep-study results showing REM disturbances | Objective physiologic corroboration—supportive but must pair with functional evidence. |
Practical Takeaway
A successful Listing 12.15 claim weaves together verified trauma exposure, clinical PTSD symptomology, and evidence of marked/extreme work-domain limits or a two-year treatment-resistant course with only marginal adaptation. A Social Security Disability lawyer can combine structured diagnostic tools (CAPS-5), therapy records, collateral statements, and detailed functional assessments yields the strongest basis for a Step 3 approval.