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APPENDIX
LIST OF STUDY TASKS

In addressing the Listings, the committee will consider:

  1. The value and utility of the current Listings for all users (claimants, SSA, health care professionals, state offices, and officials involved in the adjudication process)

  2. Conceptual models for organizing the Listings, beyond the current “body systems” model at 20 C.F.R. Part 404, Subpart P, Appendix I

  3. Processes for determining when the Listings require revision and criteria upon which to add new listings or remove old ones

  4. Feedback mechanisms to continuously assess and evaluate the Listings for the purpose of improving consistency in application by all adjudicators throughout the country

  5. Adaptability of the Listings, including methods to account for variable access to health care services (including diagnostics and pharmaceuticals) in determining whether an individual’s condition meets or equals the Listings

  6. Methods to assess and quantify the effects of multiple impairments that may not individually cross the eligibility threshold (e.g., SSA’s “equivalence” concept)

  7. Advisability of and methods for integrating functional assessment into the Listings

In addressing the organization of medical expertise, the committee will:

  1. Review SSA’s list of presumptive disability conditions and suggest revisions, additions, and/or deletions. The committee will recommend essential criteria for establishing candidate conditions for presumptive disability and recommend the level of professional expertise needed to certify that a presumptive diagnosis is adequately established.

  2. Advise on how best to provide medical expertise needed to support the entire disability adjudication process. This will involve describing the type of experts needed (academic specialists; practicing specialists; practicing generalists or non-physicians); necessary credentials and where best to locate them (from university medical centers, centers of excellence for specialized care, or community practice settings).

  3. Recommend needs for standardized training and certification for consultative examiners who assess claimant’s level of function based on integrated evaluation of medical impairment and functional capacity. Advise on content of a training curriculum, appropriate personnel to train, and mechanisms for the certification process.



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Improving the Social Security Disability Decision Process: Interim Report APPENDIX LIST OF STUDY TASKS In addressing the Listings, the committee will consider: The value and utility of the current Listings for all users (claimants, SSA, health care professionals, state offices, and officials involved in the adjudication process) Conceptual models for organizing the Listings, beyond the current “body systems” model at 20 C.F.R. Part 404, Subpart P, Appendix I Processes for determining when the Listings require revision and criteria upon which to add new listings or remove old ones Feedback mechanisms to continuously assess and evaluate the Listings for the purpose of improving consistency in application by all adjudicators throughout the country Adaptability of the Listings, including methods to account for variable access to health care services (including diagnostics and pharmaceuticals) in determining whether an individual’s condition meets or equals the Listings Methods to assess and quantify the effects of multiple impairments that may not individually cross the eligibility threshold (e.g., SSA’s “equivalence” concept) Advisability of and methods for integrating functional assessment into the Listings In addressing the organization of medical expertise, the committee will: Review SSA’s list of presumptive disability conditions and suggest revisions, additions, and/or deletions. The committee will recommend essential criteria for establishing candidate conditions for presumptive disability and recommend the level of professional expertise needed to certify that a presumptive diagnosis is adequately established. Advise on how best to provide medical expertise needed to support the entire disability adjudication process. This will involve describing the type of experts needed (academic specialists; practicing specialists; practicing generalists or non-physicians); necessary credentials and where best to locate them (from university medical centers, centers of excellence for specialized care, or community practice settings). Recommend needs for standardized training and certification for consultative examiners who assess claimant’s level of function based on integrated evaluation of medical impairment and functional capacity. Advise on content of a training curriculum, appropriate personnel to train, and mechanisms for the certification process.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 1 DDS Medical Consultants by Specialty, June 2004 Specialty Number Percentage Psychology 707 33.1 Internal medicine 341 16.0 Psychiatry 233 10.9 Pediatrics 209 9.8 Family practice 141 6.6 Speech-language pathology 59 2.8 General medicine 42 2.0 Neurology 38 1.8 Cardiology 36 1.7 Orthopedic specialist 35 1.6 Surgery 35 1.6 Ophthalmology 25 1.2 Gynecology/obstetrics 21 1.0 Anesthesiology 21 1.0 Emergency medicine 20 0.9 Physical medicine and rehabilitation 19 0.9 Orthopedic surgery 18 0.8 Osteopathy 14 0.7 Occupational medicine 13 0.6 All others 122 5.7 Total 2,136 100.0 NOTE: The percentage of specialists in each category that are board certified or board eligible is not known. SOURCE: Unpublished tables provided by the Office of Disability and Income Support Programs, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 2 Number of DDS Medical Consultants by Specialty and State, June 2004 State DDS Family practice Internal medicine Pediatrics Psychology Psychiatry Cardiology Neurology Ortho -pedics Other Total Connecticut 0 9 1 15 4 0 2 0 4 35 Maine 0 0 1 7 0 1 0 1 4 14 Massachusetts 3 24 2 28 6 0 1 0 2 66 New Hampshire 3 1 1 4 0 0 0 0 1 10 Rhode Island 0 8 1 6 2 0 0 0 1 18 Vermont 0 4 2 5 1 1 1 0 0 14 Region I Total 6 46 8 65 13 2 4 1 12 257 New Jersey 0 23 5 22 3 3 0 8 3 67 New York 3 23 16 18 33 0 0 1 15 109 Puerto Rico 0 8 0 8 3 1 1 0 3 24 Delaware 1 3 1 4 1 0 0 0 1 11 District of Columbia 0 3 3 2 0 0 0 0 0 8 Region II Total 4 60 25 56 40 4 1 9 22 219 Maryland 1 4 4 11 5 1 0 0 4 30 Pennsylvania 5 7 4 45 2 0 1 3 12 79 Virginia 6 6 8 20 2 2 0 2 9 55 West Virginia 2 7 2 9 2 0 0 0 1 23 Region III Total 14 24 18 85 11 3 1 5 26 187 Alabama 1 4 6 14 4 3 1 2 7 42 Florida 20 11 33 76 9 2 0 1 28 180 Georgia 1 18 5 24 1 1 2 4 7 63 Kentucky 0 5 4 15 1 0 0 1 14 40 Mississippi 0 3 2 11 1 0 0 2 8 27 North Carolina 9 5 4 19 4 0 1 1 6 49 South Carolina 2 4 4 21 1 0 1 1 11 45 Tennessee 2 5 8 20 3 1 1 1 15 56 Region IV Total 35 55 66 200 24 7 6 13 96 502

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Improving the Social Security Disability Decision Process: Interim Report State DDS Family practice Internal medicine Pediatrics Psychology Psychiatry Cardiology Neurology Orthopedics Other Total Illinois 6 11 10 22 4 3 0 0 22 78 Indiana 0 5 1 8 0 1 2 0 10 27 Michigan 8 17 5 15 21 0 2 0 14 82 Minnesota 0 6 2 12 1 0 0 5 2 28 Ohio 12 11 5 41 1 0 0 2 16 88 Wisconsin 0 5 3 9 0 0 1 0 2 20 Region V Total 26 55 26 107 26 4 5 7 66 323 Arkansas 0 1 5 3 2 1 1 3 2 18 Louisiana 2 5 5 19 2 2 1 2 12 50 New Mexico 5 5 2 2 2 0 0 0 1 17 Oklahoma 2 5 1 10 1 0 0 0 1 20 Texas 6 6 2 10 9 1 3 2 6 45 Region VI Total 15 22 15 44 16 4 5 7 22 150 Iowa 7 0 3 17 1 2 0 0 4 34 Kansas 9 4 1 11 3 1 0 0 2 31 Missouri 2 9 9 31 5 2 1 2 20 81 Nebraska 6 1 2 8 0 0 0 0 2 19 Region VII Total 24 14 15 67 9 5 1 2 28 165 Colorado 0 5 2 3 5 2 2 2 4 25 Montana 1 1 1 4 0 0 0 1 2 10 North Dakota 0 3 0 4 1 1 0 1 1 11 South Dakota 1 1 1 4 1 0 0 0 5 13 Utah 0 1 1 6 5 0 1 0 4 18 Wyoming 1 2 0 6 0 0 0 1 6 16 Region VIII Total 3 13 5 27 12 3 3 5 22 93

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Improving the Social Security Disability Decision Process: Interim Report State DDS Family practice Internal medicine Pediatrics Psychology Psychiatry Cardiology Neurology Ortho -pedics Other Total Arizona 1 6 2 7 9 1 4 1 13 44 California 7 28 19 1 62 2 4 2 49 174 Hawaii 1 3 1 4 2 0 0 0 4 15 Nevada 0 3 3 5 0 0 1 0 2 14 Region IX Total 9 40 25 17 73 3 9 3 68 247 Alaska 0 1 1 0 2 0 2 0 2 8 Idaho 0 1 1 2 0 0 0 1 1 6 Oregon 1 3 1 7 0 0 0 0 4 16 Washington 4 7 3 31 6 1 1 1 9 63 Region X Total 5 12 6 40 8 1 3 2 16 93 All DDSs 141 341 209 706 233 36 38 54 378 2136 NOTE: Psychiatry includes 12 child psychiatrists. Orthopedics includes 18 orthopedic surgeons, 35 orthopedic specialists, and 1 orthopedic-neurologist. SOURCE: Unpublished tables provided by the Office of Disability and Income Support Programs, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 3 Case Mix Compared with Mix of Medical Consultant Specialties Clinical field Percentage of MCs in the clinical specialty Percentage of initial decisions involving the clinical field Cardiology 1.7% 6.7% Child Psychiatry 0.6% 0.5% Child Psychology * 3.7% Endocrinology 0.2% 3.8% Family Practice 6.8% 0.0% Gastroenterology 0.3% 2.4% Internal Medicine 16.3% 6.3% Neurology 1.9% 6.8% Oncology 0.3% 4.7% Orthopedics 2.5% 19.9% Pediatrics 9.8% 0.9% Psychiatry 10.7% 19.6% Psychology 31.2% 7.5% Pulmonology 0.3% 4.7% Rheumatology 0.3% 6.7% *Less than 0.1 percent. NOTE: Part-time medical consultants are assumed to work 20 hours a week. SOURCE: Unpublished table provided by the Office of Disability and Income Support Programs, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 4 Number of Medical Experts by Specialty, June 2005 Specialty Number Percentage Clinical psychology 415 22.3 Internal medicine 371 19.9 Psychiatry 235 12.6 Orthopedic surgery 121 6.5 Pediatrics 115 6.2 Neurology 102 5.5 Cardiovascular diseases 71 3.8 Ophthalmology 57 3.1 Family Practice 31 1.7 Pulmonary diseases 22 1.2 Child psychiatry 21 1.1 Physical medicine and rehabilitation 20 1.0 Rheumatology 19 1.0 General surgery 18 1.0 Occupational Medicine 18 0.8 Gastroenterology 15 0.8 General preventive medicine 15 0.8 Urological surgery 14 0.7 Endocrinology 13 0.6 Child psychology 12 0.6 Neurological surgery 12 0.6 Emergency medicine 11 0.6 Medical oncology 11 0.6 All Others 122 6.6 Total 1,861 100.0 NOTE: The number of specialties is more than the number of MEs (1,575), because some practice in more than one specialty. SOURCE: Unpublished table provided by the Office of Hearings and Appeals, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 5 Number of Medical Experts by Specialty and Federal Region, June 2005 Federal region Clinical psychology Internal medicine Psychiatry Orthopedic surgery Pediatrics Neurology Cardiovascular diseases Ophthalmology Other Total Region I 18 23 16 10 6 9 4 5 18 109 Region II 13 25 20 7 9 7 5 5 29 120 Region III 31 35 28 3 7 13 5 5 45 172 Region IV 110 85 78 42 39 25 20 12 93 504 Region V 73 56 30 20 23 17 7 8 52 286 Region VI 47 46 22 16 6 14 6 6 48 211 Region VII 12 14 3 1 3 1 3 1 16 54 Region VIII 37 7 0 0 2 4 0 1 10 61 Region IX 43 53 32 16 12 8 19 14 47 244 Region X 31 27 6 6 8 4 2 0 16 100 All regions 415 371 235 121 115 102 71 57 374 1,861   SOURCE: Unpublished table provided by the Office of Hearings and Appeals, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 6 Impairment Codes of DDS Presumptive Disability Decisions with a Reversal Rate of Less Than 5 percent, CY 2004 SSA impairment code Number of DDS PD decisions Number reversed Reversal rate percent) 4160-Chronic pulmonary heart disease 163 8 4.9 2940-Organic mental disorders 4,505 215 4.8 3060-Somatoform disorders 42 2 4.8 3370-Disorders of the autonomic nervous system 64 3 4.7 4920-Emphysema 193 9 4.7 1830-Malignant neoplasm/ovary and other uterine adnexa 314 14 4.5 1640-Malignant neoplasm/thymus, heart, mediastinum 23 1 4.3 3430-Cerebral palsy 1,835 78 4.3 4430-Peripheral vascular disease 516 21 4.1 2950-Schizophrenic/paranoid functional disorders 4,944 198 4.0 1920-Malignant neoplasm/other parts of the nervous system 76 3 3.9 1900-Malignant neoplasm/eye 31 1 3.2 1710-Malignant neoplasm/connective and other soft tissue 99 3 3.0 1910-Malignant neoplasm/brain 830 23 2.8 3360-Other disorders of the spinal cord 517 14 2.7 1410-Malignant neoplasm/tongue 192 5 2.6 7600-Multiple body dysfunction 714 18 2.5 1510-Malignant neoplasm/stomach 249 6 2.4 1990-Malignant neoplasm/unspecified sites 131 3 2.3 2070-Leukemias 1,058 24 2.3 8060-Vertebral fracture/cord lesion 766 18 2.3 2630-Malnutrition/weight loss 139 3 2.2 7840-Loss of voice 983 20 2.0 2990-Childhood origin psychosis (adult) 637 12 1.9 3180-Mental retardation 9,643 185 1.9 1720-Malignant melanoma of skin 179 3 1.7 5850-Chronic renal failure 4,173 62 1.5 2990-Developmental disabilities including autism (children) 2,558 36 1.4 1620-Malignant neoplasm/trachea, bronchus, lung 2,606 35 1.3 1980-Malignant neoplasm/distant sites 78 1 1.3 3320-Parkinsons disease 154 2 1.3 1500-Malignant neoplasm/esophagus 367 4 1.1 1630-Malignant neoplasm/pleura 98 1 1.0 3350-Anterior horn cell disorder (ALS) 113 1 0.9 7580-Chromosome anomaly/Down syndrome 1,443 8 0.6 7650-Birth weight under 1200 grams 3,291 12 0.4 1550-Malignant neoplasm of liver and intrahepatic bile ducts 710 2 0.3 0940-Neurosyphilis 3 0 0.0 1560-Malignant neoplasm/gallbladder 56 0 0.0 1570-Malignant neoplasm/pancreas 400 0 0.0 1760-Malignant Kaposi’s sarcoma 8 0 0.0 1780-Malignant neoplasm/skeletal system 4 0 0.0 2730-Disorders of plasma protein metabolism 3 0 0.0 3210-Arachnoiditis 10 0 0.0

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Improving the Social Security Disability Decision Process: Interim Report SSA impairment code Number of DDS PD decisions Number reversed Reversal rate percent) 5010-Asbestosis 6 0 0.0 7050-Hidradenitis suppurativa 16 0 0.0 9330-Chronic fatigue syndrome 11 0 0.0   SOURCE: Unpublished table provided by the Office of Disability and Income Support Programs, SSA.

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Improving the Social Security Disability Decision Process: Interim Report Appendix Table 7 SSA Impairment Codes by Allowance Rate, from Highest to Lowest, CY 2004 SSA impairment code Number of decisions Number of allowances Allowance rate (percent) All codes 2,532,798 947,266 37.4 1550-Malignant neoplasm of liver and intrahepatic bile ducts 4,653 4,616 99.2 1570-Malignant neoplasm/pancreas 3,304 3,258 98.6 3350-Anterior horn cell disorder (ALS) 1,534 1,506 98.2 7650-Birth weight under 1200 grams 17,235 16,890 98.0 7580-Chromosome anomaly/Down syndrome 5,242 5,111 97.5 1980-Malignant neoplasm/distant sites 619 599 96.8 1630-Malignant neoplasm/pleura 806 776 96.3 1560-Malignant neoplasm/gallbladder 450 432 96.0 1620-Malignant neoplasm/trachea, bronchus, lung 19,291 18,307 94.9 1500-Malignant neoplasm/esophagus 2,916 2,744 94.1 2990-Developmental disabilities including autism (children) 10,759 9,920 92.2 1910-Malignant neoplasm/brain 6,302 5,754 91.3 1510-Malignant neoplasm/stomach 1,966 1,779 90.5 5850-Chronic renal failure 22,195 19,998 90.1 1780-Malignant neoplasm/skeletal system 20 18 90.0 1720-Malignant melanoma of skin 1,832 1,618 88.3 2070-Leukemias 6,166 5,408 87.7 1760-Malignant Kaposi’s sarcoma 40 35 87.5 1410-Malignant neoplasm/tongue 1,392 1,197 86.0 2990-Childhood origin psychosis (adult) 3,898 3,352 86.0 2030-Multiple myeloma 2,164 1,859 85.9 1590-Malignant neoplasm/other digestive organs, peritoneum 741 636 85.8 1990-Malignant neoplasm/unspecified sites 552 471 85.3 1830-Malignant neoplasm/ovary and other uterine adnexa 3,394 2,882 84.9 3180-Mental retardation 77,102 65,460 84.9 3360-Other disorders of the spinal cord 3,428 2,856 83.3 7600-Multiple body dysfunction 2,555 2,128 83.3 1920-Malignant neoplasm/other parts of the nervous system 280 230 82.1 1520-Malignant neoplasm/small intestine 552 449 81.3 1890-Malignant neoplasm/kidney, other urinary organs 2,740 2,206 80.5 0420-Malignant neoplasm/bone marrow or stem cell transplantation 5 4 80.0 7400-Anencephalus/catastrophic anomaly 569 453 79.6 2630-Malnutrition/weight loss 1,112 876 78.8 1640-Malignant neoplasm/thymus, heart, mediastinum 173 136 78.6 1700-Malignant neoplasm/bone and articular cartilage 1,550 1,207 77.9 3430-Cerebral palsy 9,864 7,546 76.5 3320-Parkinsons disease 3,853 2,894 75.1 1950-Malignant neoplasm/other sites 5,399 4,049 75.0 8060-Vertebral fracture/cord lesion 4,699 3,449 73.4 1880-Malignant neoplasm/bladder 1,535 1,122 73.1 7840-Loss of voice 5,162 3,742 72.5

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Improving the Social Security Disability Decision Process: Interim Report SSA impairment code Number of decisions Number of allowances Allowance rate (percent) 1380-Late effects of acute poliomyelitis 1,859 1,346 72.4 1710-Malignant neoplasm/connective and other soft tissue 902 650 72.1 7410-Spina bifida 1,867 1,344 72.0 1530-Malignant neoplasm/colon, rectum, anus 11,184 8,019 71.7 2950-Schizophrenic/paranoid functional disorders 56,218 40,308 71.7 3300-Cerebral degeneration/childhood 616 439 71.3 3750-Cardiac transplantation 319 226 70.8 1420-Malignant neoplasm/salivary glands 234 165 70.5 4380-Late effects of cerebrovascular disease 32,139 22,529 70.1 1790-Malignant neoplasm/uterus 2,566 1,783 69.5 4430-Peripheral vascular disease 8,979 6,240 69.5 4160-Chronic pulmonary heart disease 2,137 1,481 69.3 2840-Aplastic anemia 738 505 68.4 7830-Malnutrition, marasmus/growth impairment 2,388 1,631 68.3 3590-Muscular dystrophies 3,188 2,155 67.6 3150-Developmental/emotional disorders—infant 4,521 3,034 67.1 0300-Leprosy 3 2 66.7 4960-Cronic pulmonary insufficiency/COPD 40,287 26,348 65.4 1940-Malignant neoplasm/other endocrine glands and related 242 158 65.3 3310-Other cerebral degenerations 3,901 2,536 65.0 2940-Organic mental disorders 57,567 36,958 64.2 3210-Arachnoiditis 231 145 62.8 9070-Late effects/nervous system injuries 6,740 4,125 61.2 3690-Blindness/low vision 24,669 14,752 59.8 4280-Heart failure 15,865 9,440 59.5 1740-Malignant neoplasm/breast 17,865 10,558 59.1 3620-Other retinal disorders 3,455 2,038 59.0 3153-Speech and language delays 32,332 18,914 58.5 4460-Periarteritis nodosa/allied condition 296 171 57.8 1870-Malignant neoplasm/penis, male genital organs 158 91 57.6 7500-Congenital anomalies/upper alimentary tract 372 212 57.0 1850-Malignant neoplasm/prostate 3,233 1,827 56.5 4920-Emphysema 4,382 2,471 56.4 2760-Diabetec acidosis 222 123 55.4 4540-Varicose veins/low extremities 2,374 1,294 54.5 3570-Diabetic/peripheral neuropathy 13,714 7,460 54.4 2020-Lymphoma 7,075 3,799 53.7 3890-Deafness 15,352 8,183 53.3 7460-Congenital heart anomalies 5,542 2,910 52.5 0940-Neurosyphilis 25 13 52.0 0430- Symptomatic HIV positive 18,168 9,429 51.9 8540-Intracranial injury 5,785 2,968 51.3 1900-Malignant neoplasm/eye 194 99 51.0 2770-Disorders of metabolism/cystic fibrosis 1,426 719 50.4 3400-Multiple sclerosis 14,183 7,148 50.4 4250-Cardiomyopathy 15,472 7,581 49.0

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Improving the Social Security Disability Decision Process: Interim Report SSA impairment code Number of decisions Number of allowances Allowance rate (percent) 1170-Skin/mucus membrane infections 720 351 48.7 7140-Rheumatoid & other inflammatory arthritis 19,437 9,330 48.0 3060-Somatoform disorders 1,425 681 47.8 1860-Malignant neoplasm/testis 791 375 47.4 2960-Mood disorders (children) 21,121 9,927 47.0 2390-Neoplasm/unspecified/unknown behavior 308 144 46.8 7050-Hidradenitis suppurativa 295 135 45.8 4410-Aortic aneurysm 1,341 607 45.3 1730-Other malignant neoplasm of skin 463 209 45.1 3610-Retinal detachment with retinal defects 1,592 716 45.0 2250-Benign neoplasm/brain, nervous system 3,049 1,332 43.7 4590-Other diseases of the circulatory system 7,004 3,061 43.7 3370-Disorders of the autonomic nervous system 1,408 614 43.6 1840-Malignant neoplasm/other female genital organs 1,141 496 43.5 4140-Chronic ischemic heart disease 44,127 19,195 43.5 4030-Hypertensive vascular/renal disease 376 162 43.1 7200-Ankylosing/inflamnatory spondylopathies 1,007 430 42.7 2820-Hereditary hemolytic anemias including sickle cell 4,167 1,771 42.5 5010-Asbestosis 289 122 42.2 7300-Osteomyelitis/other infections involving bone 1,837 775 42.2 1930-Malignant neoplasm/thyroid gland 782 327 41.8 5710-Chronic liver disease/cirrhosis 30,970 12,853 41.5 7150-Osteoarthritis/allied disorders 113,194 45,730 40.4 4480-Diseases of capillaries 145 57 39.3 0930-Cardio vascular syphilis 36 14 38.9 2730-Disorders of plasma protein metabolism 93 36 38.7 3490-Cther nervous system disorders 15,534 5,996 38.6 3000-Anxiety-related disorders 46,037 17,724 38.5 3138-Oppositional/defiant disorder 7,776 2,955 38.0 3650-Glaucoma 2,958 1,121 37.9 3580-Myoneural disorders 3,118 1,160 37.2 5810-Nephrotic syndrome 2,447 903 36.9 3120-Conduct disorder 5,856 2,102 35.9 2960-Affective disorders (adult) 277,560 99,089 35.7 7590-Other congenital anomalies 3,324 1,160 34.9 2850-Other anemias 1,864 641 34.4 3660-Cataract 2,400 826 34.4 2790-Disorders immune mechanism (except HIV) 1,009 345 34.2 3010-Personality disorders 14,295 4,860 34.0 1360-Other infectious/parasitic diseases 1,488 487 32.7 5780-Gastro intestinal hemorrhage 979 311 31.8 9050-Late effects/musculoskeletal and connective tissue injuries 14,412 4,525 31.4 7100-Diffuse diseases of connective tissue 9,056 2,835 31.3 2880-Diseases of white blood cells 145 45 31.0 3140-Attention deficit hyperactivity disorder 94,862 29,312 30.9 3950-Diseases of aortic valve 3,889 1,190 30.6

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Improving the Social Security Disability Decision Process: Interim Report SSA impairment code Number of decisions Number of allowances Allowance rate (percent) 4100-Acute myocardial infarction 5,254 1,608 30.6 3070-Eating and tic disorders 349 106 30.4 2870-Purpura/other hemorrhagic conditions 499 151 30.3 2380-Neoplasm/uncertain behavior 204 60 29.4 5190-Other diseases of respiratory system 8,111 2,385 29.4 1350-Sarcoidosis 1,904 554 29.1 5300-Diseases of esophagus 984 286 29.1 3860-Vertiginous syndromes 2,155 625 29.0 7330-Other bone/cartilage disorders 16,067 4,659 29.0 4940-Bronchiectasis 674 193 28.6 7649-Birth weight between 1200 and 2000 grams 6,951 1,981 28.5 2810-Deficiency anemias 1,365 388 28.4 4020-Hypertensive vascular disease 7,426 2,109 28.4 3980-Other rheumatic heart disease 629 177 28.1 9490-Burns 1,925 537 27.9 4510-Phlebitis/thrombophlebitis 1,012 280 27.7 4240-Valvular heart diseases/other stenotic defects 3,923 1,067 27.2 3910-Rheumatic fever/heart involvement 169 45 26.6 4270-Cardiac dysrhythmias 4,966 1,311 26.4 2890-Other diseases blood/blood forming organs 1,313 339 25.8 5050-Pneumoconiosis 240 61 25.4 5560-Idiopathic proctocolitis 1,369 344 25.1 6940-Bullous disease 517 128 24.8 4130-Angina pectoris 1,761 426 24.2 2860-Coagulation defects 826 199 24.1 2720-Hyperlipidemia 175 42 24.0 7160-Other and unspecified arthropathies 27,885 6,469 23.2 6960-Dermatitis 1,951 451 23.1 2780-Obesity 20,758 4,754 22.9 5550-Regional enteritis/granulomatous colitis 4,723 1,053 22.3 3680-Visual disturbances 6,158 1,324 21.5 8690-Internal injury 506 108 21.3 8940-Lower limb open wounds 3,117 664 21.3 3152-Learning disorder 36,123 7,622 21.1 8270-Lower limb fractures 34,015 7,075 20.8 2740-Gout 1,511 308 20.4 3195-Borderline intellectual functioning 31,621 6,356 20.1 7240-Back disorders 311,813 62,674 20.1 0110-Pulmonary tuberculosis 472 90 19.1 6950-Ichthyosis 567 103 18.2 7280-Muscle, ligament, fascia disorders 58,995 10,619 18.0 2550-Disorders of adrenal glands 386 69 17.9 2500-Diabetes mellitus 67,988 11,966 17.6 5690-Other disorders gastrointestinal system 13,943 2,440 17.5 9330-Chronic fatigue syndrome 1,974 342 17.3 2530-Disorders of pituitary gland 441 75 17.0

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Improving the Social Security Disability Decision Process: Interim Report SSA impairment code Number of decisions Number of allowances Allowance rate (percent) 7800-Sleep-related disorder 2,371 403 17.0 7090-Other disorders skin/subcutaneous tissue 3,399 557 16.4 5330-Peptic ulcer 1,022 165 16.1 8390-Dislocations 2,435 392 16.1 3460-Migraine 8,011 1,282 16.0 3540-Carpal tunnel syndrome 5,627 889 15.8 8840-Upper limb open wounds 3,676 573 15.6 5530-Hernias 3,048 451 14.8 8180-Upper limb fractures 12,756 1,862 14.6 8290-Other fractures 8,432 1,214 14.4 4910-Chronic bronchitis 1,653 230 13.9 2510-Hypoglycemia 123 17 13.8 3780-Strabismus/disorders eye movements 557 76 13.6 3450-Epilepsy 37,165 4,980 13.4 7370-Curvature of spine 4,530 607 13.4 4010-Essential hypertension 32,188 3,863 12.0 6080-Disorders of male genital organs 434 49 11.3 5990-Other disorders of urinary tract 3,823 413 10.8 2520-Disorders of parathyroid 265 28 10.6 4930-Asthma 60,855 6,086 10.0 5350-Gastritis/Duodenitis 1,480 144 9.7 8790-Other open wounds 432 42 9.7 3880-Other ear disorders 3,019 281 9.3 8030-Skull fracture without intracranial injury 460 35 7.6 8480-Sprains & strains 19,846 1,111 5.6 2460-Disorders of thyroid 3,592 198 5.5 6290-Disorders of female genital organs 1,582 63 4.0 0440-Asymptomatic HIV positive 8,438 262 3.1 3040-Substance dependence/drugs (child) 100 1 1.0 3030-Addiction disorder/alcohol (adult) 8,069 0 0.0 3030-Substance dependence/alcohol (child) 39 0 0.0 3040-Addiction disorders/drugs (adult) 7,167 0 0.0 Unknown, missing, invalid codes 145,328 8,284 5.7   SOURCE: Unpublished table provided by the Office of Disability and Income Support Programs, SSA.