Revised Medical Criteria for Evaluating Endocrine Disorders (76 FR 19692, April 8, 2011)


SSA finalized the rules for evaluating endocrine disorders that the Agency proposed in 2009 (74 FR 66069, December 14, 2009).  In view of the recent medical developments in early diagnosis and treatment of endocrine disorders SSA concluded that most such disorders do not reach listing-level severity because they do not become sufficiently severe according to the SSA disability standard or do not remain at a sufficient level of severity long enough to  meet the duration requirement.  SSA abolished SSL  9.00 and 109.00 as of June 7, 2011

SSL 109.08 will remain in place for evaluating children under age 6 who have diabetes mellitus (DM) and require daily insulin.  Final listing 109.08 presumes that children under age 6 cannot participate in their own care at the most basic level and are at risk for dying unless they have 24-hour-a-day adult supervision.  Older children who may also require a 24-hour-a-day supervision can still be found disabled based on the functional equivalence (20 C.F.R. sec. 416.926(m)(5)). The final section 109.00C explains that it is is possible for a child age 6 or older to have the same limitations that SSA presumes for all children under age 6.   SSA intends to publish a ruling that will specifically address the issues of evaluating DM in children.

SSA will continue to recognize DM as a potential cause for disability in adults. DM will continue to be a medically determinable impairment that can result in disability.  Final listing 109.00B5 provides guidance about problems associated with fluctuating blood glucose levels and their effects, including diabetic ketoacidosis and hypoglycemia.  SSA did not include a listing for fluctuating blood glucose levels because the reasons for this fluctuation are highly variable and cannot be unified under a simple criteria that would identify person with listing-level impairments.   Listings in other body systems may provide framework for evaluating serious effects of uncontrolled DM (SSA will evaluate diabetic neuropathy under genitourinary listings 6.00 and 106.00, peripheral neuropathy under neurological listings 11.00 and 111.00)