Listing 1.21
Soft tissue injury or abnormality under continuing surgical management
This listing covers soft tissue injuries or abnormalities — such as severe (third- and fourth-degree) burns, crush injuries, craniofacial injuries, malformations, avulsive injuries, or amputations with residual limb complications — that require ongoing surgeries and related treatment to restore function.
Read the full plain-language explanation
SSA needs three things: (A) proof that surgical management is continuing and aimed at saving, reconstructing, or replacing the affected body part; (B) proof that the surgical management has lasted, or is expected to last, at least 12 months from the first surgery; and (C) proof you have not yet gotten the maximum benefit from therapy. The functional criteria used in other listings do not apply here.
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What Listing 1.21 asks for
What SSA looks for — see the 3 items
We will check your records against each of these. Every item comes straight from SSA's own listing.
- Your records must show you are under ongoing surgical care — surgeries plus related procedures, complications, and treatments — aimed at restoring the affected body part's function (not just for cosmetic appearance).
- A, B, and C are all required.
Read the original wording
Your records must show you are under ongoing surgical care — surgeries plus related procedures, complications, and treatments — aimed at restoring the affected body part's function (not just for cosmetic appearance). A, B, and C are all required.
(Listing 1.21, criterion A)
The surgeries and related treatment must have continued, or be expected to continue, for at least 12 months counted from the date of the first surgery.
(Listing 1.21, criterion B)
- You must not yet have reached the point where therapy can't help any further.
- SSA considers maximum benefit reached if there are no significant changes in physical findings or imaging for any 6-month period after the last surgery or treatment, or if your doctor says no further improvement is expected.
Read the original wording
You must not yet have reached the point where therapy can't help any further. SSA considers maximum benefit reached if there are no significant changes in physical findings or imaging for any 6-month period after the last surgery or treatment, or if your doctor says no further improvement is expected.
(Listing 1.21, criterion C)
How long it must last:
The surgical management must have been, or be expected to be, ongoing for a continuous period of at least 12 months from the date of the first surgical intervention.