Listing 4.11
Chronic venous insufficiency
This listing covers long-term problems with the leg veins (chronic venous insufficiency) where the deep veins are damaged or blocked, causing severe swelling or skin ulcers.
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SSA needs proof of deep vein incompetence or obstruction PLUS either extensive firm ('brawny') swelling covering a large part of the leg (Path A) or varicose veins with skin changes and ulcers that keep coming back or won't heal after 3 months of treatment (Path B). You need only one of A or B.
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What Listing 4.11 asks for
What SSA looks for — see the 2 items
We will check your records against each of these. Every item comes straight from SSA's own listing.
Path A (you need A or B, not both, plus deep vein incompetence or obstruction): firm, dense swelling called brawny edema — not the soft kind that dents when pressed (pitting edema) — covering at least two-thirds of the lower leg between ankle and knee, or the lower third of the whole leg between ankle and hip.
(Listing 4.11, criterion A)
Path B (you need A or B, not both, plus deep vein incompetence or obstruction): visible varicose veins AND skin inflammation from poor circulation (stasis dermatitis) AND leg ulcers that either keep coming back (at least three times in 12 months) or have stayed open despite at least 3 months of prescribed treatment.
(Listing 4.11, criterion B)
How long it must last:
The impairment must have lasted or be expected to last at least 12 continuous months. 'Persistent' ulceration must have failed to heal after at least 3 months of prescribed treatment; 'recurrent' means occurring at least three times in a consecutive 12-month period.