Listing code
113.21
Children (Part B)
Body system
113.00
Cancer (malignant neoplastic diseases, children)
Subsections
4
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Neuroblastoma
Subsection A
With extension across the midline. OR
Subsection B
With distant metastases. OR
Subsection C
Recurrent. OR
Subsection D
With onset at age 1 year or older.
Source: SSA Blue Book listing 113.21. Last synced 2026-05-04.
Where claims under 113.21 usually fail
One common failure is having a pathology report that confirms neuroblastoma but not having evidence that matches Subsection A, B, C, or D (midline extension, distant metastases, recurrence, or onset age 1 year or older). Another pitfall is relying on imaging alone without the needed information about type, extent, and site of the primary, recurrent, or metastatic lesion. For procedures like biopsy or needle aspiration, missing the operative note and pathology report can also stall the criteria match. Some claims also miss because there is not enough documentation of recurrence, persistence, or progression, when that information is significant for meeting the listing's C category (recurrent).
Medical evidence that strengthens this claim
Medical evidence must specify the type, extent, and site of the primary, recurrent, or metastatic lesion for listing 113.21. For biopsies or needle aspiration, SSA generally needs a copy of both the operative note and the pathology report, not just one. When those documents cannot be obtained, SSA may accept summaries of hospitalization or other medical reports that include details of the findings at surgery and, whenever appropriate, pathological findings. In situations involving recurrence or ongoing disease activity, evidence about recurrence, persistence, or progression and the response to therapy can be needed to place the case into Subsection C and to understand significant residual effects after treatment.
What happens if your records do not meet this listing
If the criteria in 113.21 are not met, the claim can still be evaluated using the next steps of the disability process, including assessing residual functional capacity (what the child can still do despite cancer). The decision then weighs the overall medical picture against functional limits rather than requiring the exact A, B, C, or D pattern. Many cases that do not match a listing still qualify later if the functional impact is sufficiently severe.
Work activity and the SGA gate for this condition
For SSDI and SSI disability evaluations, work activity is considered at the start of the claim, and approval generally depends on medical severity as well as the ability to do work despite impairments. Cancer cases evaluated under 113.21 often involve significant impairment related to extent of involvement and post-therapeutic residual effects, which can matter before and after approval. If disability is found, ongoing eligibility can continue through the trial work period and extended period of eligibility rules for those who meet the program's requirements after approval. The listing's key clinical categories for neuroblastoma under 113.21 (midline extension, distant metastases, recurrence, or onset at age 1 year or older) are the core medical facts that typically drive whether the case is treated as meeting the listing at the outset.
Listing 113.21 FAQ
Questions that come up repeatedly for neuroblastoma a disability claims.