Listing code
113.12
Children (Part B)
Body system
113.00
Cancer (malignant neoplastic diseases, children)
Subsections
3
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Retinoblastoma
Subsection A
With extension beyond the orbit. OR
Subsection B
Persistent or recurrent following initial anticancer therapy. OR
Subsection C
With regional or distant metastases.
Source: SSA Blue Book listing 113.12. Last synced 2026-05-04.
Where claims under 113.12 usually fail
One pitfall is matching the diagnosis name (retinoblastoma) but not the required disease pattern in 113.12, like extension beyond the orbit, persistence or recurrence after initial anticancer therapy, or regional/distant metastases. Another pitfall is relying on limited imaging or treatment records that do not document the required extent and site of the lesion, even though 113.00 requires medical evidence that specifies type, extent, and site. A third pitfall is submitting operative or biopsy documentation without both the operative note and the pathology report when those documents exist. A fourth pitfall is focusing only on the initial diagnosis when evidence is needed about recurrence, persistence, progression, response to therapy, or significant residuals.
Medical evidence that strengthens this claim
Medical evidence must specify the type, extent, and site of the primary, recurrent, or metastatic lesion, which ties directly to the 113.12 criteria of extension beyond the orbit, persistence or recurrence after initial anticancer therapy, or regional/distant metastases. For biopsies or needle aspiration, the usual requirement is a copy of both the operative note and the pathology report. If those documents cannot be obtained, SSA can accept summaries of hospitalization(s) or other medical reports that include details of findings at surgery and, when appropriate, pathological findings. In situations involving persistence, recurrence, or progression, SSA may also need evidence about recurrence/persistence/progression, response to therapy, and significant residuals.
What happens if your records do not meet this listing
Steps 4 and 5 work like a two-part filter. First, SSA checks whether the cancer pattern matches a specific listing criterion, like extension beyond the orbit, persistent or recurrent disease after initial anticancer therapy, or regional/distant metastases under 113.12. If it does not, SSA still evaluates the overall effect of the cancer on functioning using the residual impacts after treatment as part of the remaining disability evaluation (including any evidence about post-therapeutic residuals and how the cancer responded over time).
Work activity and the SGA gate for this condition
For a child claim evaluated under Part B with code 113.12, the eligibility decision is driven by whether the medical evidence shows one of the lettered patterns: extension beyond the orbit, persistent or recurrent retinoblastoma after initial anticancer therapy, or regional or distant metastases. The cancer evaluation also considers duration, frequency, and response to therapy, plus effects of post-therapeutic residuals, because these factors are tied to whether disease persists or recurs and what remains afterward. After approval, ongoing treatment outcomes and any significant residuals matter because SSA evaluates the lasting effects, not only the initial diagnosis; the focus stays on the pattern and extent described in 113.12 (extension beyond the orbit, persistence/recurrence, or metastases).
Listing 113.12 FAQ
Questions that come up repeatedly for retinoblastoma a disability claims.