Listing code
104.02
Children (Part B)
Body system
104.00
Cardiovascular system (children)
Subsections
3
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Chronic heart failure while on a regimen of prescribed treatment with symptoms and signs described in 104.00C2 and with one of the following:
Subsection A
Persistent tachycardia at rest (see Table I); OR
Subsection B
Persistent tachypnea at rest (see Table II) or markedly decreased exercise tolerance (see 104.00C2b ); OR
Subsection C
Growth failure as required in 1 or 2: 1. For children from birth to attainment of age 2, three weight-for-length measurements that are: a. Within a consecutive 12-month period; and b. At least 60 days apart; and c. Less than the third percentile on the appropriate weight-for-length Table I or II under 105.08B1 ; or 2. For children age 2 to attainment of age 18, three BMI-for-age measurements that are: a. Within a consecutive 12-month period; and b. At least 60 days apart; and c. Less than the third percentile on the appropriate BMI-for-age Table III or IV under 105.08B2 . Back to Top Table I ‑ Tachycardia at Rest Age Apical heart rate (beats per minute) Under 1 year 150 1 through 3 years 130 4 through 9 years 120 10 through 15 years 110 Over 15 years 100 Table II ‑ Tachypnea at Rest Age Respiratory rate over (per minute) Under 1 year 40 1 through 5 years 35 6 through 9 years 30 Over 9 years 25 Back to Top
- For children from birth to attainment of age 2, three weight-for-length measurements that are:
- For children age 2 to attainment of age 18, three BMI-for-age measurements that are:
Source: SSA Blue Book listing 104.02. Last synced 2026-05-04.
Where claims under 104.02 usually fail
One pitfall is relying on imaging or general heart diagnoses without matching the specific 104.02A persistent tachycardia at rest cutoffs in Table I (apical heart rate) or 104.02B persistent tachypnea at rest cutoffs in Table II (respiratory rate). Another pitfall is treating 'fast heart rate' or 'fast breathing' as occasional symptoms, rather than requiring persistent findings with the age-specific thresholds given. A third pitfall is missing the required timing and percentile method for growth failure in 104.02C, which requires three measurements within a consecutive 12-month period, at least 60 days apart, and below the third percentile using the appropriate weight-for-length or BMI-for-age table under 105.08B1 or 105.08B2. A fourth pitfall is using the wrong growth metric for the child's age band (weight-for-length for birth to age 2, BMI-for-age for age 2 to attainment of age 18).
Medical evidence that strengthens this claim
Medical documentation should show (1) chronic heart failure while on a regimen of prescribed treatment, (2) symptoms and signs matching 104.00C2, and (3) one additional required finding from 104.02A, B, or C. For 104.02A, documentation needs persistent apical heart rate at rest that meets the age-specific Table I values (for example, over 150 beats per minute under 1 year, over 130 for 1 through 3 years, over 120 for 4 through 9 years, over 110 for 10 through 15 years, and over 100 for over 15 years). For 104.02B, documentation needs persistent respiratory rate at rest meeting Table II cutoffs (for example, over 40 under 1 year, over 35 for 1 through 5 years, over 30 for 6 through 9 years, and over 25 for over 9 years) or markedly decreased exercise tolerance referenced as 104.00C2b. For 104.02C, documentation needs three growth measurements with the correct structure: within a consecutive 12-month period, at least 60 days apart, and less than the third percentile, using weight-for-length tables for ages birth to attainment of age 2, or BMI-for-age tables for ages 2 to attainment of
What happens if your records do not meet this listing
If the exact lettered criteria in 104.02A, B, or C are not met, approval can still happen later in the process. The next steps focus on how the child's cardiovascular impairment limits functioning despite treatment, including what symptoms and signs are present and how they affect daily activities. If the medical record supports severe ongoing functional limitations even when the listing thresholds are not matched exactly, the claim can still be decided on overall severity rather than matching one specific measurement cut point.
Work activity and the SGA gate for this condition
To get benefits based on this condition under the childhood disability framework, the record must show chronic heart failure while on prescribed treatment and still having symptoms and signs described in 104.00C2. Then one additional ongoing requirement must be documented: persistent tachycardia at rest with age-specific Table I apical heart rates (104.02A), or persistent tachypnea at rest with age-specific Table II respiratory rate cutoffs (104.02B), or growth failure using three measurements within a consecutive 12-month period that are at least 60 days apart and below the third percentile on the required weight-for-length or BMI-for-age table (104.02C). Because this listing is written around specific at-rest heart rate, breathing rate, or structured growth measurement thresholds, the strongest work-up is the documentation that directly matches one of those lettered criteria while the
Listing 104.02 FAQ
Questions that come up repeatedly for chronic heart failure while on a regimen of prescribed treatment with symptoms and signs described in 104.00c2 and with one of the following disability claims.