Listing code
5.05
Adult (Part A)
Body system
5.00
Digestive system
Subsections
7
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Chronic liver disease (CLD) (see 5.00C ) with A, B, C, D, E, F, or G:
Subsection A
Hemorrhaging from esophageal, gastric, or ectopic varices, or from portal hypertensive gastropathy (see 5.00C2a ), documented by imaging (see 5.00B3 ); resulting in 1 and 2: 1. Hemodynamic instability indicated by signs such as pallor (pale skin), diaphoresis (profuse perspiration), rapid pulse, low blood pressure, postural hypotension (pronounced fall in blood pressure when arising to an upright position from lying down), or syncope (fainting); and 2. Requiring hospitalization for transfusion of at least 2 units of blood. Consider under a disability for 1 year following the documented transfusion; after that, evaluate the residual impairment(s). OR
- Hemodynamic instability indicated by signs such as pallor (pale skin), diaphoresis (profuse perspiration), rapid pulse, low blood pressure, postural hypotension (pronounced fall in blood pressure when arising to an upright position from lying down), or syncope (fainting); and
- Requiring hospitalization for transfusion of at least 2 units of blood. Consider under a disability for 1 year following the documented transfusion; after that, evaluate the residual impairment(s). OR
Subsection B
Ascites or hydrothorax not attributable to other causes (see 5.00C2b ), present on two evaluations within a consecutive 12-month period and at least 60 days apart. Each evaluation must document the ascites or hydrothorax by 1, 2, or 3: 1. Paracentesis; or 2. Thoracentesis; or 3. Imaging or physical examination with a or b: a. Serum albumin of 3.0 g/dL or less; or b. INR of at least 1.5. OR
- Paracentesis; or
- Thoracentesis; or
- Imaging or physical examination with a or b:
Subsection C
Spontaneous bacterial peritonitis (see 5.00C2c ) documented by peritoneal fluid containing a neutrophil count of at least 250 cells/mm 3 . OR
Subsection D
Hepatorenal syndrome (see 5.00C2d ) documented by 1, 2, or 3: 1. Serum creatinine elevation of at least 2 mg/dL; or 2. Oliguria with 24-hour urine output less than 500 mL; or 3. Sodium retention with urine sodium less than 10 mEq per liter. OR
- Serum creatinine elevation of at least 2 mg/dL; or
- Oliguria with 24-hour urine output less than 500 mL; or
- Sodium retention with urine sodium less than 10 mEq per liter. OR
Subsection E
Hepatopulmonary syndrome (see 5.00C2e ) documented by 1 or 2: 1. Arterial P a O 2 measured by an ABG test, while at rest, breathing room air, less than or equal to: a. 60 mm Hg, at test sites less than 3,000 feet above sea level; or b. 55 mm Hg, at test sites from 3,000 through 6,000 feet above sea level; or c. 50 mm Hg, at test sites over 6,000 feet above sea level; or 2. Intrapulmonary arteriovenous shunting as shown by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan. Back to Top OR
- Arterial P a O 2 measured by an ABG test, while at rest, breathing room air, less than or equal to:
- Intrapulmonary arteriovenous shunting as shown by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan. Back to Top OR
Subsection F
Hepatic encephalopathy (see 5.00C2f ) with documentation of abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness (for example, confusion, delirium, stupor, or coma), present on two evaluations within a consecutive 12-month period and at least 60 days apart and either 1 or 2: 1. History of transjugular intrahepatic portosystemic shunt (TIPS) or other surgical portosystemic shunt; or 2. One of the following on at least two evaluations at least 60 days apart within the same consecutive 12-month period as in F: a. Asterixis or other fluctuating physical neurological abnormalities; or b. EEG demonstrating triphasic slow wave activity; or c. Serum albumin of 3.0 g/dL or less; or d. INR of 1.5 or greater. OR
- History of transjugular intrahepatic portosystemic shunt (TIPS) or other surgical portosystemic shunt; or
- One of the following on at least two evaluations at least 60 days apart within the same consecutive 12-month period as in F:
Subsection G
Two SSA CLD scores (see 5.00C3 ) [ SSA CLD Calculator ] of at least 20 within a consecutive 12-month period and at least 60 days apart. Consider under a disability from at least the date of the first score. Back to Top
Source: SSA Blue Book listing 5.05. Last synced 2026-05-04.
Where claims under 5.05 usually fail
One frequent failure mode is missing the required documentation type, like the need for imaging to document hemorrhaging from varices in 5.05 A, or the need for paracentesis or thoracentesis, or specific labs (albumin or INR) in 5.05 B. Another pitfall is not meeting the timing rules, such as ascites or hydrothorax needing to be present on two evaluations within a consecutive 12-month period at least 60 days apart (5.05 B), or hepatic encephalopathy needing abnormal mental status findings on two evaluations at least 60 days apart (5.05 F). A third issue is using the wrong objective threshold, for example albumin must be 3.0 g/dL or less (5.05 B and 5.05 F), INR must be at least 1.5 (5.05 B and 5.05 F includes albumin/INR thresholds), and hepatorenal syndrome criteria use specific creatinine, urine output, or urine sodium cutoffs (5.05 D). A fourth pitfall is treating SSA CLD score requirements casually, since 5.05 G requires two SSA CLD scores of at least 20 within a consecutive 12-month period at least 60 days apart.
Medical evidence that strengthens this claim
Strong documentation matches the lettered criteria exactly. For 5.05 A, records need hemorrhaging from esophageal, gastric, or ectopic varices (or portal hypertensive gastropathy) documented by imaging, plus hemodynamic instability signs (such as pallor, diaphoresis, rapid pulse, low blood pressure, postural hypotension, or syncope) and hospitalization for transfusion of at least 2 units of blood. For 5.05 B, provide two evaluations at least 60 days apart showing ascites or hydrothorax not attributable to other causes, and include the specific evidence used at each evaluation: paracentesis, thoracentesis, or the combination of imaging or physical exam with serum albumin 3.0 g/dL or less or INR at least 1.5. For 5.05 C, provide peritoneal fluid results showing spontaneous bacterial peritonitis with neutrophil count at least 250 cells/mm3. For 5.05 D, provide kidney-related thresholds such as serum creatinine elevation at least 2 mg/dL, or oliguria with 24-hour urine output under 500 mL, or sodium retention with urine sodium under 10 mEq per liter. For 5.05 E, provide ABG PaO2 at rest,
What happens if your records do not meet this listing
If the specific 5.05 lettered criteria are not fully met, SSA generally still considers whether the overall impairments from chronic liver disease can produce a level of functional limitation that matches disability through the usual process after reviewing medical evidence. Steps 4 and 5 focus on residual functional capacity (RFC) and whether work is still possible given that RFC. Even when a listing is not met or equaled, the medical evidence can still support that an inability to do sustained work exists based on the documented effects of liver disease and its complications.
Work activity and the SGA gate for this condition
At the start of an SSDI claim, SSA evaluates whether work activity counts as substantial gainful activity (SGA). If SGA is not met, the claim moves forward, and then SSA checks whether chronic liver disease meets 5.05 A through G using the required objective documentation and timing rules, such as two evaluations at least 60 days apart for ascites or hydrothorax in 5.05 B, or two SSA CLD scores of at least 20 in 5.05 G. If approved, eligibility continues according to SSDI rules, including the trial work period and extended period of eligibility for people who return to work.
Listing 5.05 FAQ
Questions that come up repeatedly for chronic liver disease (cld) disability claims.