Listing code
114.04
Children (Part B)
Body system
114.00
Immune system disorders (children)
Subsections
3
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Systemic sclerosis (scleroderma). As described in 114.00D3 . With:
Subsection A
Involvement of two or more organs/body systems, with: 1. One of the organs/body systems involved to at least a moderate level of severity; and 2. At least two of the constitutional symptoms and signs (severe fatigue, fever, malaise, or involuntary weight loss). OR
- One of the organs/body systems involved to at least a moderate level of severity; and
- At least two of the constitutional symptoms and signs (severe fatigue, fever, malaise, or involuntary weight loss). OR
Subsection B
One of the following: 1. Toe contractures or fixed deformity of one or both feet, 114.00C6 ; or--> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 101.00C6e(ii) ); or 2. Finger contractures or fixed deformity in both hands and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ); or 3. Atrophy with irreversible damage in one or both lower extremities 114.00C6 ; or--> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii) ); or 4. Atrophy with irreversible damage in both upper extremities and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ); or Back to Top OR -->
- Toe contractures or fixed deformity of one or both feet, 114.00C6 ; or--> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 101.00C6e(ii) ); or
- Finger contractures or fixed deformity in both hands and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ); or
- Atrophy with irreversible damage in one or both lower extremities 114.00C6 ; or--> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii) ); or
- Atrophy with irreversible damage in both upper extremities and medical documentation of an inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ); or Back to Top OR -->
Subsection C
Raynaud's phenomenon, characterized by: 1. Gangrene involving at least two extremities; or 2. Ischemia with ulcerations of toes or fingers 114.00C6 and 114.00C7 --> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii) ); or An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ). Back to Top
- Gangrene involving at least two extremities; or
- Ischemia with ulcerations of toes or fingers 114.00C6 and 114.00C7 --> and medical documentation of at least one of the following: A documented medical need (see 114.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 101.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 101.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ), and a documented medical need (see 114.00C6 ) for a one-handed, hand-held assistive device (see 101.00C6d ) that requires the use of the other upper extremity or a wheeled and seated mobility device involving the use of one hand (see 1.00C6e(ii) ); or An inability to use both upper extremities to the extent that neither can be used to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 114.00C7 ). Back to Top
Source: SSA Blue Book listing 114.04. Last synced 2026-05-04.
Where claims under 114.04 usually fail
Many claims fail subsection A because they have only one organ/body system involved, or because there are not at least two constitutional symptoms and signs (severe fatigue, fever, malaise, or involuntary weight loss). Other claims fail subsection B because they show toe contractures, finger contractures, or atrophy, but miss the linked requirement for medical documentation of mobility/assistive device needs (walker, bilateral canes, bilateral crutches, or a wheeled and seated mobility device involving use of both hands) or the specific age-appropriate fine and gross movement inability with the correct one-handed assistive device or wheeled seating device involving use of one hand. Claims often miss subsection B when the fixed deformity/contracture is not in the correct location pattern (toe/feet, both hands, one or both lower extremities, or both upper extremities) or when it does not match the "independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements" standard. Claims under subsection C often fail because they have Raynaud's but do
Medical evidence that strengthens this claim
To support 114.04, documentation needs to align to the lettered pathways in the criteria. For subsection A, medical records must show involvement of two or more organs/body systems, with one involved to at least a moderate level of severity, plus at least two constitutional symptoms and signs from severe fatigue, fever, malaise, or involuntary weight loss. For subsection B, records must document the specific physical findings (toe contractures or fixed deformity of one or both feet, finger contractures or fixed deformity in both hands, atrophy with irreversible damage in one or both lower extremities, or atrophy with irreversible damage in both upper extremities) and also include medical documentation of at least one required mobility/assistive device need (walker, bilateral canes, bilateral crutches, or a wheeled and seated mobility device involving the use of both hands, or a one-handed hand-held assistive device requiring the use of the other upper extremity, or a wheeled and seated mobility device involving the use of one hand). For subsection C, documentation must show Raynaud's
What happens if your records do not meet this listing
If the child does not meet 114.04, the claim does not automatically end. The decision process can still consider the child's residual functional capacity (RFC) and whether the overall medical and functional limits are consistent with disability, even when the listing-level pattern in A, B, or C is not met.
Work activity and the SGA gate for this condition
At the start of a child's SSDI claim, the ability to do work activity at a level higher than substantial gainful activity (SGA) is a gate. For systemic sclerosis (scleroderma) under 114.04, the criteria focus on severe multi-organ involvement with constitutional symptoms (114.04A) or major functional problems like contractures, fixed deformities, irreversible atrophy, or Raynaud's complications with gangrene or ischemia/ulcerations plus the required assistive device or fine and gross movement limitations (114.04B and 114.04C). If approved, work activity rules and eligibility periods after approval follow the standard child SSDI framework that applies once a medical listing is met or equaled; the specific SGA dollar threshold is not provided here.
Listing 114.04 FAQ
Questions that come up repeatedly for systemic sclerosis (scleroderma) disability claims.