Listing code
14.04
Adult (Part A)
Body system
14.00
Immune system disorders
Subsections
4
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 14.00D3 . 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 or 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 or signs (severe fatigue, fever, malaise, or involuntary weight loss). OR
Subsection B
With one of the following: 1. Toe contractures or fixed deformity of one or both feet 14.00C6 --> and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d ) 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 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 work-related activities involving fine and gross movements (see 14.00C7 ); or 3. Atrophy with irreversible damage in one or both lower extremities 14.00C6 --> and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d) 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 (see 14.00C8 ) 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 work-related activities involving fine and gross movements (see 14.00C7 ); OR
- Toe contractures or fixed deformity of one or both feet 14.00C6 --> and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d ) 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
- 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 work-related activities involving fine and gross movements (see 14.00C7 ); or
- Atrophy with irreversible damage in one or both lower extremities 14.00C6 --> and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d) 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 (see 14.00C8 ) 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 work-related activities involving fine and gross movements (see 14.00C7 ); OR
Subsection C
Raynaud's phenomenon, characterized by: 1. Gangrene involving at least two extremities; or 2. Ischemia with ulcerations of toes or fingers and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d ) 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 work-related activities involving fine and gross movements (see 14.00C7 ); OR
- Gangrene involving at least two extremities; or
- Ischemia with ulcerations of toes or fingers and medical documentation of at least one of the following: A documented medical need (see 14.00C6 ) for a walker, bilateral canes, or bilateral crutches (see 1.00C6d ) or a wheeled and seated mobility device involving the use of both hands (see 1.00C6e(i) ); or An inability to use one upper extremity to independently initiate, sustain, and complete work-related activities involving fine and gross movements (see 14.00C7 ), and a documented medical need (see 14.00C6 ) for a one-handed, hand-held assistive device (see 1.00C6d ) 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 work-related activities involving fine and gross movements (see 14.00C7 ); OR
Subsection D
Repeated manifestations of systemic sclerosis (scleroderma), with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level: 1. Limitation of activities of daily living. 2. Limitation in maintaining social functioning. 3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace. Back to Top
- Limitation of activities of daily living.
- Limitation in maintaining social functioning.
- Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace. Back to Top
Source: SSA Blue Book listing 14.04. Last synced 2026-05-04.
Where claims under 14.04 usually fail
A frequent failure mode is mixing parts of different subsections, like having constitutional symptoms but not meeting the multi-organ severity requirement in Subsection A, or not matching the specific marked-level functioning limits required by Subsection D. Another common pitfall is focusing on diagnosis and general pain while missing the required constitutional symptoms list (severe fatigue, fever, malaise, or involuntary weight loss) or the required count (two or more in Subsection A, two or more plus marked limits in Subsection D). For Subsection B, people often miss the combination requirement: toe contractures or finger contractures or irreversible atrophy plus documented inability to use hands/feet in the exact way described, and plus documented need for the specified assistive device (walker, canes, crutches, or a wheeled and seated mobility device, or a one-handed, hand-held assistive device with the other hand required to use it). For Subsection C, a key pitfall is having Raynaud's symptoms without meeting the specific severe outcomes (gangrene involving at least two extrem
Medical evidence that strengthens this claim
For Subsection A, medical evidence should document involvement of two or more organs or body systems, with at least one organ system involved to a moderate level of severity, plus at least two constitutional symptoms or signs from this list: severe fatigue, fever, malaise, or involuntary weight loss. For Subsection B, documentation needs to support (1) the required fixed deformities or atrophy (toe contractures or fixed deformity of one or both feet, finger contractures or fixed deformity in both hands, or atrophy with irreversible damage in one or both lower extremities, or in both upper extremities), and (2) the matching functional inability and assistive-device need, such as a documented medical need for a walker, bilateral canes, or bilateral crutches, or a wheeled and seated mobility device involving the use of both hands, or a documented medical need for a one-handed, hand-held assistive device where the other upper extremity must be used (or a wheeled and seated mobility device involving the use of one hand). For Subsection C, documentation should cover Raynaud's phenomenon in
What happens if your records do not meet this listing
If the medical situation does not match the exact criteria in subsections A, B, C, or D, the claim is still evaluated using the rest of the disability evaluation process. Steps 4 and 5 are where ability to do work is assessed based on residual functional capacity (RFC), meaning the most a person can still do despite limitations. Even without meeting this listing word-for-word, a case can still be approved if the remaining functional capacity and work limitations lead to a finding of disability under the normal evaluation process.
Work activity and the SGA gate for this condition
Systemic sclerosis affects work only if its documented limitations prevent sustained work activities. This listing includes very specific severe findings, like involuntary weight loss plus marked constitutional patterns (Subsection A or D), or fixed deformities/contractures plus documented mobility or hand-use assistive-device needs (Subsection B), or Raynaud's complications with gangrene or ischemia with ulcerations plus documented mobility or hand-use assistive-device needs (Subsection C). For SSDI claims, SGA is still the work activity gate at the start of the process, and the listing's described severe limitations can make sustained work above SGA less realistic. If approved, the trial work period and extended period of eligibility apply after the approval.
Listing 14.04 FAQ
Questions that come up repeatedly for systemic sclerosis (scleroderma) disability claims.