Listing code
101.23
Children (Part B)
Body system
101.00
Musculoskeletal disorders (children)
Subsections
2
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Non-healing or complex fracture of an upper extremity (see 101.00N ), documented by A and B:
Subsection A
Nonunion or complex fracture, of the shaft of the humerus, radius, or ulna, under continuing surgical management see 101.00P1 ) directed toward restoration of functional use of the extremity. AND
Subsection B
Medical documentation of an inability to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 101.00E4 ) that has lasted, or is expected to last, for a continuous period of at least 12 months.
Source: SSA Blue Book listing 101.23. Last synced 2026-05-04.
Where claims under 101.23 usually fail
One pitfall is focusing only on "slow healing" without documented nonunion or a complex shaft fracture of the humerus, radius, or ulna under Subsection A. Another pitfall is missing the "under continuing surgical management" requirement, including whether the ongoing surgery is directed toward restoration of functional use. A third pitfall is treating imaging or fracture notes as enough, when Subsection B also requires medical documentation that the child cannot independently initiate, sustain, and complete age-appropriate fine and gross movement activities, lasting at least 12 continuous months. A fourth pitfall is mixing up the movement requirement, using general limits (like pain) without the specific inability to independently carry out age-appropriate fine and gross movement activities as referenced by 101.00E4.
Medical evidence that strengthens this claim
Strong documentation for 101.23 includes medical records showing nonunion or a complex fracture of the shaft of the humerus, radius, or ulna, along with evidence of continuing surgical management directed toward restoring functional use. For Subsection B, the file needs medical documentation describing the child's inability to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements, with a duration that has lasted or is expected to last at least 12 continuous months. Reports that cover only fracture status without tying it to ongoing surgical management and functional movement limitations usually do not match the lettered criteria structure of 101.23.
What happens if your records do not meet this listing
If the exact combination in 101.23 is not met, the claim still proceeds through the usual medical and functional steps used to decide disability for children. The next step typically involves looking at the child's overall functional limits across domains, including whether the medical condition results in disabling limitations even if it does not match Subsections A and B exactly. Many claims that miss a specific listing still succeed later if the overall record supports equivalent functional severity, rather than stopping at the listing-level criteria.
Work activity and the SGA gate for this condition
For an SSDI claim by a child under Part B, the evaluation uses the listing 101.23 criteria as a gate for whether the medical condition matches a listed impairment. Meeting listing 101.23 requires both continuing surgical management for a nonunion or complex shaft fracture of the humerus, radius, or ulna (Subsection A) and medical documentation of inability to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements lasting at least 12 continuous months (Subsection B). If approved, work activity considerations still apply under the child program rules, but this listing is primarily about the functional impact tied to the fracture and ongoing treatment course described in the criteria. Trial work period and extended period of eligibility concepts are handled by SSA according to the general program process once benefits are awarded.
Listing 101.23 FAQ
Questions that come up repeatedly for non-healing or complex fracture of an upper extremity disability claims.