Listing code
101.19
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
Pathologic fractures due to any cause (see 101.00J ), documented by A and B:
Subsection A
Pathologic fractures occurring on three separate occasions within a 12-month period. AND
Subsection B
Impairment-related physical limitation of musculoskeletal functioning that has lasted, or is expected to last, for a continuous period of at least 12 months, and medical documentation of at least one of the following: 1. A documented medical need (see 101.00C6a ) 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 2. An inability to use one upper extremity to independently initiate, sustain, and complete age-appropriate activities involving fine and gross movements (see 101.00E4 ), and a documented medical need (see 101.00C6a ) 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 3. 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 101.00E4 ).
- A documented medical need (see 101.00C6a ) 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 101.00E4 ), and a documented medical need (see 101.00C6a ) 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
- 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 101.00E4 ).
Source: SSA Blue Book listing 101.19. Last synced 2026-05-04.
Where claims under 101.19 usually fail
One pitfall is counting fracture events that are not documented as pathologic fractures. Another pitfall is missing the timing requirement in Subsection A, since it must be three separate occasions within a 12 months period. A third pitfall is meeting the fracture history but not showing the 12-month physical limitation requirement in Subsection B. A fourth pitfall is choosing the wrong B pathway, such as providing evidence of general weakness without one of the specific documented medical-need or upper-extremity limitations described in items 1 through 3.
Medical evidence that strengthens this claim
Medical documentation should cover both A and B. For Subsection A, the record should document pathologic fractures on three separate occasions within a 12-month period. For Subsection B, documentation should support either (1) a documented medical need for a walker, bilateral canes, or bilateral crutches, or a wheeled and seated mobility device involving both hands, or (2) an inability to use one upper extremity for age-appropriate fine and gross movements plus a documented medical need for a one-handed hand-held assistive device that requires the other upper extremity or a wheeled and seated mobility device involving one hand, or (3) an inability to use both upper extremities to the extent that neither can independently initiate, sustain, and complete age-appropriate fine and gross movements. The documentation should also address that the physical limitation has lasted, or is expected to last, for a continuous period of at least 12 months.
What happens if your records do not meet this listing
If the criteria for 101.19 are not met, the evaluation does not end. Step 4 focuses on whether the child can do past relevant physical activities, based on functional limits. If the child cannot do the relevant physical activities, Step 5 considers whether the child has limitations that prevent performing other age-appropriate physical activities, again tied to the medical severity described in the record.
Work activity and the SGA gate for this condition
For children in Part B, work activity rules that apply to adults are not the focus; eligibility turns on meeting the medical listing criteria for pathologic fractures under 101.19. This listing requires the combination of three separate pathologic fracture occasions within a 12-month period (Subsection A) and an impairment-related physical limitation that has lasted or is expected to last at least 12 months, along with medical documentation of one of the specific mobility or upper-extremity limitations in Subsection B. If those specific fracture timing and functional documentation elements are present, the listing can be used to establish disability at the medical step level for children.
Listing 101.19 FAQ
Questions that come up repeatedly for pathologic fractures due to any cause disability claims.