Listing code
1.21
Adult (Part A)
Body system
1.00
Musculoskeletal disorders
Subsections
3
Lettered criteria paths
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Soft tissue injury or abnormality under continuing surgical management (see 1.00L ), documented by A, B, and C:
Subsection A
Evidence confirms continuing surgical management (see 1.00O1 ) directed toward saving, reconstructing, or replacing the affected part of the body. AND
Subsection B
The surgical management has been, or is expected to be, ongoing for a continuous period of at least 12 months. AND
Subsection C
Maximum benefit from therapy (see 1.00O2 ) has not yet been achieved.
Source: SSA Blue Book listing 1.21. Last synced 2026-05-04.
Where claims under 1.21 usually fail
Many claims fail because they can't document that the surgical management is continuing and specifically directed toward saving, reconstructing, or replacing the affected part (subsection A). Another common failure is the timing: surgery or procedures may have started, but the record does not show an expected continuous period of at least 12 months (subsection B). Some cases get denied when maximum benefit from therapy has already been reached, even if the person still has pain or limitations (subsection C). Others miss the "soft tissue" focus and end up more squarely fitting other musculoskeletal listings for different problems like skeletal spine curvatures (1.15) rather than soft tissue abnormalities under ongoing surgical care.
Medical evidence that strengthens this claim
The strongest documentation is medical records that confirm continuing surgical management aimed at saving, reconstructing, or replacing the affected part (subsection A). The timeline matters too, so the record should support that the surgical management has been or is expected to be ongoing for a continuous period of at least 12 months (subsection B). Evidence also needs to address whether maximum benefit from therapy has not yet been achieved (subsection C), which is typically addressed in follow-up treatment planning and assessment of progress under the ongoing care plan. The clinical problem can be located anywhere the body system allows, including the face and skull, as long as it is a soft tissue injury or abnormality under continuing surgical management.
What happens if your records do not meet this listing
If the record does not satisfy all three lettered criteria (A, B, and C), step 4 is where the focus shifts to what still can be done in work-like activities despite the medical limits, using the person's residual functional capacity. If the person cannot do past relevant work, step 5 looks at whether other work is possible given the remaining functional abilities. Even when a listing like 1.21 is not met, an approval may still happen later through the residual functional capacity and vocational analysis rather than through this specific "continuing surgical management" pathway.
Work activity and the SGA gate for this condition
For an SSDI claim, work activity above the substantial gainful activity (SGA) level can prevent benefits from starting. Whether work is possible depends on how the ongoing care and the functional limits it causes affect sustained activity, but the listing-specific criteria for 1.21 focus on continuing surgical management (subsection A), its expected duration of at least 12 months (subsection B), and that maximum benefit has not yet been achieved (subsection C). If approved, SSA then uses the usual trial work period and extended period of eligibility rules for maintaining benefits while work is attempted after the medical decision.
Listing 1.21 FAQ
Questions that come up repeatedly for soft tissue injury or abnormality under continuing surgical management disability claims.