Listing Forms for Social Security Disability Evaluation

These Social Security disability listing forms are for your doctor to fill out.

If your doctor says that your medical condition meets the criteria of a listing from the Social Security Blue Book, you should be able to get approved for Social Security disability  benefits, as long as the medical evidence backs up the doctor's opinion. In order to provide Social Security with your doctor's  opinion, we've created "listing forms" for the most common medical conditions that Social Security sees. This form can help you at the initial application phase and the appeal phase.

Ask your doctor to fill out the listing form for your medical condition when you file for disability or when you file an appeal. The forms are short and shouldn't take long for your doctor to fill out. If your doctor hasn't performed one of the tests on the listing form, this will be a good prompt for your doctor to assess you.

You can download a Portable Document File (PDF) version of these listing forms below.  

Asthma Listing Form, 3.03

Stroke Listing Form, 11.04  

Back Disorders Listing Form, 1.04

Multiple Sclerosis Listing Form, 11.09

Liver Disease/Liver Failure Listing Form, 5.05

Heart and Cardiovascular Problems  Listing Form

HIV Listing Form, 14.08

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