# SSR 02-2p: SSR 02-2p: Rescinded

> Federal · Rulings · Rescinded

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_02_2p

## Section

- **Citation:** SSR 02-2p
- **Heading:** SSR 02-2p: Rescinded
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** Rescinded
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / DI / Disability Insurance — Medical / SSR 02-2p

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Disability Insurance

Rescinded and replaced by SSR 15-1p effective March 18, 2015

[Federal Register: November 5, 2002 (Volume 67, Number 214)] [Page
67436-67439]

EFFECTIVE DATE: November 5, 2002.

Policy Interpretation Ruling

Purpose:

To provide guidance on SSA policy concerning the development and
evaluation of interstitial cystitis (IC) in disability claims filed under
titles II and XVI of the Social Security Act (the Act).

Citations:

Sections 216(i), 223(d), 223(f), 1614(a), and 1614(c) of the Act, as
amended; Regulations No. 4, subpart P, sections 404.1502, 404.1505,
404.1508, 404.1509, 404.1511, 404.1512, 404.1513, 404.1520, 404.1520a,
404.1521, 404.1523, 404.1525, 404.1526, 404.1528, 404.1529, 404.1530,
404.1545, 404.1546, 404.1561, 404.1594, and appendix 1; and Regulations
No. 16, subpart I, sections 416.902, 416.905, 416.906, 416.908, 416.909,
416.911, 416.912, 416.913, 416.920, 416.920a, 416.921, 416.923, 416.924,
416.925, 416.926, 416.926a, 416.928, 416.929, 416.930, 416.945, 416.946,
416.961, 416.994, and 416.994a.

Introduction:

The Act and our implementing regulations require that an individual
establish disability based on the existence of a medically determinable
impairment; that is, one that can be shown by medical evidence, consisting
of symptoms, signs, and laboratory findings. Disability may not be
established on the basis of an individual's statement of symptoms
alone.
.994, and 416.994a.

Introduction:

The Act and our implementing regulations require that an individual
establish disability based on the existence of a medically determinable
impairment; that is, one that can be shown by medical evidence, consisting
of symptoms, signs, and laboratory findings. Disability may not be
established on the basis of an individual's statement of symptoms
alone.

This Ruling explains that IC (a complex, chronic bladder disorder), when
accompanied by appropriate symptoms, signs, and laboratory findings, is a
medically determinable impairment that can be the basis for a finding of
"disability." It also provides guidance for the evaluation of claims
involving IC.

Policy Interpretation

General

- What Is IC? IC is a complex, chronic bladder disorder characterized by urinary
frequency, urinary urgency, and pelvic pain. IC occurs most frequently in
women (about 10 times more often than in men), and sometimes prior to age
18. IC may be associated with other disorders, such as fibromyalgia,
chronic fatigue syndrome, allergies, irritable bowel syndrome,
inflammatory bowel disease, endometriosis, and vulvodynia (vulvar/vaginal
pain). IC also may be associated with systemic lupus erythematosus. The symptoms of IC may vary in incidence, duration, and severity. The
causes of IC are currently unknown, and treatments are directed towards
relief of symptoms. While no treatment is uniformly effective for
everyone, there are many treatments available, and individuals may obtain
some measure of relief. However, response to treatment is variable, and
some individuals may have symptoms that are intractable to the current
treatments available. Treatment may include bladder distention; bladder
instillation; oral drugs, such as the prescription drug Elmiron,
antidepressants, antihistamines, and narcotic analgesics; and the use of
transcutaneous electrical nerve stimulation.
asure of relief. However, response to treatment is variable, and
some individuals may have symptoms that are intractable to the current
treatments available. Treatment may include bladder distention; bladder
instillation; oral drugs, such as the prescription drug Elmiron,
antidepressants, antihistamines, and narcotic analgesics; and the use of
transcutaneous electrical nerve stimulation.

- How Is IC Diagnosed? The diagnosis is one of exclusion. A physician must rule out other
conditions before making a diagnosis of IC because there is currently no
definitive test to identify IC. The symptoms of IC are similar to those of
other disorders, such as acute urinary tract or vaginal infections,
post-radiation bladder inflammation or infection, bladder cancer, kidney
stones, endometriosis, neurological disorders, sexually transmitted
diseases, and, in men, chronic bacterial and nonbacterial prostatitis. Symptoms of IC vary both in kind and in intensity from individual to
individual, and even in the same individual. The three most common
symptoms are an urgent need to urinate (urgency), a frequent need to
urinate (frequency), and pain in the bladder and surrounding pelvic
region. These symptoms may occur either singly or in combination. The pain
may range from mild discomfort to extreme distress. The intensity of the
pain may increase as the bladder fills, and decrease as it empties. In
addition, many patients experience vaginal, testicular or penile pain, or
low back and thigh pain. A woman's symptoms may worsen around the time of
menstruation
g pelvic
region. These symptoms may occur either singly or in combination. The pain
may range from mild discomfort to extreme distress. The intensity of the
pain may increase as the bladder fills, and decrease as it empties. In
addition, many patients experience vaginal, testicular or penile pain, or
low back and thigh pain. A woman's symptoms may worsen around the time of
menstruation. A diagnosis of IC is based on the presence of some or all of the
following: Presence of urinary urgency or frequency (day and/or night), either singly
or in combination; Pain in the bladder and surrounding pelvic region; Suprapubic tenderness on physical examination; Glomerulations (pinpoint bleeding caused by recurrent irritation) on the
bladder wall after hydrodistention on cystoscopy; Hunner's ulcers on the bladder wall after hydrodistention on cystoscopy;
and, Absence of other disorders that could cause the symptoms. Diagnostic tests used to identify or exclude other disorders include
urinalysis, urine culture, urine cytology, cystoscopy, biopsy of the
bladder wall, and, in men, culture of prostate secretions. The standard test currently used to aid in the diagnosis of IC is a
cystoscopy with hydrodistention of the bladder (performed under
anesthesia). It can be used to reveal glomerulations or Hunner's ulcers. A
biopsy of the bladder wall can be taken to rule out diseases such as
bladder cancer. Cystoscopy with hydrodistention also makes it possible to
estimate bladder capacity, which is an important guide to treatment. The
hydrodistention of the bladder itself also sometimes provides a
therapeutic benefit, with a reduction in pain and urinary frequency for a
limited time period. A report on the results of a cystoscopy, if done,
should be part of the medical record. An absence of glomerulations or
Hunner's ulcers on cystoscopy does not exclude a diagnosis of IC; a
minority of individuals with IC (10%) will not have either of these
medical signs
so sometimes provides a
therapeutic benefit, with a reduction in pain and urinary frequency for a
limited time period. A report on the results of a cystoscopy, if done,
should be part of the medical record. An absence of glomerulations or
Hunner's ulcers on cystoscopy does not exclude a diagnosis of IC; a
minority of individuals with IC (10%) will not have either of these
medical signs. Cystoscopy should not be purchased to establish a diagnosis
of IC because it is an invasive procedure. While the medical findings discussed above are the principal symptoms,
signs, and laboratory findings currently used to establish a diagnosis of
IC, and, consequently, the existence of a medically determinable
impairment, they are not all-inclusive. As progress is made in medical
research into IC, additional signs and laboratory findings may be
identified and new diagnostic techniques may be developed that also would
establish a diagnosis of IC. The existence of IC may be documented with
medical signs or laboratory findings other than those listed above,
provided that such documentation is consistent with medically accepted
clinical practice and is consistent with the other evidence in the case
record.

- What Is a Medically Determinable Impairment? Sections 216(i) and 1614(a)(3) of the Act define
"disability" 1 as the inability
to engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment (or combination of impairments)
which can be expected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months. 2 Sections 223(d)(3) and 1614(a)(3)(D) of the Act and 20 CFR 404.1508 and
416.908 require that an impairment result from anatomical, physiological,
or psychological abnormalities that can be shown by medically acceptable
clinical and laboratory diagnostic techniques
ected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months. 2 Sections 223(d)(3) and 1614(a)(3)(D) of the Act and 20 CFR 404.1508 and
416.908 require that an impairment result from anatomical, physiological,
or psychological abnormalities that can be shown by medically acceptable
clinical and laboratory diagnostic techniques. The Act and regulations
further require that an impairment be established by medical evidence that
consists of symptoms, signs, and laboratory findings, and not only by an
individual's statement of symptoms.

- How Is IC Identified as a Medically Determinable Impairment? We 3 generally will rely on the
judgment of a physician who has made the diagnosis after a review of the
claimant's medical history, a physical examination of the claimant, and
any pertinent testing to establish the existence of IC. In the absence of
evidence to the contrary in the case record, we will find a medically
determinable impairment is established if the evidence contains the
appropriate symptoms, signs, and laboratory findings, as discussed under
question 2 above. However, if there is evidence that indicates that the
diagnosis is questionable, and the evidence is inadequate to determine
whether or not the individual is disabled, we will contact the treating
source for clarification, using the guidelines in 20 CFR 404.1512(e) and
416.912(e).

- How Do We Consider IC in the Sequential Evaluation
Process? 4 Once we determine that the individual has the medically determinable
impairment IC, we will consider it in determining whether: The individual's impairment(s) is severe. The individual's impairment(s) meets or equals the requirements of a
listed impairment in the listings. The individual's impairment(s) prevents him or her from doing past
relevant work and other work that exists in significant numbers in the
national economy.
has the medically determinable
impairment IC, we will consider it in determining whether: The individual's impairment(s) is severe. The individual's impairment(s) meets or equals the requirements of a
listed impairment in the listings. The individual's impairment(s) prevents him or her from doing past
relevant work and other work that exists in significant numbers in the
national economy.

- Can We Find an Individual Disabled Based on IC Alone? If an individual has the medically determinable impairment IC that is
"severe" as described in question 7 below, we may find that the IC
medically equals a listing, if appropriate. (See 20 CFR 404.1525 and
416.925.) (In the case of a child seeking benefits under title XVI, we
also may find that it functionally equals the listings (20 CFR 416.926a).)
We also may find in a title II claim, or an adult claim under title XVI,
that the IC results in a finding that the individual is disabled based on
his or her residual functional capacity (RFC), age, education, and past
work experience. An individual with IC also may report symptoms suggestive of a mental
impairment (for example, the individual may say that he or she is anxious
or depressed, having difficulties with memory and concentration, etc.). If
the evidence supports a possible discrete mental impairment or symptoms
such as anxiety or depression resulting from the individual's IC or the
side effects of medication, we will develop the possible mental
impairment. If the evidence does not establish a medically determinable
mental impairment, but does establish the presence of symptoms such as
anxiety or depression resulting from the individual's IC or side effects
of medication, we will determine whether there are any work-related
functional limitations resulting from the symptoms. We will address any
work- related functional limitations at steps 4 and 5 of the sequential
evaluation process.

What Is IC?
mental impairment, but does establish the presence of symptoms such as
anxiety or depression resulting from the individual's IC or side effects
of medication, we will determine whether there are any work-related
functional limitations resulting from the symptoms. We will address any
work- related functional limitations at steps 4 and 5 of the sequential
evaluation process.

What Is IC?

IC is a complex, chronic bladder disorder characterized by urinary
frequency, urinary urgency, and pelvic pain. IC occurs most frequently in
women (about 10 times more often than in men), and sometimes prior to age
18. IC may be associated with other disorders, such as fibromyalgia,
chronic fatigue syndrome, allergies, irritable bowel syndrome,
inflammatory bowel disease, endometriosis, and vulvodynia (vulvar/vaginal
pain). IC also may be associated with systemic lupus erythematosus.

The symptoms of IC may vary in incidence, duration, and severity. The
causes of IC are currently unknown, and treatments are directed towards
relief of symptoms. While no treatment is uniformly effective for
everyone, there are many treatments available, and individuals may obtain
some measure of relief. However, response to treatment is variable, and
some individuals may have symptoms that are intractable to the current
treatments available. Treatment may include bladder distention; bladder
instillation; oral drugs, such as the prescription drug Elmiron,
antidepressants, antihistamines, and narcotic analgesics; and the use of
transcutaneous electrical nerve stimulation.

How Is IC Diagnosed?
er, response to treatment is variable, and
some individuals may have symptoms that are intractable to the current
treatments available. Treatment may include bladder distention; bladder
instillation; oral drugs, such as the prescription drug Elmiron,
antidepressants, antihistamines, and narcotic analgesics; and the use of
transcutaneous electrical nerve stimulation.

How Is IC Diagnosed?

The diagnosis is one of exclusion. A physician must rule out other
conditions before making a diagnosis of IC because there is currently no
definitive test to identify IC. The symptoms of IC are similar to those of
other disorders, such as acute urinary tract or vaginal infections,
post-radiation bladder inflammation or infection, bladder cancer, kidney
stones, endometriosis, neurological disorders, sexually transmitted
diseases, and, in men, chronic bacterial and nonbacterial prostatitis.

Symptoms of IC vary both in kind and in intensity from individual to
individual, and even in the same individual. The three most common
symptoms are an urgent need to urinate (urgency), a frequent need to
urinate (frequency), and pain in the bladder and surrounding pelvic
region. These symptoms may occur either singly or in combination. The pain
may range from mild discomfort to extreme distress. The intensity of the
pain may increase as the bladder fills, and decrease as it empties. In
addition, many patients experience vaginal, testicular or penile pain, or
low back and thigh pain. A woman's symptoms may worsen around the time of
menstruation.

A diagnosis of IC is based on the presence of some or all of the
following:

- Presence of urinary urgency or frequency (day and/or night), either singly
or in combination;

- Pain in the bladder and surrounding pelvic region;

- Suprapubic tenderness on physical examination;

- Glomerulations (pinpoint bleeding caused by recurrent irritation) on the
bladder wall after hydrodistention on cystoscopy;
sis of IC is based on the presence of some or all of the
following:

- Presence of urinary urgency or frequency (day and/or night), either singly
or in combination;

- Pain in the bladder and surrounding pelvic region;

- Suprapubic tenderness on physical examination;

- Glomerulations (pinpoint bleeding caused by recurrent irritation) on the
bladder wall after hydrodistention on cystoscopy;

- Hunner's ulcers on the bladder wall after hydrodistention on cystoscopy;
and,

- Absence of other disorders that could cause the symptoms.

Presence of urinary urgency or frequency (day and/or night), either singly
or in combination;

Pain in the bladder and surrounding pelvic region;

Suprapubic tenderness on physical examination;

Glomerulations (pinpoint bleeding caused by recurrent irritation) on the
bladder wall after hydrodistention on cystoscopy;

Hunner's ulcers on the bladder wall after hydrodistention on cystoscopy;
and,

Absence of other disorders that could cause the symptoms.

Diagnostic tests used to identify or exclude other disorders include
urinalysis, urine culture, urine cytology, cystoscopy, biopsy of the
bladder wall, and, in men, culture of prostate secretions.

The standard test currently used to aid in the diagnosis of IC is a
cystoscopy with hydrodistention of the bladder (performed under
anesthesia). It can be used to reveal glomerulations or Hunner's ulcers. A
biopsy of the bladder wall can be taken to rule out diseases such as
bladder cancer. Cystoscopy with hydrodistention also makes it possible to
estimate bladder capacity, which is an important guide to treatment. The
hydrodistention of the bladder itself also sometimes provides a
therapeutic benefit, with a reduction in pain and urinary frequency for a
limited time period. A report on the results of a cystoscopy, if done,
should be part of the medical record
adder cancer. Cystoscopy with hydrodistention also makes it possible to
estimate bladder capacity, which is an important guide to treatment. The
hydrodistention of the bladder itself also sometimes provides a
therapeutic benefit, with a reduction in pain and urinary frequency for a
limited time period. A report on the results of a cystoscopy, if done,
should be part of the medical record. An absence of glomerulations or
Hunner's ulcers on cystoscopy does not exclude a diagnosis of IC; a
minority of individuals with IC (10%) will not have either of these
medical signs. Cystoscopy should not be purchased to establish a diagnosis
of IC because it is an invasive procedure.

While the medical findings discussed above are the principal symptoms,
signs, and laboratory findings currently used to establish a diagnosis of
IC, and, consequently, the existence of a medically determinable
impairment, they are not all-inclusive. As progress is made in medical
research into IC, additional signs and laboratory findings may be
identified and new diagnostic techniques may be developed that also would
establish a diagnosis of IC. The existence of IC may be documented with
medical signs or laboratory findings other than those listed above,
provided that such documentation is consistent with medically accepted
clinical practice and is consistent with the other evidence in the case
record.

What Is a Medically Determinable Impairment?

Sections 216(i) and 1614(a)(3) of the Act define
"disability" 1 as the inability
to engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment (or combination of impairments)
which can be expected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months. 2
able Impairment?

Sections 216(i) and 1614(a)(3) of the Act define
"disability" 1 as the inability
to engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment (or combination of impairments)
which can be expected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months. 2

Sections 223(d)(3) and 1614(a)(3)(D) of the Act and 20 CFR 404.1508 and
416.908 require that an impairment result from anatomical, physiological,
or psychological abnormalities that can be shown by medically acceptable
clinical and laboratory diagnostic techniques. The Act and regulations
further require that an impairment be established by medical evidence that
consists of symptoms, signs, and laboratory findings, and not only by an
individual's statement of symptoms.

How Is IC Identified as a Medically Determinable Impairment?

We 3 generally will rely on the
judgment of a physician who has made the diagnosis after a review of the
claimant's medical history, a physical examination of the claimant, and
any pertinent testing to establish the existence of IC. In the absence of
evidence to the contrary in the case record, we will find a medically
determinable impairment is established if the evidence contains the
appropriate symptoms, signs, and laboratory findings, as discussed under
question 2 above. However, if there is evidence that indicates that the
diagnosis is questionable, and the evidence is inadequate to determine
whether or not the individual is disabled, we will contact the treating
source for clarification, using the guidelines in 20 CFR 404.1512(e) and
416.912(e).

How Do We Consider IC in the Sequential Evaluation
Process? 4

Once we determine that the individual has the medically determinable
impairment IC, we will consider it in determining whether:

- The individual's impairment(s) is severe.
hether or not the individual is disabled, we will contact the treating
source for clarification, using the guidelines in 20 CFR 404.1512(e) and
416.912(e).

How Do We Consider IC in the Sequential Evaluation
Process? 4

Once we determine that the individual has the medically determinable
impairment IC, we will consider it in determining whether:

- The individual's impairment(s) is severe.

- The individual's impairment(s) meets or equals the requirements of a
listed impairment in the listings.

- The individual's impairment(s) prevents him or her from doing past
relevant work and other work that exists in significant numbers in the
national economy.

The individual's impairment(s) is severe.

The individual's impairment(s) meets or equals the requirements of a
listed impairment in the listings.

The individual's impairment(s) prevents him or her from doing past
relevant work and other work that exists in significant numbers in the
national economy.

Can We Find an Individual Disabled Based on IC Alone?

If an individual has the medically determinable impairment IC that is
"severe" as described in question 7 below, we may find that the IC
medically equals a listing, if appropriate. (See 20 CFR 404.1525 and
416.925.) (In the case of a child seeking benefits under title XVI, we
also may find that it functionally equals the listings (20 CFR 416.926a).)
We also may find in a title II claim, or an adult claim under title XVI,
that the IC results in a finding that the individual is disabled based on
his or her residual functional capacity (RFC), age, education, and past
work experience.
25 and
416.925.) (In the case of a child seeking benefits under title XVI, we
also may find that it functionally equals the listings (20 CFR 416.926a).)
We also may find in a title II claim, or an adult claim under title XVI,
that the IC results in a finding that the individual is disabled based on
his or her residual functional capacity (RFC), age, education, and past
work experience.

An individual with IC also may report symptoms suggestive of a mental
impairment (for example, the individual may say that he or she is anxious
or depressed, having difficulties with memory and concentration, etc.). If
the evidence supports a possible discrete mental impairment or symptoms
such as anxiety or depression resulting from the individual's IC or the
side effects of medication, we will develop the possible mental
impairment. If the evidence does not establish a medically determinable
mental impairment, but does establish the presence of symptoms such as
anxiety or depression resulting from the individual's IC or side effects
of medication, we will determine whether there are any work-related
functional limitations resulting from the symptoms. We will address any
work- related functional limitations at steps 4 and 5 of the sequential
evaluation process.

Sequential Evaluation: Step 2, Severe Impairment

- When Is IC a "Severe" Impairment? As with any other medical condition, we will find that IC is a "severe"
impairment when, alone or in combination with another medically
determinable physical or mental impairment(s), it significantly limits an
individual's physical or mental ability to do basic work activities. (For
children applying for disability under title XVI, we will find that IC is
a "severe" impairment when it causes more than minimal functional
limitations.) We also will consider the effects of any symptoms (such as
pain or fatigue) that could limit functioning
sical or mental impairment(s), it significantly limits an
individual's physical or mental ability to do basic work activities. (For
children applying for disability under title XVI, we will find that IC is
a "severe" impairment when it causes more than minimal functional
limitations.) We also will consider the effects of any symptoms (such as
pain or fatigue) that could limit functioning. (See SSR 85-28 , "Titles II and XVI: Medical
Impairments That Are Not Severe" and SSR
96-3p , "Titles II and XVI: Considering Allegations of Pain and Other
Symptoms In Determining Whether a Medically Determinable Impairment Is
Severe.") Therefore, we will find that an impairment(s) is "not severe"
only if it is a slight abnormality (or a combination of slight
abnormalities) that has no more than a minimal effect on the individual's
ability to do basic work activities (or, for a child applying under title
XVI, if it causes no more than minimal functional limitations).

When Is IC a "Severe" Impairment?

As with any other medical condition, we will find that IC is a "severe"
impairment when, alone or in combination with another medically
determinable physical or mental impairment(s), it significantly limits an
individual's physical or mental ability to do basic work activities. (For
children applying for disability under title XVI, we will find that IC is
a "severe" impairment when it causes more than minimal functional
limitations.) We also will consider the effects of any symptoms (such as
pain or fatigue) that could limit functioning
sical or mental impairment(s), it significantly limits an
individual's physical or mental ability to do basic work activities. (For
children applying for disability under title XVI, we will find that IC is
a "severe" impairment when it causes more than minimal functional
limitations.) We also will consider the effects of any symptoms (such as
pain or fatigue) that could limit functioning. (See SSR 85-28 , "Titles II and XVI: Medical
Impairments That Are Not Severe" and SSR
96-3p , "Titles II and XVI: Considering Allegations of Pain and Other
Symptoms In Determining Whether a Medically Determinable Impairment Is
Severe.") Therefore, we will find that an impairment(s) is "not severe"
only if it is a slight abnormality (or a combination of slight
abnormalities) that has no more than a minimal effect on the individual's
ability to do basic work activities (or, for a child applying under title
XVI, if it causes no more than minimal functional limitations).

Sequential Evaluation: Step 3, the Listings

- How Do We Evaluate IC at Step 3 of Sequential Evaluation, the Listings? IC may be a factor in both "meets" and "equals" determinations. Because there is no listing for IC, we will find that an individual with
IC "meets" the requirements of a listing if he or she has another
impairment that, by itself, meets the requirements of a listing. We also
will find that a listing is met if there is an impairment that, in
combination with IC, meets the requirements of a listing. For example, IC
may increase the severity of coexisting or related impairments, including
mental disorders, to the extent that the combination of impairments meets
the requirements of a listing. This also may be true in the reverse;
coexisting or related impairments may increase the severity of IC. We also may find that IC, by itself, is medically equivalent to a listed
impairment (or, in the case of a child applying under title XVI, also
functionally equivalent to the listings)
ental disorders, to the extent that the combination of impairments meets
the requirements of a listing. This also may be true in the reverse;
coexisting or related impairments may increase the severity of IC. We also may find that IC, by itself, is medically equivalent to a listed
impairment (or, in the case of a child applying under title XVI, also
functionally equivalent to the listings). We also will find equivalence if an individual has multiple impairments,
including IC, no one of which meets or equals the requirements of a
listing, but the combination of impairments is equivalent in severity to a
listed impairment. However, we will not make assumptions about the severity or functional
effects of IC combined with other impairments. IC in combination with
another impairment may or may not increase the severity or functional
limitations of the other impairment. We will evaluate each case based on
the information in the case record. Further, we will never deny an individual's claim because the individual's
IC does not meet or medically equal a listing. If an individual with IC
has a severe impairment that does not meet or medically equal a listing,
we may still find the individual disabled based on other rules in the
"sequential evaluation process" that we use to evaluate all disability
claims.

How Do We Evaluate IC at Step 3 of Sequential Evaluation, the Listings?

IC may be a factor in both "meets" and "equals" determinations.
isting. If an individual with IC
has a severe impairment that does not meet or medically equal a listing,
we may still find the individual disabled based on other rules in the
"sequential evaluation process" that we use to evaluate all disability
claims.

How Do We Evaluate IC at Step 3 of Sequential Evaluation, the Listings?

IC may be a factor in both "meets" and "equals" determinations.

Because there is no listing for IC, we will find that an individual with
IC "meets" the requirements of a listing if he or she has another
impairment that, by itself, meets the requirements of a listing. We also
will find that a listing is met if there is an impairment that, in
combination with IC, meets the requirements of a listing. For example, IC
may increase the severity of coexisting or related impairments, including
mental disorders, to the extent that the combination of impairments meets
the requirements of a listing. This also may be true in the reverse;
coexisting or related impairments may increase the severity of IC.

We also may find that IC, by itself, is medically equivalent to a listed
impairment (or, in the case of a child applying under title XVI, also
functionally equivalent to the listings).

We also will find equivalence if an individual has multiple impairments,
including IC, no one of which meets or equals the requirements of a
listing, but the combination of impairments is equivalent in severity to a
listed impairment.

However, we will not make assumptions about the severity or functional
effects of IC combined with other impairments. IC in combination with
another impairment may or may not increase the severity or functional
limitations of the other impairment. We will evaluate each case based on
the information in the case record.
tion of impairments is equivalent in severity to a
listed impairment.

However, we will not make assumptions about the severity or functional
effects of IC combined with other impairments. IC in combination with
another impairment may or may not increase the severity or functional
limitations of the other impairment. We will evaluate each case based on
the information in the case record.

Further, we will never deny an individual's claim because the individual's
IC does not meet or medically equal a listing. If an individual with IC
has a severe impairment that does not meet or medically equal a listing,
we may still find the individual disabled based on other rules in the
"sequential evaluation process" that we use to evaluate all disability
claims.

Sequential Evaluation: Steps 4 and 5, Assessing Functioning in Adults;
Step 3, Assessing Functional Equivalence in Children

- How Do We Evaluate IC in Assessing Residual Functional Capacity (RFC) in
Adults and Functional Equivalence in Children? IC can cause limitation of function. The functions likely to be limited
depend on many factors, including urinary frequency and pain. An
individual may have limitations in any of the exertional functions such as
sitting, standing, walking, lifting, carrying, pushing, and pulling. It
also may affect ability to do postural functions, such as climbing,
balancing, stooping, and crouching. The ability to tolerate extreme heat,
humidity, or hazards also may be affected. The effects of IC may not be obvious. For example, many people with IC
have chronic pelvic pain, which can affect the ability to focus and
sustain attention on the task at hand. Nocturia (nighttime urinary
frequency) may disrupt sleeping patterns. This can lead to drowsiness and
lack of mental clarity during the day. IC also may affect an individual's
social functioning. The presence of urinary frequency alone can
necessitate trips to the bathroom as often as every 10 to 15 minutes, day
and night
the ability to focus and
sustain attention on the task at hand. Nocturia (nighttime urinary
frequency) may disrupt sleeping patterns. This can lead to drowsiness and
lack of mental clarity during the day. IC also may affect an individual's
social functioning. The presence of urinary frequency alone can
necessitate trips to the bathroom as often as every 10 to 15 minutes, day
and night. Consequently, some individuals with IC essentially may confine
themselves to their homes. In assessing RFC, we must consider all of the
individual's symptoms in deciding how such symptoms may affect functional
capacities. An assessment also should be made of the effect IC has upon the
individual's ability to perform routine movement and necessary physical
activity within the work environment. Individuals with IC may have
problems with the ability to sustain a function over time. As explained in SSR 96-8p ("Titles II
and XVI: Assessing Residual Functional Capacity in Initial Claims"), our
RFC assessments must consider an individual's maximum remaining ability to
do sustained work activities in an ordinary work setting on a regular and
continuing basis. A "regular and continuing basis" means 8 hours a day,
for 5 days a week, or an equivalent work
schedule. 5 In cases involving
IC, fatigue may affect the individual's physical and mental ability to
sustain work activity. This may be particularly true in cases involving
urinary frequency. For a child applying for benefits under title XVI, we will evaluate the
functional consequences of IC (either alone or in combination with other
impairments) to decide if the child's impairment(s) functionally equals
the listings
C, fatigue may affect the individual's physical and mental ability to
sustain work activity. This may be particularly true in cases involving
urinary frequency. For a child applying for benefits under title XVI, we will evaluate the
functional consequences of IC (either alone or in combination with other
impairments) to decide if the child's impairment(s) functionally equals
the listings. For example, the functional limitations imposed by IC, by
itself or in combination with another impairment(s), may establish an
extreme limitation in one broad area of functioning (e.g., attending and
completing tasks) or marked limitations in two broad areas of functioning
(e.g., attending and completing tasks, and interacting and relating with
others). As with any other impairment, we will explain how we reached our
conclusions on whether IC caused any physical or mental limitations.

How Do We Evaluate IC in Assessing Residual Functional Capacity (RFC) in
Adults and Functional Equivalence in Children?

IC can cause limitation of function. The functions likely to be limited
depend on many factors, including urinary frequency and pain. An
individual may have limitations in any of the exertional functions such as
sitting, standing, walking, lifting, carrying, pushing, and pulling. It
also may affect ability to do postural functions, such as climbing,
balancing, stooping, and crouching. The ability to tolerate extreme heat,
humidity, or hazards also may be affected.
on many factors, including urinary frequency and pain. An
individual may have limitations in any of the exertional functions such as
sitting, standing, walking, lifting, carrying, pushing, and pulling. It
also may affect ability to do postural functions, such as climbing,
balancing, stooping, and crouching. The ability to tolerate extreme heat,
humidity, or hazards also may be affected.

The effects of IC may not be obvious. For example, many people with IC
have chronic pelvic pain, which can affect the ability to focus and
sustain attention on the task at hand. Nocturia (nighttime urinary
frequency) may disrupt sleeping patterns. This can lead to drowsiness and
lack of mental clarity during the day. IC also may affect an individual's
social functioning. The presence of urinary frequency alone can
necessitate trips to the bathroom as often as every 10 to 15 minutes, day
and night. Consequently, some individuals with IC essentially may confine
themselves to their homes. In assessing RFC, we must consider all of the
individual's symptoms in deciding how such symptoms may affect functional
capacities.

An assessment also should be made of the effect IC has upon the
individual's ability to perform routine movement and necessary physical
activity within the work environment. Individuals with IC may have
problems with the ability to sustain a function over time.

As explained in SSR 96-8p ("Titles II
and XVI: Assessing Residual Functional Capacity in Initial Claims"), our
RFC assessments must consider an individual's maximum remaining ability to
do sustained work activities in an ordinary work setting on a regular and
continuing basis. A "regular and continuing basis" means 8 hours a day,
for 5 days a week, or an equivalent work
schedule. 5 In cases involving
IC, fatigue may affect the individual's physical and mental ability to
sustain work activity. This may be particularly true in cases involving
urinary frequency.
ity to
do sustained work activities in an ordinary work setting on a regular and
continuing basis. A "regular and continuing basis" means 8 hours a day,
for 5 days a week, or an equivalent work
schedule. 5 In cases involving
IC, fatigue may affect the individual's physical and mental ability to
sustain work activity. This may be particularly true in cases involving
urinary frequency.

For a child applying for benefits under title XVI, we will evaluate the
functional consequences of IC (either alone or in combination with other
impairments) to decide if the child's impairment(s) functionally equals
the listings. For example, the functional limitations imposed by IC, by
itself or in combination with another impairment(s), may establish an
extreme limitation in one broad area of functioning (e.g., attending and
completing tasks) or marked limitations in two broad areas of functioning
(e.g., attending and completing tasks, and interacting and relating with
others).

As with any other impairment, we will explain how we reached our
conclusions on whether IC caused any physical or mental limitations.

Effective Date:

This Ruling is effective November 5, 2002.

Cross-References:

SSR 85-28 , "Titles II and XVI: Medical
Impairments That Are Not Severe"; SSR
96-2p , "Titles II and XVI: Giving Controlling Weight to Treating
Source Medical Opinions"; SSR 96-3p ,
"Titles II and XVI: Considering Allegations of Pain and Other Symptoms in
Determining Whether a Medically Determinable Impairment is Severe"; SSR 96-4p , "Titles II and XVI: Symptoms,
Medically Determinable Physical and Mental Impairments, and Exertional and
Nonexertional Limitations"; SSR 96-5p ,
"Titles II and XVI: Medical Source Opinions on Issues Reserved to the
Commissioner"; SSR 96-6p , "Titles II and
XVI: Consideration of Administrative Findings of Fact by State Agency
Medical and Psychological Consultants and Other Program Physicians and
Psychologists at the Administrative Law Judge and Appeals Council
airments, and Exertional and
Nonexertional Limitations"; SSR 96-5p ,
"Titles II and XVI: Medical Source Opinions on Issues Reserved to the
Commissioner"; SSR 96-6p , "Titles II and
XVI: Consideration of Administrative Findings of Fact by State Agency
Medical and Psychological Consultants and Other Program Physicians and
Psychologists at the Administrative Law Judge and Appeals Council Levels
of Administrative Review; Medical Equivalence"; SSR 96-7p , "Titles II and XVI:
Evaluation of Symptoms in Disability Claims: Assessing the Credibility of
an Individual's Statements"; SSR 96-8p ,
"Titles II and XVI: Assessing Residual Functional Capacity in Initial
Claims"; and SSR 96-9p , "Titles II and
XVI: Determining Capability to Do Other Work—Implications of a
Residual Functional Capacity for Less Than a Full Range of Sedentary
Work."

1 Except for statutory
blindness.

2 For a child under age 18
claiming benefits under title XVI, disability will be established if the
child is suffering from a medically determinable physical or mental
impairment (or combination of impairments) that results in "marked and
severe functional limitations." See section 1614(a)(3)(C) of the Act and
20 CFR 416.906. However, for clarity, the following discussions refer only
to claims of individuals claiming disability benefits under title II and
individuals age 18 or older claiming disability benefits under title XVI.
The concepts in this ruling, however, are also intended to apply in
determining disability based on IC for individuals under age 18 under
title XVI.

3 The terms we and us in this
Social Security Ruling have the same meaning as in 20 CFR 404.1502 and
416.902. We or us refers to either the Social Security
Administration or the State agency making the disability or blindness
determination; i.e. , our adjudicators at all levels of the
administrative review process and our quality reviewers.
or individuals under age 18 under
title XVI.

3 The terms we and us in this
Social Security Ruling have the same meaning as in 20 CFR 404.1502 and
416.902. We or us refers to either the Social Security
Administration or the State agency making the disability or blindness
determination; i.e. , our adjudicators at all levels of the
administrative review process and our quality reviewers.

4 For ease of reading, we refer
in this Ruling only to the steps of the sequential evaluation processes
for initial adult claims, 20 CFR 404.1520 and 416.920. We use separate
sequential evaluation processes when we do continuing disability reviews; i.e. , reviews to determine whether individuals who are receiving
disability benefits are still disabled, or when we determine whether an
individual has a "closed period of disability." These rules are set out in
20 CFR 404.1594 and 416.994, and the guidance in this Ruling applies to
all of the appropriate steps in those regulations as well.

5 However, see footnote 2 of SSR 96-8p . That footnote explains that
the ability to work 8 hours a day for 5 days a week is not always required
for a finding at step 4 of the sequential evaluation process for adults
when an individual can do past relevant work that was part-time work, if
that work was substantial gainful activity, performed within the
applicable period, and lasted long enough for the person to learn to do
it.

## Nearby sections

- [SSR 00-1c SSR 00-1c: Sections 222(c) and 223(a), (d)(2)(a), and (e)(1) of the Social Security Act (42 U.S.C. 422(c) and 423(a), (d)(2)(A), and (e)(1)) Disability Insurance Benefits—Claims Filed Under Both the Social Security Act and the Americans with Disabilities Act](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_00_1c.md)
- [SSR 00-3p SSR 00-3p: Superseded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_00_3p.md)
- [SSR 02-1p SSR 02-1p: Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_02_1p.md)
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- [SSR 03-01p SSR 03-01p: SSR 03-1p: Titles II and XVI: Development and Evaluation of Disability Claims Involving Postpolio Sequelae](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_03_01p.md)
- [SSR 03-02p SSR 03-02p: SSR 03-2p: Titles II and XVI: Evaluating Cases Involving Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_03_02p.md)
- [SSR 03-03p SSR 03-03p: SSR 03-3p: Policy Interpretation Ruling - Titles II and XVI: Evaluation of Disability and Blindness in Initial Claims for Individuals Aged 65 or Older](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_03_03p.md)
- [SSR 06-01p SSR 06-01p: Titles II and XVI: Evaluating Cases Involving Tremolite Asbestos-Related Impairments](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_06_01p.md)
- [SSR 06-03p SSR 06-03p: Rescinded](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_06_03p.md)
- [SSR 07-01p SSR 07-01p: Titles II and XVI: Evaluating Visual Field Loss Using Automated Static Threshold Perimetry](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_07_01p.md)
- [SSR 11-1p SSR 11-1p: Titles II and XVI: Procedures for Handling Requests to File Subsequent Applications for Disability Benefits](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_11_1p.md)
- [SSR 11-2p SSR 11-2p: Titles II and XVI: Documenting and Evaluating Disability in Young Adults](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_11_2p.md)
- [SSR 12-2p SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_12_2p.md)
- [SSR 13-2p SSR 13-2p: TITLES II AND XVI: EVALUATING CASES INVOLVING DRUG ADDICTION AND ALCOHOLISM (DAA)](https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_13_2p.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_DI_SSR_02_2p. Check the current official text before relying on it. Not legal advice.