March 31, 2021

New Social Security Rules Affecting Bone, Joint, Spinal and Related Medical Conditions To Take Effect April 2

Allsup explains importance of changes to musculoskeletal listing for Social Security disability claims 

Belleville, Illinois — March 31, 2020 The Social Security Administration (SSA) is implementing revisions to its listing of impairments, specifically for disorders of the musculoskeletal system effective April 2, 2021, and this will have an effect on thousands of individuals with disabilities, according to Allsup, which has helped more than 350,000 people receive their Social Security Disability Insurance (SSDI) benefits nationwide.

The revised criteria for the musculoskeletal listing were announced in the Federal Register in December, and changes will apply to all applications for SSDI benefits filed or pending on or after April 2, 2021. Musculoskeletal disorders refer to a variety of conditions affecting bones, muscles, joints, the spine and connective tissues.

In December, the SSA stated revisions to the medical listings reflect the adjudicative experience, advances in medical knowledge and comments from the public following the notice of proposed rulemaking (NPRM) in May 2018.

“These new revisions will increase the number of SSDI denials as it will be more difficult for people with disabilities to meet the very stringent criteria for certain musculoskeletal conditions,” said T.J. Geist, director of Claims at Allsup. “However, while some applicants may not meet these new revised requirements and may be denied, they will continue to have the option to request a hearing with a medical professional or vocational expert.”

These new rules highlight the vital importance of having an expert SSDI claims representative such as Allsup to assist individuals with disabilities when filing their initial disability application, and – if their claim is denied – having someone to advocate for their claim when filing an appeal.

The final rules reflect comments from advocacy groups, legal services organizations, medical organizations and individual commenters during the 60-day public comment period. While several commenters requested the rules be withdrawn due to the impact they may have on the number of application-level denials, the likelihood of delays and the increased need for hearings, the SSA declined to withdraw this final rule.

Some public comments that were considered but not adopted included requests to use plain language terminology instead of medical terminology, such as “pins and needles” instead of paresthesia, requests to clarify which sources are considered to be acceptable medical sources, and that physical therapists be considered acceptable medical sources.

However, some public concerns were addressed with these revisions:

  • Muscle strength: Measurement will be based on a muscle strength grading system that is considered medically acceptable for the person’s age and impairments. The SSA will also accept muscle strength tests using scales other than the 0 to 5 scale, provided the scales used are equivalent, medically acceptable scales.
  • Hand-held devices: The SSA clarified that hand-held assistive devices are devices one holds onto, not carries with their hands.
  • Wheeled and seated mobility devices: These will be added to the list of functional criteria based on how the wheeled and seated mobility device affects the person’s use of the upper extremities.
  • Obesity: The SSA confirmed that obesity and its effect on the musculoskeletal system will continue to be evaluated to assess if it is a medically determinable impairment.

The new final rules will be in effect for five years, unless they are extended or revised, Geist explained. “These revisions to the medical listings will likely have a significant impact on the SSDI approval process, particularly at the initial and reconsideration levels,” he said. “But the SSA will not terminate someone’s benefits solely because of changes to these listings.”

For more information about applying for SSDI, or to learn if you are likely to be eligible, visit or call 1-800-678-3276.


Allsup and its subsidiaries provide nationwide Social Security disability, veterans disability appeal, return to work, and healthcare benefits services for individuals, their employers and insurance carriers. Allsup professionals deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. Founded in 1984, the company is based in Belleville, Illinois, near St. Louis. Learn more at and @Allsup or download a free PDF of Applying for Social Security Disability Insurance: Getting It Right The First Time.


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