Social Security Ruling, SSR 98-1p; Title XVI: Determining Medical Equivalence in Childhood Disability Claims When a Child Has Marked Limitations in Cognition and Speech

In accordance with 20 CFR 402.35(b)(1), the Commissioner of Social Security gives notice of Social Security Ruling, SSR 98-1p. This Ruling results from the ``top-to-bottom'' review of the implementation of changes to the Supplemental Security Income childhood disability program necessitated by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. 104-193). It provides a policy interpretation that children who have a ``marked'' limitation in cognitive functioning and a ``marked'' limitation in speech have an impairment or combination of impairments that medically equals Listing 2.09. It also provides guidance for determining when a child has a ``marked'' or an ``extreme'' limitation in each of these areas.