Listing 13.05 Lymphoma in 2026
Lymphoma is one of the most heavily litigated cancer categories at the Social Security disability level. That is not because the rule is vague. Listing 13.05 is actually one of the tighter listings in Section 13.00. It is because most claimants do not know that the four paragraphs of 13.05 each fire at a different clinical inflection point, and their attorneys often try to argue the wrong paragraph. If you match your case to the correct paragraph, and you document the clinical trigger the way SSA writes it, this listing pays fast.
Here is the verbatim rule text from the current Blue Book. Listing 13.05 covers Lymphoma (excluding T-cell lymphoblastic lymphoma, which is evaluated under 13.06 Leukemia) as follows. Paragraph A applies to Non-Hodgkin lymphoma (see 13.00K1), as described in 1 or 2. Paragraph A1 is aggressive lymphoma (including diffuse large B-cell lymphoma) persisting or recurring following initial anticancer therapy. Paragraph A2 is indolent lymphoma (including mycosis fungoides and follicular small cleaved cell) requiring initiation of more than one (single mode or multimodal) anticancer treatment regimen within a period of 12 consecutive months. SSA will consider you disabled from at least the date of initiation of the treatment regimen that failed within 12 months. Paragraph B is Hodgkin lymphoma with failure to achieve clinically complete remission, or recurrent lymphoma within 12 months of completing initial anticancer therapy. Paragraph C is mantle cell lymphoma.
That is the whole rule. Four paths, each with a specific trigger. Below I walk through each one with real 2026 clinical criteria, the diagnostic evidence SSA wants to see, the traps that get people denied under the wrong paragraph, and how CAR-T therapy and bispecific antibodies (both of which have exploded in the lymphoma space since 2023) get handled at the continuing disability review.
Get a free eligibility check in 60 seconds.
See If You Qualify
Why lymphoma volume matters for SSA
The American Cancer Society projected roughly 89,190 new lymphoma cases in the United States for 2026 (about 8,830 Hodgkin and about 80,360 non-Hodgkin). Non-Hodgkin lymphoma sits as the seventh most common cancer overall, with a lifetime risk near 1 in 42 for men and 1 in 55 for women. Five-year relative survival for all NHL is now about 74 percent, but that number hides massive variation. Diffuse large B-cell lymphoma sits at about 65 percent, follicular at about 90 percent, mantle cell at about 60 percent, peripheral T-cell lymphoma at about 40 percent, and primary CNS lymphoma at about 33 percent. Hodgkin lymphoma five-year survival is about 89 percent overall, higher than 95 percent for early stage.
Those survival numbers are relevant to your SSDI case because SSA distinguishes indolent from aggressive lymphomas, and it also distinguishes initial therapy failure from later recurrence. The rule is written to catch the cases where therapy did not work, not the cases where the patient sailed through R-CHOP and is back at work six months later. If your case is the latter, 13.05 will not pay. If your case is the former, 13.05 will pay retroactive to the failure date.
Paragraph A1: aggressive NHL persisting or recurring after initial therapy
This is the paragraph that covers diffuse large B-cell lymphoma (DLBCL, the most common NHL subtype at about 30 percent of all NHL cases), Burkitt lymphoma, peripheral T-cell lymphoma (PTCL), anaplastic large cell lymphoma (ALCL), primary CNS lymphoma, primary mediastinal B-cell lymphoma, and high-grade B-cell lymphoma with MYC/BCL2 or MYC/BCL6 rearrangements (double-hit or triple-hit lymphoma).
The rule requires two things. Your NHL must be an aggressive histology. And your NHL must be persisting or recurring after initial anticancer therapy. Both parts matter.
For aggressive histology, SSA does not publish a formal list. Instead it points to 13.00K1, which explains that SSA considers lymphomas aggressive if they behave clinically like intermediate-grade or high-grade lymphomas under the older Working Formulation, or if they are classified as such under the current WHO classification. In practice, the following histologies are always accepted as aggressive: DLBCL and its variants, Burkitt lymphoma, peripheral T-cell lymphoma not otherwise specified, angioimmunoblastic T-cell lymphoma, anaplastic large cell lymphoma (ALK+ and ALK-), extranodal NK/T-cell lymphoma nasal type, cutaneous T-cell lymphoma at Stage IIB or higher (transformed mycosis fungoides is usually aggressive), primary CNS lymphoma, primary mediastinal B-cell lymphoma, high-grade B-cell lymphoma with MYC/BCL2 or MYC/BCL6 (double-hit), and Richter transformation from CLL.
For persisting or recurring after initial therapy, you need documentation that first-line therapy failed. First-line therapy for DLBCL in 2026 is either R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone) for six cycles, or the newer Pola-R-CHP regimen (polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, prednisone) that got approved based on the POLARIX trial. For Burkitt it is DA-EPOCH-R or hyper-CVAD. For PCNSL it is high-dose methotrexate-based induction. For PTCL it is CHOEP or brentuximab-CHP for CD30+ ALCL.
Persisting means residual disease at the end of planned therapy, documented by end-of-treatment PET-CT with a Deauville score of 4 or 5. Recurring means new disease found after a documented complete metabolic response, at any point after initial therapy ended. Both count for A1. There is no time cap on recurrence for aggressive NHL under A1, unlike Hodgkin under B, which caps at 12 months.
What A1 does not require
A1 does not require a specific number of relapses, does not require bone marrow involvement, does not require B symptoms, does not require any particular imaging modality, and does not require CAR-T eligibility. If your aggressive NHL persisted after or recurred after first-line therapy, you meet A1. Full stop.
Paragraph A2: indolent NHL requiring more than one treatment in 12 months
This is the paragraph that trips up the most claimants because indolent lymphoma is often not treated the way aggressive lymphoma is treated. Follicular lymphoma, marginal zone lymphoma (splenic, nodal, extranodal MALT), lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia), small lymphocytic lymphoma (SLL, the tissue counterpart of CLL and evaluated under 13.05 not 13.06), and mycosis fungoides Stage IA to IIA are all indolent and are all covered by A2. So is hairy cell leukemia when it presents as a lymphoma-predominant phenotype (though HCL is usually evaluated under 13.06).
The trigger under A2 is not persistence or recurrence. It is treatment intensity. You must have started more than one (single mode or multimodal) anticancer treatment regimen within 12 consecutive months. The clock starts when the second regimen begins. And the second regimen must be started because the first regimen failed to achieve or maintain adequate response, not because you or your oncologist chose to switch for convenience.
Here is why that distinction matters. Indolent lymphomas are often watched, not treated (the classic watch and wait approach for asymptomatic follicular Grade 1-2). When treatment starts, it is usually a single anti-CD20 (rituximab or obinutuzumab) monotherapy, or bendamustine-rituximab (BR), or rituximab-CVP, or R-CHOP if there is high tumor burden. If that regimen achieves partial or complete response and you stay stable, A2 does not fire.
A2 fires when the first regimen fails and a second regimen has to start inside a 12-month window. Failure can be primary refractory disease (no response), early progression (POD24 in follicular, which independently confers a 5-year survival of about 50 percent versus 90 percent for non-POD24), transformation to aggressive lymphoma (which shifts you to A1 automatically), or high tumor burden requiring more intensive therapy after an inadequate initial response.
SSA also codified in 13.00K1 that a change in therapy for indolent lymphomas is usually an indicator that therapy is not achieving its intended effect. But it excluded changes made solely because you or your physician chose to change. So the medical record needs to say why the switch happened.
The onset date benefit under A2
A2 has a special onset provision that A1 does not. SSA will consider you disabled from at least the date of initiation of the treatment regimen that failed within 12 months. That means if your first regimen started in January 2026 and failed by August 2026, and your second regimen started in September 2026, your listing-level onset is January 2026, not September 2026. That eight-month backdate can mean a full year of retroactive benefits (SSDI has a 5-month waiting period plus up to 12 months of prospective backpay from application date, so an earlier onset directly pays out).
Paragraph B: Hodgkin lymphoma without complete remission or recurrence within 12 months
Hodgkin lymphoma responds to first-line therapy better than any other lymphoma. Five-year survival is 89 percent overall, above 95 percent for Stage I-II favorable. That is why Paragraph B is written more restrictively than the NHL paragraphs. SSA does not want to hand out permanent disability to Hodgkin patients who complete ABVD or BV-AVD and go into durable remission.
Paragraph B has two triggers, and you only need one.
Trigger one: failure to achieve clinically complete remission after initial anticancer therapy. Complete remission is defined by the Lugano 2014 criteria as Deauville score of 1, 2, or 3 on end-of-treatment PET-CT with no residual FDG-avid disease. A Deauville 4 or 5 is not a complete response. Partial response is not complete remission. Stable disease is not complete remission. Progressive disease is obviously not complete remission. Any of those failures fires Paragraph B.
Trigger two: recurrent lymphoma within 12 months of completing initial anticancer therapy. If you completed ABVD or BV-AVD in June 2025, and you relapse in April 2026 (10 months later), Paragraph B fires. If you completed ABVD in June 2025 and relapse in September 2026 (15 months later), Paragraph B does NOT fire. SSA treats a Hodgkin recurrence more than 12 months after completing initial therapy as a new disease rather than a recurrence. In that case you have to start over with a new Paragraph B claim based on the new therapy course, or evaluate under Paragraph A if the recurrence transformed to NHL.
2026 first-line Hodgkin therapy for advanced stage is BV-AVD (brentuximab vedotin plus doxorubicin, vinblastine, dacarbazine) based on the ECHELON-1 trial, which showed 6-year overall survival of 93.9 percent for BV-AVD versus 89.4 percent for ABVD. For early stage favorable, ABVD for 2 cycles plus involved-site radiation therapy (ISRT) remains standard. For early stage unfavorable, ABVD for 4 cycles plus ISRT. Nivolumab-AVD (N-AVD) from SWOG S1826 is now first-line for advanced stage in adolescents and young adults based on the improved PFS shown in the 2024 update.
Paragraph C: mantle cell lymphoma
Mantle cell lymphoma got its own paragraph in the 2015 revision because it does not fit cleanly into either the aggressive or indolent buckets. It is technically classified as an aggressive NHL (median survival 5-7 years in older data, though better with modern regimens), but it behaves like an indolent lymphoma in that it is incurable with standard chemotherapy and almost always recurs.
Paragraph C is the shortest and most generous paragraph in 13.05. Any confirmed diagnosis of mantle cell lymphoma meets the listing. You do not need to fail therapy. You do not need to recur. You do not need to have symptoms. You just need pathologic confirmation of mantle cell lymphoma with cyclin D1 overexpression (or CCND1 gene rearrangement t(11;14)(q13;q32)) or SOX11 positivity in the rare cyclin D1-negative variant.
The one caveat: the very rare leukemic non-nodal indolent variant of mantle cell (also called SOX11-negative MCL with hypermutated IGHV, often presenting as isolated splenomegaly with lymphocytosis) can be watched for years and looks like SLL/CLL. SSA still accepts it as MCL if the pathology confirms it. But adjudicators sometimes push back if the disease is truly indolent and untreated. The counter is that the rule text does not require symptomatic disease or treatment. It requires the diagnosis.
Pre-listing onset: how to backdate the disability period
Lymphoma patients almost always stopped working before they met a paragraph of 13.05. The gap between symptom onset (B symptoms, mass effect, cytopenias from marrow involvement, chemo toxicity) and formal listing-meeting can be six months or more.
SSA allows a medical-vocational allowance during that pre-listing period based on residual functional capacity (RFC). The evidence usually looks like this. B symptoms including fever above 100.4 F, drenching night sweats, or unexplained weight loss of more than 10 percent body weight over six months. Fatigue with functional evidence such as inability to complete a 6-minute walk test, or documented ECOG performance status of 2 or higher. Cytopenias from marrow involvement, meaning Hgb below 10 g/dL or platelets below 100,000 or ANC below 1500. Chemotherapy toxicities including neutropenic fever hospitalizations, myalgias, peripheral neuropathy from vincristine (part of R-CHOP) or brentuximab, cardiotoxicity from doxorubicin (part of ABVD and R-CHOP) with LVEF drop, and pulmonary toxicity from bleomycin (older ABVD variants). Mass effect from bulky disease including superior vena cava syndrome from mediastinal masses, ureteral obstruction from retroperitoneal masses, or CNS symptoms from primary CNS lymphoma or CNS involvement of systemic NHL.
The RFC assessment during the pre-listing period should focus on cognitive slowing (chemo brain, well documented in the literature to affect processing speed, working memory, and executive function during and after chemotherapy), physical limitations from cytopenias and fatigue, and treatment schedule interference with work (weekly infusions plus recovery time make consistent full-time work impossible).
How CAR-T therapy and bispecifics fit the CDR
The 2020s brought two waves of new lymphoma therapies. First was CAR-T cell therapy, with axicabtagene ciloleucel (axi-cel, Yescarta), tisagenlecleucel (tisa-cel, Kymriah), lisocabtagene maraleucel (liso-cel, Breyanzi), and brexucabtagene autoleucel (brexu-cel, Tecartus) all approved for various NHL indications. Axi-cel and liso-cel are now approved for second-line DLBCL after ZUMA-7 and TRANSFORM. Second was bispecific antibodies, with epcoritamab, glofitamab, and mosunetuzumab all approved for relapsed/refractory NHL.
Both classes work but both come with serious toxicities that persist and matter for the continuing disability review (CDR). CRS (cytokine release syndrome) hits about 90 percent of CAR-T patients (about 10 percent Grade 3+). ICANS (immune effector cell-associated neurotoxicity syndrome) hits about 30 to 60 percent (about 10 to 30 percent Grade 3+, depending on the product). Prolonged cytopenias from CAR-T persist beyond 30 days in 25 to 40 percent of patients and can last a year or more. Hypogammaglobulinemia requires IVIG in a substantial subset. Cognitive effects from ICANS can persist for months to years.
For the CDR (SSA's periodic check to see if you are still disabled), these residuals are the ammunition. If your DLBCL went into complete remission after CAR-T, the underlying lymphoma no longer meets 13.05. But the residuals get evaluated under other body systems. Persistent cytopenias qualify under 7.00 (Hematologic Disorders). Cognitive effects qualify under 12.02 (Neurocognitive Disorders). Recurrent infections from hypogammaglobulinemia qualify under 14.07 (Immune System Disorders, Immune Deficiency Disorders). Fatigue with functional limitations qualifies under 14.06 (Undifferentiated and Mixed Connective Tissue Disease, using the extra-articular manifestations pathway) or gets folded into an RFC-based continuation. See our full breakdown of the 14.07 immune deficiency listing and the Section 13.00 three-year post-remission rule for how cancer-related residuals get carried forward.
Pediatric 113.05
Children with lymphoma are evaluated under 113.05, which mirrors adult 13.05 in structure but uses pediatric-appropriate examples. Paragraph A covers non-Hodgkin lymphoma persisting or recurring after initial therapy (both aggressive and indolent are folded together at the pediatric level because indolent lymphomas are rare in children). Paragraph B covers Hodgkin lymphoma with failure to achieve complete remission or recurrence within 12 months. Paragraph C covers mantle cell lymphoma (extremely rare in children).
Pediatric NHL is dominated by Burkitt lymphoma (about 40 percent of pediatric NHL, evaluated as aggressive), DLBCL (about 20 percent), lymphoblastic lymphoma T-cell type (evaluated under 113.06 Leukemia), and anaplastic large cell lymphoma (about 10 percent). Pediatric Hodgkin is dominated by nodular sclerosis subtype.
Common denial reasons and how to counter them
Denial one: adjudicator says your DLBCL is in remission so you do not meet A1. Counter: A1 says persisting or recurring, which is about the initial therapy course, not current remission status. If your first-line therapy failed and you are now in remission on second-line CAR-T, you still met A1 at the point of first-line failure. The listing-level allowance covers you from that date.
Denial two: adjudicator says your follicular lymphoma second regimen was a physician preference change, not a failure. Counter: pull the oncology note that says why the switch happened. If it says progression, POD24, or inadequate response, that is failure. If it truly was preference, A2 does not fire but you may still qualify under 13.00K (persistent post-therapy residuals) or RFC.
Denial three: adjudicator says your Hodgkin recurred at 14 months, so Paragraph B does not apply. Counter: they are right, but SSA treats that as a new disease. You file a new claim based on the new therapy course, which if it fails resets Paragraph B on the new timeline.
Denial four: adjudicator says your MCL is watch-and-wait, so you are not disabled. Counter: Paragraph C requires only the diagnosis. It does not require treatment. Point to the rule text. Also note that even indolent MCL almost always progresses within 3 to 5 years.
State-level filing notes
Lymphoma claims are filed the same way across all 50 states, but processing times vary. Fastest DDS offices for cancer claims include Hawaii (typically under 90 days for a Blue Book listing meet), Vermont, and North Dakota. Slowest offices for cancer claims include California, New Jersey, and Nevada. Compassionate Allowance (CAL) fast-track designations that apply to lymphoma include Adult-Onset Peripheral T-Cell Lymphoma (POC), Burkitt Lymphoma with CNS involvement, Diffuse Large B-Cell Lymphoma stage 4, and Primary CNS Lymphoma. If your case matches a CAL condition, mark that on the SSA-3368 disability report to trigger expedited processing (target 15 to 30 days).
Frequently asked questions
Does every lymphoma diagnosis qualify for SSDI?
No. Listing 13.05 has four paragraphs, and each has a specific trigger. A1 requires aggressive NHL that persisted or recurred after initial therapy. A2 requires indolent NHL that needed more than one treatment regimen within 12 months due to failure. B requires Hodgkin lymphoma without clinically complete remission, or recurrence within 12 months of finishing initial therapy. C requires a mantle cell lymphoma diagnosis. If your case does not match one of these, you can still qualify through a medical-vocational allowance based on RFC.
Does CAR-T therapy count as failing initial therapy?
Yes. If you received CAR-T, it means your first-line therapy (R-CHOP, ABVD, or equivalent) did not work. That satisfies Paragraph A1 for DLBCL and other aggressive NHL. The CAR-T itself is second-line treatment, so the listing-level onset is the date first-line failure was documented, not the date of CAR-T infusion.
What is POD24 and does it help my follicular lymphoma claim?
POD24 (progression of disease within 24 months of frontline immunochemotherapy) is a well-established prognostic marker for follicular lymphoma. It cuts 5-year overall survival from about 90 percent to about 50 percent. It also means your first-line regimen failed, and if you needed a second regimen inside 12 months, Paragraph A2 fires. POD24 by itself is powerful evidence that satisfies the failure requirement.
My Hodgkin recurred 14 months after ABVD. Am I still covered under Paragraph B?
Not under the original claim. SSA treats Hodgkin recurrence more than 12 months after completing initial therapy as a new disease. You would file a new SSDI claim based on the new therapy course. If second-line therapy fails or the disease recurs within 12 months of the new therapy, Paragraph B fires on the new timeline.
Does chronic lymphocytic leukemia (CLL) fall under 13.05 or 13.06?
Neither by default. CLL and its tissue counterpart SLL (small lymphocytic lymphoma) are evaluated under 13.05 as an indolent NHL. Watch-and-wait CLL usually does not meet 13.05 A2 unless treatment starts and fails inside 12 months. If CLL transforms to DLBCL (Richter transformation), you shift to 13.05 A1 automatically. If CLL requires allogeneic stem cell transplant, you are evaluated under 7.17 hematopoietic stem cell transplant with a 12-month post-transplant automatic allowance.
Does mantle cell lymphoma always meet 13.05?
Yes. Paragraph C requires only the confirmed diagnosis. You do not need to fail therapy, recur, or even be symptomatic. The pathology must confirm cyclin D1 overexpression, CCND1 rearrangement t(11;14), or SOX11 positivity in the rare cyclin D1-negative variant.
What happens to my SSDI when I go into remission after CAR-T?
The underlying lymphoma no longer meets 13.05, but SSA evaluates residuals from CAR-T under other body systems at the continuing disability review. Persistent cytopenias fall under Section 7.00 (Hematologic). Cognitive effects from ICANS fall under 12.02 (Neurocognitive). Hypogammaglobulinemia with recurrent infections falls under 14.07 (Immune Deficiency). Section 13.00K also allows a 3-year post-remission window during which cancer-related residuals continue to support disability.
Next steps
If your diagnosis and treatment history match one of the four paragraphs, start your SSDI application today. Bring your pathology reports, PET-CT reports (particularly end-of-treatment restaging), treatment records with dates and regimen names, and any documentation of therapy failure or recurrence. The Blue Book listing meet is the fastest path to approval, and lymphoma cases that clearly match 13.05 often get approved at the initial DDS level without a hearing.
Related reading: Section 13.00 general cancer rules and the 3-year post-remission window, Listing 7.17 hematopoietic stem cell transplant, and Listing 14.07 immune deficiency.