What is considered a disability? Social Security Administration (SSA) defines disability as an individual:
- having a medical impairment or combination of impairments;
- the impairment prevents the person from working; and
- they cannot work for at least twelve months.
Social Security provides a “Listing of Medical Impairments”. This is also known as the “Blue Book”. These impairments will automatically qualify you for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
However, you must meet certain conditions. You can be found disabled if these specific conditions are met. You may still qualify for disability benefits under other guidelines if your medical condition is not on the list.
Listing of Medical Impairments for SSDI include:
The Listing of Impairments is generally broken down by body system or function. They are the most severe level of disabilities. There are separate disability listings for adults and children under the age of 18. For adults, the medical conditions that qualify for Social Security Disability:
- Musculoskeletal system, such as back conditions or dysfunction of the joints and bones;
- Special Senses and Speech, such as vision and hearing loss;
- Respiratory Disorders, such as breathing disorders like asthma, cystic fibrosis or lung transplant;
- Cardiovascular System, such as chronic heart failure, chronic venous insufficiency or peripheral arterial disease;
- Digestive System, such as chronic liver disease or inflammatory bowel disease;
- Genitourinary Disorders, such as chronic kidney disease; or
- Hematological Disorders, such as blood disorders.
Additional examples are:
- Skin Disorders, such as chronic skin infections, dermatitis or burns
- Endocrine Disorders, such as diabetes, thyroid gland disorders or pituitary gland disorders
- Congenital Disorders that Affect Multiple Body Systems, such as Down syndrome
- Neurological Disorders, such as epilepsy, Parkinsonian syndrome, Multiple Sclerosis, cerebral palsy or peripheral neuropathy
- Mental Disorders, such as depression, anxiety, post-traumatic stress disorder or schizophrenia
- Cancer (Malignant Neoplastic Diseases)
- Immune System Disorders, such as systemic lupus erythematosus, mixed connective tissue disease, inflammatory arthritis or HIV/AIDS
The Listings of Impairments for children are almost identical to the adult disability listings. However, the Childhood Listings also include growth impairments.
Does Your Condition Meet a Listing?
First, your doctor must diagnosis you with a disability under the Listings. There are some conditions that will qualify you for disability with a diagnosis alone. Some examples include:
- ALS;
- An organ transplant; or
- Certain cancers such as esophageal cancer, mucosal melanoma, anaplastic carcinoma of the thyroid gland or small-cell carcinoma (prostate, ovaries, breast, lungs, pleura, intestines or bladder)
Generally, just a diagnosis of a disability is not enough. The Listings of Impairments set out the requirements for how severe the symptoms are affecting you. SSA will review clinical findings and laboratory tests to determine if your disability meets the listing. If you have not had the clinical or laboratory tests required in the listing, you can ask your doctor to perform them.
Medical Equivalence
Your disability may also medically equal the Listings.
Medical equivalence is found if:
- Your medical impairment is at least equal in severity and duration; and
- Does not quite match the requirements under the listing.
The SSA also recognizes that there are many ways to diagnose and document the same illness. Your disability may “equal’ a listing if it does not quite meet all of the requirements under the listing. For example, the listing may require a specific result on a specific lab test. However, you were given a different test that showed the same results. SSA may find that your disability equals the listing.
You can also equal a listing if you have multiple disabilities but none of them meet the listings individually. SSA will look at listings that are close to your disabilities. If the combination of your impairments adds up to an impairment that is just as severe as the listing, your disabilities would equal the listings.
What if your medical condition is not under the Listings?
You can still be found disabled if your disability does not meet or equal the listings. However, you must show that your medical condition keeps you from working.
Some examples of other disabilities include:
- Carpal Tunnel Syndrome
- Fibromyalgia
- Chronic Regional Pain Syndrome
- Reflex sympathetic dystrophy
- Celiac Disease
- Degenerative Disc Disease
Your disability must be supported by medical evidence. Medical evidence may include:
- Physical examinations
- Treatment notes
- MRIs
- CAT scans
- X-rays
- Blood work results
- Biopsy results
- Pulmonary function tests
- Mental health records
What medical evidence is considered relevant?
Your medical evidence must cover the period of time that you became disabled and unable to work. Your treatment should be continuous and ongoing. Treatment received prior to becoming unable to work is not necessary. In fact, it can be harmful in some cases.
How does SSA evaluate your medical evidence?
Your medical condition must limit your ability to perform daily activities. SSA will determine the most that you can do despite your disabilities based on your medical evidence. An RFC includes both exertional and non-exertional limitations. Exertional limitations include the:
- Ability to sit
- To stand
- To walk
- The amount of weight you can lift or carry
Non-exertional limitations include:
- Your ability to climb stairs or ramps or ladders, or ropes or scaffolds
- Ability to bend, stoop, kneel, crouch, crawl or balance
- Your ability to use your hands
- Environmental restrictions such as your ability to tolerate temperature extremes or dusts, odors, gases or fumes
- Your ability to follow instructions, get along with other people, stay focused or concentrate, maintain a regular, full-time work schedule
Your doctors may also submit an opinion about your disabilities. The opinion should include specific restrictions about your activities.
Disability Help Group, Call Now for a Free Case Review, 800-700-0652
Make sure you start your claim the right way and apply for all the benefits you deserve. If you have already applied for SSI or SSDI, call immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation. Contact us now for a free consultation.
