Medical Conditions and Disability Claims: Do You Qualify?
Created by FindLaw's team of legal writers and editors | Last reviewed March 27, 2019
The Social Security Administration (SSA) maintains a "Listing of Medical Impairments" (known as the blue book) that automatically qualify you for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), provided certain conditions are met. If your medical condition, or its equivalent, is on SSA's Listing of Impairments, then you're generally considered disabled and therefore eligible to receive SSA disability benefits. If your medical condition is not on the list, you may still be eligible under other SSA guidelines.
Medical Conditions and Disability Claims: List of Impairments
The SSA's Listing of Impairments is generally broken down by bodily system or function. There are separate lists for adults and children under the age of 18. For adults, the medical conditions that qualify for SSDI or SSI include:
- Musculoskeletal problems, such as back conditions and other dysfunctions of the joints and bones
- Senses and speech issues, such as vision and hearing loss
- Respiratory illnesses, such as asthma and cystic fibrosis
- Cardiovascular conditions, such as chronic heart failure or coronary artery disease
- Digestive tract problems, such as liver disease and inflammatory bowel disease (IBD)
- Neurological disorders, such as multiple sclerosis, cerebral palsy, Parkinson's disease, and epilepsy
- Blood disorders, such as sickle cell disease or hemophilia
- Mental disorders, such as depression, anxiety, schizophrenia, autism, or intellectual disability
- Immune system disorders, such as HIV/AIDS, lupus, rheumatoid arthritis, and kidney disease
The list of medical conditions for children under the age of 18 is virtually identical to the one for adults. Growth impairment is the only medical condition covered for children that isn't covered for adults. For a complete list of impairments, including detailed evaluation methods, visit www.ssa.gov.
What If Your Medical Condition Is Not on the List?
Even if your medical condition isn't on the Listing of Impairments, you may still qualify for SSDI or SSI if certain criteria are met. First, the medical condition must be a medically determinable impairment. A medically determinable impairment is a medical condition that has been the subject of clinical and laboratory testing. In other words, your medical condition must be supported by clinical reports.
Next, the medical condition must limit your residual functional capacity (RFC). RFC is determined by looking at the most demanding activity you can still do despite your medical limitations. Based on your residual functional capacity, a disability claims examiner will determine your exertional level. Exertional levels vary from sedentary work to very heavy work and are based on how much weight you can lift and carry.
The RFC also includes non-exertional limitations, like the ability to climb or bend down, the use of hands, the capacity to cope with anxiety or depression, and any environmental restrictions. The disability claims examiner will take your medical history, reports, and residual functional capacity into consideration to determine if your medical condition qualifies for disability benefits.
What Medical Evidence Do I Need to Show?
Medical evidence for a Social Security disability case can include:
- Physician examination
- Treatment notes or reports
- CAT scan
- Mental health records
- Blood work panels
The medical evidence must be recent and must encompass the time period from when you became disabled to the present time. Further, your medical records must show that your condition is severe enough to prevent you from performing your standard work-related duties.
Do You Have Medical Conditions That Qualify for Disability Claims? Get Professional Legal Help
Determining whether your medical condition qualifies for Social Security-related benefits can be confusing. If you have questions about medical conditions and disability claims, or if you've been denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), make sure you explore your legal options. Find an experienced SSDI attorney near you today.
You Don’t Have To Solve This on Your Own – Get a Lawyer’s Help
Meeting with a lawyer can help you understand your options and how to best protect your rights. Visit our attorney directory to find a lawyer near you who can help.
Contact a qualified social security lawyer to assist in your social security disability matter.