If you are considering filing an application for Social Security Disability, you probably have a medical condition that makes it difficult or impossible to work. This is not enough to prove you suffer from a disability, however. Only certain totally disabling medical conditions qualify for Social Security disability. Learn more below.
What conditions are in the Blue Book?
The SSA publishes a book of impairment listings, sometimes called “The Blue Book.” This book lists many of the health conditions that qualify for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). If your medical records show you received a diagnosis listed in this book and you meet the severity criteria for that condition, and you meet all other applicable qualifications, you likely qualify for Social Security disability benefits.
When you look at the impairment listings on the Social Security Administration’s (SSA) website, you will see is it separated into body systems. Within each of those sections, there are a number of potentially disabling conditions which affect that body system. Under each condition, you will find the criteria necessary to qualify for Social Security Disability benefits.
The body systems covered under the listings include:
- Musculoskeletal (e.g., burns, spinal disorders)
- Special Senses and Speech (e.g., loss of speech, loss of visual efficiency)
- Respiratory (e.g., asthma, lung transplant)
- Cardiovascular (e.g., heart disease, heart transplant)
- Digestive (e.g., chronic liver disease, short bowel syndrome)
- Genitourinary (e.g., chronic kidney disease, nephrotic disease)
- Hematological (e.g., hemolytic anemias, complications of hematological diseases)
- Skin (e.g., dermatitis, burns)
- Endocrine (e.g., thyroid disorders, adrenal gland disorders)
- Multiple Body Systems (e.g., non-Mosaic down syndrome)
- Neurological (e.g., epilepsy, stroke)
- Mental Disorders (e.g., anxiety, anorexia)
- Cancer (e.g., skin cancer, leukemia)
- Immune System Disorders (e.g., lupus, HIV)
For example, if you suffer from asthma so severe it prevents you from working, you would look under Section 3.00, Respiratory Disorders. You would find Section 3.03, Asthma. Under that heading, you can see the criteria you must meet to qualify for benefits. This includes being unable to attain above a certain FEV1/FVC ratio (also known as the Tiffeneau-Pinelli index) based on your size and age. In addition, you must have serious asthma-related complications that require at least 48 hours of hospitalization three times or more in a single 12-month period.
There is a similar but separate listing of impairments for children and teens under the age of 18.
Can I qualify for Social Security Disability if my condition is not on the list?
If you do not qualify based on the medical conditions listed in the Blue Book, you might have another option.
When you apply for disability with a condition not included in the impairment listings, the SSA relies on your medical records and/or a consultative exam with a doctor it chooses to determine if you have a medically determinable impairment that severely limits your residual functional capacity (RFC).
Put simply, your RFC provides an overview of how much you are capable of doing. This may include things such as how far you can walk and how much weight you can lift, as well as whether you can squat, bend, and use both of your hands. The factors considered as a part of your RFC vary somewhat based on your medical condition. For example, if you cannot work due to a traumatic brain injury, they may base your RFC off cognitive abilities instead of physical abilities.
Your medical records need to include laboratory tests, imaging scans, or other clinical proof of your condition. Make sure you let your doctor know you plan to apply for Social Security disability so he can properly document your condition in your records and ensure they are up to date. Your doctor can also help you determine your limitations, which play a key role in how the disability claims representative will establish your RFC.
We can examine your medical records to determine if you might be able to qualify for benefits.
What type of evidence is necessary to prove my Social Security disability claim?
Providing the right documentation to prove your medical condition qualifies you for Social Security disability is key. By submitting the proper documentation, you greatly increase your chances of having your application approved the first time, and avoiding the lengthy appeals process.
The type of medical evidence necessary depends on your medical condition, but you can expect to submit:
- Any pertinent medical records
- Treatment notes from your doctor
- Reports about hospitalizations or treatments
- Imaging scans, such as MRIs, CAT scans, or X-rays
- Laboratory reports or pathology results, such as blood panels
- Mental health records, if applicable
While most of your records will come from your primary care physician and any specialists treating your condition, you should also consider documentation from other practitioners familiar with your condition. This may include your chiropractor or a physical therapist. If your qualifying condition is related to your mental health, you may need to submit records from a psychiatric or psychological professional.
Do I need to discuss my claim with a Raleigh Social Security disability lawyer?
Most people navigate the initial application process without help from a North Carolina Social Security disability attorney. However, it is difficult to determine whether you qualify if you have no experience with the process.
Give us a call and let us review your claim and your medical records and other supporting documentation before your submit your application. There are no guarantees when it comes to applying for SSDI and/or SSI, but we do have the experience to know what the SSA is looking for when it reviews disability claims. We can give you our honest opinion about your case before you submit your application.
While we do recommend you get our help from the start, when you will really need us is if you receive a letter denying your application for benefits. If you receive a denial from disability determination services, you need to call our office immediately. We have 60 days to file a request for reconsideration, and begin the appeals process.
Reconsiderations are rarely successful, so we will use this time to prepare for your hearing in front of an administrative law judge. This is when we are often able to obtain disability benefits for qualified applicants. However, if we are not successful in this step of the appeals process, we can fight for you until you receive the benefits you deserve or we exhaust all possible options.
Call a Social Security disability lawyer from Lunn & Forro, PLLC today.
If you have questions about your Social Security disability qualifications or received a letter of denial, call Lunn & Forro, PLLC today. You can reach our office at 888-966-6566 to schedule a time to meet with one of our knowledgeable Social Security disability attorneys.