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What Disabling Conditions qualify for Social Security Disability?

There is a listing of impairments, commonly called “The Blue Book”, which provides eligibility criteria for every aliment recognized by the Social Security Administration.

SSDI List of Impairments

There is a listing of impairments, commonly called “The Blue Book”, which provides eligibility criteria for every aliment recognized by the Social Security Administration.

Have you recently been diagnosed with a disabling disease that prevents you from working?

You may be eligible for Social Security Disability (SSDI) benefits. Many Texas residents think that SSD benefits only apply to people who have suffered injuries that prevent them from working entirely or limit their ability to work full-time. However, the Social Security Administration (SSA) recognizes a number of diseases as sufficiently disabling that they should entitle you to federal benefits. In other words, diseases can be just as disabling as a one-time injury. How can you be sure if your disabling disease will allow you to successfully apply for SSD benefits? Each case is different, and it is important to have a Texas Social Security disability lawyer on your side.


What is a Disabling Disease for SSD Purposes?

When it comes to defining a disabling disease under the Social Security Administration’s terms, you must meet certain conditions. First, it is important to keep in mind that both physical and mental illnesses can qualify as disabling diseases for SSDI purposes. What qualifies as a disabling disease? The SSA maintains a “Listing of Impairments” that specifies the different kinds of illnesses and diseases that can qualify a person for SSD benefits.


It was originally called “The Blue Book” because the tables of disease were published in a blue pamphlet.

Now that the tables are published online, some disability experts refer to the listings as “the grid”. The grid is divided into adult and childhood impairments and then further into impairments by body system.


Social Security was originally a retirement program only, and did not originally include disability insurance- partially because of the difficulty of determining whether or not someone is capable of work.

In 1955, a 15-member committee of experts on medicine, insurance, welfare, and labor-relations was formed to develop standards for determining disability. They drew heavily from the evaluation process that was already in place for providing assistance for civilian victims of war-time violence. The standards and criteria they developed set the precedent for our current process.


The Social Security Disability Benefits Reform Act of 1984 revolutionized how claims were evaluated, as it created a more universal standard for disability determination.

Before the act was passed, it was very difficult to obtain benefits for less-obvious impairments such as severe pain or mental illness. The relaxed standards allowed many more disabled to seek government assistance. When President Ronald Regan signed the bill into law, he emphasized the importance of ensuring “no disabled beneficiary has to wait any longer than necessary for the proper decision on his or her case.”


The Blue Book is legally codified in the Code of Federal Regulations, appendix 1, subpart P, part 404. However, it is more easily accessible on the Social Security Administration’s website. There are currently 14 sections of listings:

 

  1.    Musculoskeletal
  2.    Special Senses and Speech
  3.    Respiratory System
  4.    Cardiovascular System
  5.    Digestive System
  6.    Genitourinary Disorders
  7.    Hematological Disorders
  8.    Skin Disorders
  9.    Endocrine Disorders
  10.    Congenital Disorders
  11.    Neurological
  12.    Mental Disorders
  13.    Cancer
  14.    Immune System Disorders

 


Each section is further divided into subsections correlating to a specific condition.

Then, under each condition are the criteria required for a case to rise to level of disability. For example, the criteria for burns:
8.08 Burns, with extensive skin lesions that have lasted or can be expected to last for a continuous period of at least 12 months (see 8.00F).
Section 8.00F provides guidelines for evaluating skin lesions. These criteria are designed by medical professionals so that those with serious disability can get help and those with minor aliments will be screened out. A minor burn usually does not result in long lasting skin lesions, but a serious burn can be permanently disfiguring.


The Social Security Administration does have a process for handling aliments not listed in the blue book.

The human body is amazingly complex and it would be nearly impossible to list all the things that can go wrong with it.
If your impairment is similar to a current listing, or you have multiple aliments which are not severe enough to qualify for any single listing, you may still be eligible. In these instances, the Social Security Administration tries to determine the “medical equivalence” to a listing.


In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

  1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
  2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

  1.   Are you working?   Your disability must be “total”.
  2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
  3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
  4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
  5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.


More details can be found on our Qualifying for Disability page.

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Bemis, Roach & Reed has helped clients who are disabled from a wide variety of medical conditions. If you are unable to work due to any of the following conditions and have been denied disability benefits, contact us. We would like to help.

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