Which Disabilities Qualify for Social Security Benefits?

Unlike other disability programs that pay benefits for temporary and partial disability, the disabilities eligible for Social Security benefits must be permanent and total. Each application for benefits through the Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs, two federal programs paying disability benefits, is reviewed to determine if the claimants meet the eligibility requirements.

If a physical or mental impairment prevents you from working, you may be wondering about the specific medical conditions that qualify for disability benefits through the SSDI and SSI programs. The disability professionals at Sackett and Associates devoted the past 45 years to helping people in California and throughout the country obtain federal disability benefits. This article explains the process used to determine the medical conditions that qualify for benefits the programs administered by the Social Security Administration (SSA).

Does A Disability Qualify According To The Federal Definition?

When you apply for disability benefits through SSDI and SSI, you must prove through medical documentation that you have a disability as defined in the Code of Federal Regulations. According to the Code, you must be unable to do any substantial gainful activity because of a medically determinable physical or mental impairment or a combination of impairments. The impairment or impairments must be severe and be expected to result in death or to last for at least 12 months.

The severity of the symptoms caused by your medical condition and how long they have lasted or are expected to last are essential factors in determining whether you are disabled according to the federal definition. Types of SSA-approved medical conditions considered as severe enough to meet be severe enough to be permanently disabling can be found in the listing of impairments compiled and maintained by the SSA.

SSDI & SSI Disability List

The listing of impairments, commonly called the “Blue Book,” lists SSA approved medical conditions severe enough to qualify for disability benefits if you meet the criteria listed for them. The following categories from the listing of impairments contain medical and mental health conditions severe enough to qualify for disability benefits:

1. Section 1.00 Musculoskeletal Disorders includes disorders of the skeletal spine, joint abnormalities, pathologic fractures, amputation, and complex pelvis fractures.
2. Section 2.00 Special Senses and Speech includes vision impairment, inability to speak, and hearing loss.
3. Section 3.00 Respiratory Disorders includes asthma, chronic respiratory disorders, and cystic fibrosis.
4. Section 4.00 Cardiovascular System includes chronic heart failure, ischemic heart disease, and recurrent arrhythmias.
5. Section 5.00 Digestive Disorders includes intestinal failure, inflammatory bowel disease (IBD), chronic liver disease (CLD), and weight loss due to a digestive disorder.
6. Section 6.00 Genitourinary Disorders include chronic kidney disease with and without a transplant and complications of chronic kidney disease.

The 14 sections of the adult listing of impairments cover conditions affecting each major body system, including mental disorders, with medical criteria that must be met to prevent a person from working according to the disability definition.

For example, a person diagnosed with post-traumatic stress disorder may qualify for SSDI using listing Section 12.15: Trauma- and stressor-related disorders, provided they can prove all of the following:

1. Exposure to actual or threat of death, violence, or serious injury.
2. Experiencing intrusive thoughts, dreams, or flashbacks of the event.
3. Avoiding reminders of the traumatic event.
4. Mood and behavior disturbance.
5. Exaggerated startle response, sleep disturbance, or other arousal or reactivity.

A person experiencing all of the listed criteria also needs to prove extreme limitation of one or a marked limitation of two of the following:

1. Understand, apply, or remember information.
2. Interact with others.
3. Persist, concentrate, or maintain pace.
4. Adapt or manage oneself.

If you cannot document the above criteria, you may qualify for benefits if your PTSD is severe and persistent by proving that it has existed for at least two years, but you also need to document that mental health therapy, medical treatment, psychosocial support, or an ongoing highly structured setting diminishes the symptoms. There must also be medical evidence documenting that you have minimal capacity to adapt to environmental changes or demands outside of those already part of your daily life.

What If You Do Not Meet The Criteria Of The Listing Of Impairments?

Many qualifying disabilities for SSDI and SSI do not meet the criteria of the listing of impairments. Instead, you may qualify for benefits by proving that your physical or mental impairment does not allow you to do work you did in the past or other types of work available through the national or regional economies.

Get Help From Experienced Disability Lawyers

The disability team at Sackett Law has more than 45 years of experience helping disabled individuals living in Northern California and throughout the country obtain SSDI and SSI for medical conditions that qualify for benefits. From assistance with initial applications to appeals of claim denials, learn how Sackett Law disability attorneys can help you. Contact us today for a free consultation.