For which medical conditions can you apply for disability?

There are many medical conditions (physical or mental) that you may prevent you from working and earning enough to support yourself (this concept is known as substantial gainful activity). Consequently, you may apply for Social Security Disability or SSI disability benefits for practically any medical condition, or any combination of medical conditions.

What are valid conditions for Social Security?

You can apply for Social Security Disability for any disabling condition or conditions that:

1. Are medically determinable severe mental impairments or physical impairments;

2. Prevent you from performing substantial gainful (work) activity, or SGA;

3. Have lasted twelve months, are expected to last twelve months, or may possible end in death.

The definition of disability for the purposes of a Social Security Disability determination not only involves a severe debilitating mental and/or physical condition but the inability to perform SGA. The performance of SGA-level work activity is so important to the disability process that your disability claim will be denied without a medical determination (even if your condition is terminal) if you are performing SGA. Your disability claim can only proceed if you are not working, or your monthly earnings are below the monthly SGA limit.

The Social Security list of impairments

Social Security uses a five step sequential evaluation process to make their disability determinations. The first three steps involve an SGA determination, establishing that you have a severe impairment that has lasted or is expected to last twelve continuous months, and whether or not your disabling condition meets or equals the criteria of an impairment listing.

Social Security uses a disability guidebook called the Blue Book, often referred to as the Social Security Disability list of of impairments, to establish criteria for Social Security Disability based on certain medical conditions.

The Blue Book contains impairment listings for the: musculoskeletal system, special senses (vision and hearing) and speech, respiratory system ,cardiovascular system, digestive system, genito-urinary system, hemic and lymphatic system, skin, endocrine system, multiple body systems, neurological, mental disorders, neoplastic diseases, and the immune system. Each impairment listing lists the criteria needed to meet or equal the severity requirements for Social Security Disability.

If your disabling condition meets or equals an impairment listing, the sequential disability evaluation process stops and you may be approved for disability benefits.

However, it is difficult to meet or equal an impairment listing; therefore the vast majority of disability claims are evaluated through steps four and five before a decision is made.

What if you can't get approved on a listing?

Most individuals who get awarded disability are approved not on a listing, but, instead, after their medical records are examined, and their work history is evaluated, and the decision is made that they cannot do their past work or any other work.

In steps four and five of the evaluation process, disability examiners must first evaluate your ability to perform any of your past relevant work (relevant work can be any job that you performed in the past fifteen years that lasted three months or more and for which your earnings were SGA). If they determine that you can perform one of your past jobs, your disability claim will be denied at step four.

But, if you cannot perform any of your past work, you are not approved yet. The examiner must still consider your ability to perform other types of work after considering your education, age, residual functional capacity, and job skills. If they determine you can do some other kind of work, your disability claim will be denied at step five.

However if they determine you are not able do any other kind of work your disability claim may be approved through a medical vocational allowance.

For this reason, the social security administration will evaluate a claimant's work history and medical history. This is to determine what the requirements of their past jobs were. By comparing an individual's present limitations to their past work requirements, social security can gauge whether or not it is reasonable to expect a person to be able to go back to a former job.

Also, by examining a person's work history, the social security administration can determine if it is possible for an individual to seek another type of employment based on a variety of factors including their age, education and job skills.

Additional information: Medical Disability Requirements for SSD and SSI

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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