What conditions do they Award Disability Benefits for?

A person filing for disability can potentially be awarded on the basis of any condition. This is because the SSD and SSI programs do not focus on the disagnosis that a claimant has. Instead, attention is paid to the severity level of the individual's condition.

The essential question that will be asked on any disability case will be: "Is the person's condition severe enough to prevent them from working and earning a substantial and gainful income for at least one full year". If the condition is severe enough to make gainful work activity impossible and this situation has lasted for one year, or can be projected to last for one year, then the Social security definition of disability will have been satisfied and the person may be approved for disability benefits.

How does the social security administration determine if a claimant's condition is severe enough to meet this definition of disability?

If the claimant is an adult, social security will review the medical records and work history to determine if their condition will allow them to return to work or perform some type of other work.

If the claimant is a child, social security will review the medical records and most likely the child's school records (if they are of school age) to determine if the child is capable of engaging in age-appropriate activities, such as staying on pace with their peers.

The disability determination process used by SSA is designed to award disability benefits in two separate fashions. Both will involve meeting all the requirements of the social security definition of disability. The first is through the possibility of satisfying a listing in the SSA blue book, a reference source that in printed format is titled "Disability Evaluation under Social Security".

Most claims that are approved are not approved by satisfying the requirements of a listing. This is because the listing requirements tend to be very specific and demanding and meeting a listing requires that an individual's medical records contain very specific qualifying information.

Moreover, not all conditions are listed in the Social security list of impairments. fibromyalgia and carpal tunnel syndrome are two very commonly cited impairments on disability applications and appeals and neither receives consideration in the listing manual.

The conditions that are listed are organized under the following body systems:

  • Musculoskeletal - Including spinal stenosis, spinal arachnoiditis, herniated nucleus pulposus, scoliosis, kyphoscoliosis, osteoarthritis, degenerative disc disease, facet arthritis, fractures, and soft tissue injuries.
  • Special Senses and Speech - Including Vision, Speech, and Hearing deficits.
  • Respiratory System - Incuding asthma, cystic fibrosis, COPD, Cor Pulmonale, and sleep related breathing disorders.
  • Cardiovascular System - Including angina, ischemic heart disease (coronary artery disease), heart failure, peripheral vascular disease, lymphedema, congenital heart disease, aneurysm, chronic venous insufficiency, and arrhythmias.
  • Digestive System - Including chronic liver disease, hepatitis, inflammatory bowel disease, gastrointestinal hemorrhaging, and liver transplantation.
  • Genitourinary System - Including kidney disease and nephrotic syndrome.
  • Hematological System - Including anemia, sickle cell diease, thrombocytopenia, hereditary telengiectasia, polycythemia, and granulocytopenia.
  • Skin System - Including pemphigus, dermatitis, eczema, burns, infections, icthyosis, and hidradenitis suppurtiva.
  • Endocrine System - Including thyroid disorders.
  • Multiple Body System impairments - Including down syndrome.
  • Neurological System - Including epilepsy, traumatic brain injury, parkinson's diseae, cerebral palsy, stroke, multiple sclerosis, myastenia gravis, and ALS (Lou Gehrig's disease).
  • Mental Disorders - Including depression, anxiety related disorders, bipolar disorder, personality disorder, somatoform disorder, austism, and mental retardation.
  • Malignant Neoplasms- Including cancers affecting all body systems.
  • Immune System - Including lupus, scleroderma, sjogren's syndrome, vasculitis, HIV, and inflammatory arthritis.
Disability examiners who render decisions at the disability application and reconsideration appeal levels, and administrative law judges who decide claims at the disability hearing level, typically find that less than a quarter of their approvals are made as a result of a claimant's medical records actually meeting the requirments of a listed impairment.

How, then, do most claimants get approved for disability? Most claimants are awarded on the basis of a medical vocational allowance.

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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