What Medical Conditions Qualify for Disability

If you live with a disability that prevents you from working, you could be eligible for Social Security disability benefits. In Arkansas, that means filing a Social Security Disability claim. Unfortunately, this process is not always easy and very rarely straightforward. In fact, close to 70 percent of all applications are denied. This means the majority of claimants will need to appeal for reconsideration and attend a hearing held by a federal administrative judge.

For these reasons, it is important to adequately establish that you have a disabling condition that has lasted or will last a full year and has prevented you from engaging in substantial work activity. To do this, you must check your disability against Social Security Disability’s List of Impairments. This is also known as the “Blue Book.” Disability examiners use this book as a guide to determine if an individual’s disability qualifies them for benefits. In some cases, you may even be able to have your case fast-tracked if your condition qualifies under the Compassionate Allowances program. This program identifies cases and conditions that are clearly approved and helps their case move quickly, so claimants get the benefits they need.

What happens if your disability is not in the book? There are still ways to get approved for SSDI benefits even if your disability is not listed. Your attorney can make a case to show that your impairment is equal to one that is listed in the book. That is why it is crucial to discuss your case with an experienced Arkansas SSDI lawyer immediately. Your lawyer can help you build a case to collect the benefits you need.

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What is the Listing of Medical Impairments?

The Blue Book is the list of medical impairments that Social Security uses to determine eligibility. This book contains the most common medical conditions that are considered to be severe enough to warrant disability benefits. Each medical condition has criteria and conditions that must be met before an individual will qualify for disability. It is divided into two parts: adult disability and childhood disability.

Adult Disability Evaluation Under Social Security

The adult disability portion of the Blue Book contains medical criteria that applies to the evaluation of impairments in adults over the age of 18. It can also apply to some children under the age of 18 as well. This section contains information about different types of disabilities, including sections on:

• Musculoskeletal
• Vision, hearing and speech
• Respiratory
• Cardiovascular
• Digestive
• Genitourinary
• Hematological disorders
• Skin disorders
• Endocrine
• Multiple body systems
• Neurological
• Mental disorders
• Neoplastic diseases and cancers
• Immune system disorders

Childhood Disability Evaluation Under Social Security

The childhood disability section of the Blue Book contains medical criteria that can only be applied to children under the age of 18. Those include:

• Low birth weight and failure to thrive
• Musculoskeletal
• Respiratory
• Cardiovascular
• Special senses and speech
• Digestive system
• Genitourinary disorders
• Blood disorders
• Skin disorders
• Endocrine
• Congenital disorders
• Neurological
• Mental disorders
• Cancers
• Immune system

Is Your Disability Severe Enough?

Each injury and illness is outlined in the book with specific criteria a claimant must meet. In other words, just because your injury or illness is listed in the book does not mean that you will automatically qualify. Your condition must be severe enough.

As you can see, the listing requirements can be complex. That is why it is important to work with an experienced lawyer at Rainwater, Holt & Sexton, as well as medical professionals, to help to determine if you meet the qualifications.

What is the Compassionate Allowances List?

It can take a long time to qualify for disability benefits. As such, the Social Security Administration set up a fast track for individuals with medical conditions that are so serious, they would automatically qualify for disability. This allows very sick and disabled individuals to get the benefits they need very quickly after applying. If you have a condition that is on the Compassionate Allowances List, you can receive an approval in as little as 10 days.

Some of the conditions that qualify for Compassionate Allowances include, but are not limited to:

• Most cancers, if they have metastasized
• ALS
• Muscular dystrophy
• Muscular atrophy
• Early-onset Alzheimer’s disease
• Fibrolamellar cancer
• Esophageal cancer
• Megacystis Microcolon Intestinal Hypoperistalsis Syndrome
• Tetrasomy 18p
• Adult Non-Hodgkin Lymphoma
• Heart transplant graft failure
• Inflammatory breast cancer

For a complete list of Compassionate Allowances Conditions, vist the SSA website.

What If Your Medical Condition Is Not on the List?

If your impairment does not match the requirements, you must prove that your impairment is considered to be equivalent to a similar listing. The Social Security Administration allows claimants this option because although the Blue Book is very extensive, it does not contain every possible listing or every possible way to document that illness. If your condition is not on the list, you must provide extensive medical documentation and testing to prove that your disability is equal to another disability that is listed.

In some cases, claimants have multiple injuries and illnesses that are not severe enough to meet a specific listing. However, when added together, they may then meet the qualifications for disability. Your disability attorney will be able to review all of your medical records to determine if your injuries and illnesses together would help you gain eligibility for SSDI benefits.

Can an RFC Help?

Filling out an RFC (Residual Functional Capacity) is one of the best ways to help you obtain benefits if your medical condition is not listed. An RFC assessment will help the Social Security Administration determine if you have trouble with specific requirements of working, such as standing, sitting or walking. It will also help show if you have any disabilities that prevent you from mentally performing job-related duties. You can have an RFC completed by your own doctor or an SSA doctor.

When you take an RFC, you are helping the SSA understand better how your disability affects your ability to work. Perhaps your medical condition makes you tired and unable to work for more than a few hours at a time. Perhaps you are unable to sit for more than 20 minutes at a time. This information will help them make a more accurate determination regarding eligibility.

Your impairments likely cause both exertional and non-exertional limitations.

Exertional Limitation

An exertional limitation affects your ability to do the physical demands of your job that involve strength. This includes tasks like sitting, standing, walking and lifting. The SSA will use your exertional limitations to determine what work level you can perform. In general, there are 5 categories of work you may qualify for:

• Sedentary work
• Light work
• Medium work
• Heavy work
• Very heavy work

If the SSA determines that you can do any of this type of work, then your disability claim will be denied.

Non-exertional Limitation

Non-exertional limitations affect your ability to do non-strength related physical tasks in your job. Those include things like handling objects, paying attention, hearing or functioning in a noisy environment. Limitations may be the result of pain, decreased mobility, stiffness, cognitive functioning or anxiety. These are usually well documented on your RFC.

If you have both non-exertional and exertional limitations, the SSA will use the combined effect of these limitations on your ability to work and hold a job. This will help them reach a determination regarding disability benefits and eligibility.

What Medical Evidence Do I Need?

When seeking disability benefits, you must provide adequate evidence of your medical condition. In general, the most recent and up-to-date records will help you get a determination faster. Even if your condition is not rapidly changing, the SSA likes to have medical records that are not more than 6 months old. It is also important to make sure that your medical records are accurate. This means obtaining qualifying medical testing from a credible medical expert or physician.

Some of the tests they may ask for include:

• CT scans
• MRIs
• X-rays
• Blood work and lab testing
• Biopsy
• Chemotherapy
• Medications

The medical records that make the most difference are the ones from your treating physician. These records are often longitudinal and provide an accurate picture of your illness and disability in its entirety.

Should I Hire a Lawyer?

Knowing what tests and records you need to compile is difficult. That is why it is important to contact an experienced SSDI attorney as soon as you can. Your attorney can help you get the records and tests you need to help the SSA evaluate your claim efficiently. In addition, your attorney will need to help you file a complete claim the first time to reduce the risk of having your disability claim denied.

If your claim is denied, your attorney will be able to help you through the appeals process, gathering the critical evidence you need to prove your disability. This includes working with physicians and medical teams to accurately depict how your disability affects your entire life and your ability to work.

At Rainwater, Holt and Sexton, our Arkansas SSDI attorneys know how to help disabled claimants through the process. We know how difficult it can be to prove disability and obtain the benefits you deserve. That is why we work tirelessly throughout the process to help move your claim along and get you the benefits you deserve.