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What medical conditions qualify someone for Social Security disability benefits?

 

That question has no definitive answer, but the closest thing you'll find is the Social Security Blue Book.

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This online compendium, also known as Disability Evaluation Under Social Security, runs down the physical and mental health disorders that automatically qualify you as meeting the medical requirements for receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), provided you meet the stringent list of criteria for each condition.

"Automatic” here means that Social Security recognizes that these conditions meet its baseline definition of disability: an illness or injury that prevents you from working for at least a year or likely will cause death. To receive SSDI, you also must have spent a certain period doing work for which you paid Social Security taxes. To be eligible for SSI, you must have very limited income and financial assets.

Listing of impairments

Blue Book listings are split into sections for adults and children, reflecting the different ways Social Security examiners assess the effect of a particular condition on those younger than 18 and those 18 and older. Part A, the adult section, is divided into 14 categories representing types of disorders or diseases of various bodily systems:

  • Musculoskeletal system, such as amputation, chronic joint pain and spinal disorders
  • Special senses and speech, such as impaired hearing, sight or speech
  • Respiratory illnesses, such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis
  • Cardiovascular illnesses, such as arrhythmia, congenital heart disease and heart failure
  • Digestive system, such as bowel or liver disease
  • Chronic kidney disease
  • Blood disorders, such as sickle cell disease and other anemias, bone marrow failure or hemophilia
  • Skin disorders, such as burns, dermatitis and ichthyosis, a group of about 20 conditions that cause dryness and scaling
  • Endocrine disorders, such as diabetes and thyroid problems
  • Congenital disorders such as Down syndrome that affect multiple body systems
  • Neurological disorders, such as amyotrophic lateral sclerosis (ALS), epilepsy, multiple sclerosis, Parkinson's disease and traumatic brain injuries
  • Cognitive and mental health conditions, such as bipolar disorder, dementia, depression, intellectual disabilities and schizophrenia
  • Cancer
  • Immune system diseases, such as human immunodeficiency virus (HIV), inflammatory arthritis and lupus

Part B, the childhood listings, encompass the 14 categories in the adult section plus one child-specific category, low birth weight and failure to thrive. The disability standard for minors is also different. Rather than looking at work factors, Social Security examiners evaluate whether a condition will cause severe functional limitations for at least a year or is likely to be fatal.

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The listing of impairments is not exhaustive: You can still qualify for SSDI or SSI if your disorder is not specified in the Blue Book or if it is but you don't exactly match the cited medical requirements. You will, however, have to make a case to Social Security that your illness or symptoms are as severe as those in the book in terms of limiting your work or daily functioning.

Keep in mind

The Blue Book is not to be confused with Social Security's Compassionate Allowances (CAL) program, although both list conditions that by definition meet Social Security's disability standard. The CAL program designates conditions that can get you an expedited ruling on an SSDI or SSI claim. The Blue Book sets out criteria for considering a condition as disabling, not for speeding up the process.

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