Social Security Disability and Medical Impairments

Types of Disabilities and Coverage

The Social Security disability list of impairments is part of a publication called "Disability Evaluation Under Social Security" which is more commonly known as the Social Security Blue Book.

When you file a claim for social security disability benefits, the first thing that will be evaluated is your non-medical eligibility for benefits, such as your age, work history and the number of Social Security credits you have earned. Assuming your claim passes the non-medical eligibility requirements review, you will next have your medical condition evaluated.

Social Security and the List of Impairments

Social security maintains a list of impairments that outlines the various diseases and disabilities that have historically been suitable for social security disability benefits.

• The list of impairments in the Blue Book outlines hundreds of different conditions categorized by major body system functions.
• The list of impairments contains the guidelines that will be used to compare your medical condition to what Social Security has said is a permanent, disabling condition.

The list of impairments is carefully organized by major body system, and includes a category covering impairments that impact more than one body system. The categories found in the Blue Book list of impairments are:

• Musculoskeletal
• Special Senses and Speech
• Respiratory
• Cardiovascular
• Digestive
• Genitourinary
• Hematological
• Skin
• Endocrine
• Impairments Affecting Multiple Body Systems
• Neurological
• Mental
• Malignant Neoplastic Diseases
• Immune System

Your disability claim is handled by a state level agency which is funded by Social Security called Disability Determination Services, or DDS. Expert staff and medical professionals will be evaluating your disability claim against the Blue Book’s list of impairments.

Proving Medical Impairment

Proving to Disability Determination Services (DDS) that your alleged disability matches or surpasses the description of your condition found in the Blue Book takes convincing evidence.

• While Social Security will advise you not to consider the process of filing a claim for benefits as adversarial, you should remember that the burden of proof is on you.
• The more convincing and compelling your medical evidence is, the better your chances of proving to DDS that you meet their legal definition of disabled.
• The list of impairments is a public document, available for you to read and also available to the medical professionals who are treating you. If your doctor does not agree that you are disabled as defined by the law, DDS may not agree either.

Your Medical Records

When you file your claim be careful to include every doctor, hospital, diagnostic lab, therapist or other medical professional that has treated you. Include complete contact information such as name, mailing address, telephone number and fax number.

• This is extremely important because if you don’t have all of your medical records, DDS will request them on your behalf.
• If you have a large number of places where medical records have to be retrieved this can add processing time to your claim.

Consultative Examinations

If after reviewing your medical records DDS cannot make a determination as to whether or not you are disabled, you may be asked to visit a doctor of their choice for an evaluation, often called the consultative exam or CE.

• Social Security will pay for this medical exam, and any required associated diagnostic tests. You may also be reimbursed for some travel expenses if the doctor is not located close to where you live.
• Do your best not to miss the appointment that is scheduled for you because this will also cause your claim processing and review to be delayed.

Medical Equivalence

When you have a medical condition, or a variety of medical conditions which combined make you unable to perform significant work but your medical condition does not exactly match a condition in the Blue Book list of impairments, or your not all of the manifestations of your condition meet the severity requirements listed, you may find yourself trying to prove that your condition is medically equivalent to a qualifying disabling condition that is found in the Blue Book.

• According to regulations, proving medical equivalence is possible but in reality it can be next to impossible to make happen.
• Symptoms alone are not enough.

Proving medical equivalence requires compelling evidence in the form of symptoms, laboratory results, testimony from treating and non-treating physicians, statements from the individual, their family members and others regarding the depth of the condition.

Mental Impairments

Mental disorders are a recognized disability category found in the list of impairments. Mental disorders which may be severe enough to be considered disabling include but are not limited to:

• Autism
• Personality disorders
• Mental retardation
• Organic mental disorders which occur when the brain does not function properly
• Paranoia, schizophrenia, anxiety related disorders

As with physical disorders, the claimant has to be able to prove that their impairment has interfered with or will interfere with their ability to work for at least a year.

Alcohol and Drug Issues

Substance Addiction Disorders is a subcategory of the mental disorder impairment, however you will not receive benefits for abusing alcohol and drugs. It is possible to receive benefits under certain circumstances when other body systems have been affected by past drug use. How recent the abuse was, as well as the medical records on file will be examined and considered.

• Medical issues resulting from substance addiction are evaluated independently form the alcohol and drug abuse, and you must be able to prove that your condition won’t improve simply because the abuse stops.
• Physical disabilities are more likely to be approved than mental impairments are when drug or alcohol use is involved in the recent medical history.

Proving medical equivalence or disabilities related to mental disorders or substance abuse are extremely technical. You would be well advised to seek assistance and advice from an attorney who is familiar with Social Security disability prior to filing a claim for disability benefits.

Next Steps

9. Benefits Denied: Request for Reconsideration
10. Administrative Appeals Hearing
11. Collecting Social Security Benefits

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