Most individuals who apply for Social Security disability don't know what disability criteria the Social Security Administration (SSA) uses to determine whether claimants are disabled. In part, disability examiners use a list of impairments known as the "Blue Book" to determine if an individual will meet the Social Security definition of disability.
The Blue Book is a list of impairments with detailed requirements for when the SSA should judge a medical condition to be disabling. The official name of this disability handbook is Disability Evaluation Under Social Security. This listing of impairments contain the most common medical conditions considered to be severe enough to keep an individual from working. If you match the requirements of a listed impairment (called a "listing"), you will qualify for disability automatically, regardless of whether you can actually work or not.
The Blue Book is divided into two main parts:
Each of these parts is divided into sections (15 for children, 14 for adults), which contain information about different types of disabilities. The major body systems addressed within the Social Security disability handbook are as follows: Musculoskeletal, Special Senses (Vision and Hearing), Respiratory System, Cardiovascular System, Digestive System, Genitourinary System, Hematological Disorders, Skin Disorders, Endocrine Disorders, Multiple Body Systems, Neurological, Mental Disorders, Neoplastic Diseases (Cancer), and Immune System Disorders.
For each major body system, the Blue Book contains a list of disabling conditions. For instance, you find fractures and spinal disorders addressed in the musculoskeletal section.
Because illnesses and injuries have varying degrees of severity, the Blue Book sets out the requirements for how severe the symptoms, clinical findings, and laboratory tests for a particular impairment have to be -- to make sure that the condition is severe enough for an automatic approval. (If your condition doesn't match a listing, the SSA goes through a longer determination process to see if you're disabled, but if you can match a listing, the process stops there.) Here's how to use the listings to see if you should automatically qualify for disability.
You can look at the SSA's impairment listings to see if you can find your medical condition in a listing, or look at our list of illness-specific articles, which will tell you whether the condition is listed.
If your disability is listed, the next step is to determine if your medical condition meets the specific criteria for that condition to automatically qualify for benefits. The listing requirements are often quite complex; your doctor can help you determine if you meet a listing (or again, you can read our illness-specific articles, which attempt to simplify some of the medical jargon in the listings).
If you haven't had the clinical or laboratory tests required in the listing, you can ask your doctor to perform them. (Or you can wait for the SSA to pay for a consultative exam, but this makes your claim take longer, and it's generally better if the test results are already in your medical record.) Then you can check to see if your test results meet the requirements of the listing.
If your impairment doesn't match the requirements of the listing, the disability claims examiner will determine if your impairments can be considered equivalent to a similar listing, in terms of severity. The SSA allows you to "equal" a listing because it can't include every form or variant of a severe disability in its impairment listings. The SSA also recognizes that there are various ways to diagnose and document the same illness. For instance, the listing may require a specific result on a specific lab test, and you weren't given that test, but you did take a test that shows the same results as the test required by the listing.
Another way to equal a listing is by having a combination of impairments that by themselves are not severe enough to meet a specific listing, but combined, their severity equals that of a listed impairment. If the SSA says your impairments are equally as severe as those in the listings, you will be granted disability benefits. If you have to appeal an initial denial of benefits, and you want to argue that your condition is equal to a listed impairment, you would probably need a disability lawyer to argue your case.
For more information, see our article on how to equal a disability listing.
Not all medical and psychological conditions are listed in the Blue Book -- it would be impossible to list all disabling illnesses and injuries in a handbook. (For more information on the medical conditions that qualify for disability, whether they are in the blue book or not, see our article on the medical conditions that qualify for Social Security disability.)
You can get disability for a condition not listed in the Blue Book if you can prove the condition limits your functioning too much for you to work. Learn more about how Social Security decides if you are disabled if you don't meet a listing.