What Medical Conditions Qualify for Social Security Disability or SSI?

An illness or disease does not need to be listed in Social Security's blue book to qualify for disability benefits.

The Social Security Administration's impairment listing manual (called the blue book) lists a number of impairments, both physical and mental, that will automatically qualify an individual for Social Security disability benefits (SSDI) or Supplemental Security Income (SSI), provided the individual's condition meets the specified criteria for a listing.

What Medical Conditions Are Listed?

The listing manual, which has been updated for 2019, includes:

For articles on getting disability for many common conditions, some of which are in the blue book and some of which aren't, see Medical Conditions, Impairments, and Problems.

How Do You Get Disability for Listed Medical Conditions?

If your disability is listed, the first step is to get a diagnosis of the condition from your doctor. A mere diagnosis will get you an automatic disability approval for only a few conditions, however, like ALS, an organ transplant, or certain serious cancers, such as esophageal cancer, mucosal melanoma, anaplastic carcinoma of the thyroid gland, or small-cell carcinoma (of the prostate, ovaries, breast, lungs, pleura, intestines, or bladder).

The next step is to determine if your medical condition meets the specific criteria for that condition. Here are some examples of qualifying criteria for various conditions:

  • COPD: an FEV1 of 1.75 or lower for an adult male who is 5'10"
  • coronary artery disease: 50% or more narrowing of a left main coronary artery
  • congestive heart failure: an ejection fraction of 30% or less (during a period of stability)
  • nephrotic syndrome: proteinuria of 10.0g or greater per 24 hours, on two different occasions 90 days apart
  • hepatorenal syndrome: serum creatinine elevation of at least 2 mg/dL
  • blindness: central visual acuity of 20/200 or less in the better eye (with correction)
  • hearing loss: average hearing threshold sensitivity for air conduction 90 decibels (dB) or worse in the better ear
  • HIV infection: absolute CD4 count of 50 cells/mm3 or less
  • weight loss due to a digestive disorder: a BMI of 17.5 or less, on two different occasions 60 days apart.

The listing requirements are often quite complex; our illness-specific articles attempt to simplify many of the medical criteria 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. 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, and if they match the criteria or are close, you can apply for disability.

Does a Medical Condition Have to Match the Blue Book Listing?

An individual filing for Social Security disability benefits does not necessarily have to satisfy the exact listing requirements for a particular illness or condition to be awarded disability benefits based on this condition. You can be awarded disability benefits if Social Security considers aspects of your condition medically equivalent to the criteria in the listing or a related listing. This is called "equaling a disability listing." (According to recent government statistics, 37% of all approved disability applications "met" a listing and only 6% "equaled" a listing.)

Alternatively, you can be eligible for disability benefits if you don't meet or equal the criteria for the blue book listing, if your condition limits your functioning so much that you can't work. The SSA will consider the effect of your condition on your capacity to perform routine daily activities and work and will then determine whether there is any kind of job you can safely be expected to do. For more information, see our section on how Social Security decides if your limitations make you disabled. (In a recent year, half of all approved disability applications were approved based on an assessment of applicants' limitations.)

Does a Medical Condition Have to Be in the Blue Book?

A Social Security disability claimant doesn't even have to have an impairment that is listed in the Social Security disability blue book to be awarded disability benefits. For instance, migraine headaches are not included in the blue book, but if a claimant's migraines are severe enough and are well documented, the SSA may grant disability benefits if the migraines make it impossible for the disability applicant to work a full-time job. The keys here are that the condition be a medically determinable impairment and that it reduces someone's RFC enough so that they can't do their prior job or any job. In this case, an applicant could qualify for benefits under a medical-vocational allowance. Other common impairments that aren't listed in Social Security's blue book include carpal tunnel syndrome, fibromyalgia, chronic regional pain syndrome, reflex sympathetic dystrophy, celiac disease, and degenerative disc disease.

Which Medical Conditions Are Likely to Qualify for Disability?

While any of the above medical conditions are SSDI and SSI qualifying disabilities, some medical conditions are more likely to lead to an approval of benefits than others. We recently surveyed our readers about their experiences in applying for disability benefits and compared their answers to government statistics. For details, see our article on survey statistics on getting Social Security disability for common medical conditions.

How Do You Apply for Disability for Any of the Above Conditions?

There are three ways to apply:

  • file online at www.ssa.gov/applyfordisability (not available to most SSI applicants)
  • call the Social Security office at 800-772-1213 for an appointment to apply, or
  • go to your local Social Security office without an appointment.

Click the links above to learn about getting disability for your medical condition. The articles include a discussion of whether your condition meets a disability listing, equals a disability listing, or should be eligible for a medical-vocational allowance.

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