If you’ve developed a medical or mental health condition that makes it impossible for you to work, you may seek financial assistance from the Social Security Administration’s disability programs. These include Social Security Disability Insurance, Supplemental Security Income, or Disabled Widow Benefits. However, to obtain these benefits, you must prove that you have a qualifying disability. The SSA’s regulations impose strict criteria on what qualifies as a “disability.” As a result, you may need substantial medical evidence to demonstrate that your condition meets those criteria.
An experienced Social Security disability lawyer can help you assemble a comprehensive, compelling disability benefits application that presents the most robust case for why your condition entitles you to disability benefits. Contact Wambach Disability Law for a free initial case evaluation with a Social Security disability attorney. We’ll explain more about what constitutes a qualifying disability under Social Security regulations and discuss how our firm can help you seek the benefits you need.
Understanding What the Social Security Administration Considers a Qualifying Disability
Under Social Security regulations, a person may have a “disability” that can entitle them to disability benefits if they:
- Have a medically determinable condition (i.e., a condition diagnosed by a healthcare professional using objective medical evidence) that
- Has lasted for at least 12 months, or
- Will likely last for at least 12 months or result in the person’s death.
Furthermore, a qualifying disability must impose functional limitations on a person’s ability to do basic work tasks, such that they cannot perform “substantial gainful employment” (SGA).
In most cases, the Social Security Administration defines SGA as earning more than a certain amount of net monthly income. People with statutorily defined blindness have a higher SGA threshold than individuals with other kinds of disabilities.
The Social Security Administration recognizes various medical conditions as potentially qualifying as a “disability.” However, a person with a medical condition that is not on the SSA’s list may still qualify as disabled if they meet the agency’s evaluation criteria. Applicants for Social Security disability benefits must present objective medical evidence to prove they have a medical condition (or combination of conditions) and that the limitations imposed by that medical condition limit their ability to perform basic work tasks.
Examples of Qualifying Medical Conditions
Various medical conditions can qualify an individual for disability benefits, depending on the severity of the condition’s symptoms and the limitations they impose on the individual’s daily activities. The Social Security Administration maintains a list of medical conditions, called the Blue Book, which provides the criteria that claims reviewers use to evaluate the impairments caused by those conditions.
Common medical conditions that may qualify you for Social Security disability benefits include:
- Musculoskeletal disorders, such as spine disorders, arthritis, broken bones that never properly healed, or limb amputations
- Respiratory disorders, such as chronic obstructive pulmonary disorder (COPD), asthma, cystic fibrosis, or lung transplants
- Digestive disorders, such as inflammatory bowel disease, internal gastric bleeding, chronic liver disease, or liver transplant
- Skin orders, including third-degree burns, ichthyosis, bullous disease, chronic skin infections, and hidradenitis suppurativa
- Vision disorders
- Cardiovascular disorders, such as congestive heart failure, ischemic heart disease, recurrent arrhythmias, chronic venous insufficiency, peripheral arterial disease, and heart transplant
- Blood disorders, such as sickle cell disease, thrombosis, or bone marrow disorders
- Neurological disorders, such as epilepsy, benign brain tumors, Parkinsonian syndrome, cerebral palsy, multiple sclerosis, peripheral neuropathy, and traumatic brain injury
- Hearing loss
- Cancer
- Mental health disorders, such as neurocognitive disorders, schizophrenia spectrum disorder, depressive and bipolar disorders, intellectual disorders, anxiety and obsessive-compulsive disorders, autism spectrum disorder, trauma or stress-related disorders (e.g., PTSD), or eating disorders
- Chronic kidney disease
- Immune system disorders, such as lupus, scleroderma, connective tissue disorders, inflammatory arthritis, or HIV
What If You Have a Non-Listed Condition?
Not every condition that may qualify for Social Security disability benefits has a listing in the Blue Book. For example, a person may still qualify for benefits with a non-listed condition such as fibromyalgia or chronic fatigue syndrome. However, applicants with non-listed conditions must show that their condition limits their functional ability and prevents them from working.
In other words, you may still qualify for Social Security disability benefits, even if you do not have a medical condition listed in the Social Security Administration’s Blue Book. When the SSA reviews your disability benefits application, it will consider whether you have a medical condition listed in the Blue Book or whether your condition “equals” the severity of a listed condition, potentially entitling you to a medical-vocational allowance.
Claims reviewers assess the severity of conditions by evaluating whether an applicant has a “residual functional capacity” (RFC). During the RFC determination, the SSA will look at the medical and vocational evidence to determine what basic work tasks (e.g., standing, sitting, lifting, following instructions, remembering things) you can perform and whether you need accommodations to perform them. Based on the work tasks you can perform despite the limitations imposed by your condition, the SSA will consider whether you can perform a job you’ve held in the past.
In the event that you cannot, the SSA will then consider whether you can do other jobs that exist in substantial numbers in the national economy, given your age, education, training, skills, and work experience. Should your non-listed condition limit you from doing any generally available work, the SSA may deem you disabled and eligible for disability benefits.
How Can a Disability Lawyer Help You Prove You Have a Qualifying Disability
The process of applying for Social Security Disability benefits is a difficult one, and the agency denies many otherwise valid claims because of submission errors, insufficient documentation, and other avoidable mistakes. An SSD attorney from Wambach Disability Law can help you build a compelling case for eligibility for disability benefits by:
- Advising you on the medical evidence you need to support your disability claim, including medical records, diagnostic scans, lab results, and notes or narrative letters from treating providers and vocational experts
- Filling out your disability benefits applications to present a compelling description of your condition and the limitations it has on your social and professional functioning, ensuring that your condition and limitations align with the language of the disability criteria
- Responding to the Social Security Administration’s request for additional medical information and preparing you for a consultative examination if the SSA asks you to sit for one
- Reviewing a claim denial notice letter to explain the grounds for the SSA’s decision and discuss your options for continuing to pursue your disability benefits claim, including following the administrative appeals process
- Representing you at each stage of your administrative appeal from the denial of your disability benefits application
Contact Our SSD Attorneys Today
Before you can obtain benefits from Social Security Disability Insurance or Supplemental Security Income, you must prove you have a qualifying disability. An experienced SSD lawyer can help you prepare a comprehensive, compelling disability benefits claim to give you the best chance of success during the application process. Contact Wambach Disability Law today for a free, no-obligation consultation to learn more about what makes a medical condition a qualifying disability and discuss your eligibility for Social Security disability benefits.
This is not an exhaustive list. Any medical condition could qualify if it prevents you from working.
Musculoskeletal Disorders
- Spine disorders
- Arthritis
- Bone fractures
- Limb amputation
Respiratory Disorders
- COPD
- Asthma
- Cystic Fibrosis
- Lung Transplant
Digestive Disorders
- Inflammatory bowel disease
- Chronic liver disease
- Liver transplant
- Internal gastric bleeding
Skin Disorders
- Ichthyosis
- Bullous disease
- Chronic skin infections
- Hidradenitis suppurativa
- Burns
Vision Disorders
Cardiovascular Disorders
- Congestive Heart Failure
- Ischemic heart disease
- Recurrent arrhythmias
- Heart transplant
- Chronic venous insufficiency
- Peripheral arterial disease
Blood Disorders
- Sickle cell disease
- Thrombosis
- Bone marrow disorders
Neurological Disorders
- Epilepsy
- Traumatic brain injury
- Benign brain tumors
- Parkinsonian syndrome
- Cerebral palsy
- Multiple sclerosis
- Peripheral neuropathy
Hearing Loss
Cancer
Mental Health Disorders
- Neurocognitive disorders
- Schizophrenia spectrum disorders
- Depressive and bipolar disorders
- Intellectual disorders
- Anxiety and obsessive-compulsive disorders
- Personality and impulse-control disorders
- Autism spectrum disorders
- Eating disorders
- Trauma-and stress-related disorders
Chronic Kidney Disease
Immune System Disorders
- Lupus
- Scleroderma
- Connective tissue disorders
- Inflammatory arthritis
- HIV
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I worked for a high-volume Indianapolis-based disability practice for ten years, and I’ve represented claimants in over one-thousand disability hearings before ALJs in Indiana, Illinois, Kentucky, and New Mexico. I’m also a sustaining Member of NOSSCR (National Organization for Social Security Claimant’s Representatives). When I’m not in the courtroom, I’m spending family time with my wife, kids, and dog.