Chicago residents who suffer from disabling conditions often think their impairments clearly qualify for Social Security Disability benefits. However, many SSD claims are denied because of the Social Security Administration’s strict criteria for disabilities. When evaluating disability, the SSA uses Disability Evaluation Under Social Security, or the “blue book”. This book establishes medical and evidentiary standards that conditions must meet to be considered disabling.
Blue book standards
The blue book outlines the SSA definition of disability and the earnings requirements SSD applicants must meet. It also establishes evidentiary requirements for disability claims:
- An acceptable medical source must diagnose the condition. These professionals include licensed physicians, psychologists, optometrists and podiatrists.
- Evidence must be from appropriate sources. The SSA prefers evidence from professionals with a history of treating the applicant. The SSA also accepts medical records from any treating facilities.
- Applicants must provide full medical documentation. The SSA typically requires a diagnosis, medical history, lab or clinical findings and descriptions of treatment. An acceptable medical source should also give a written evaluation of the individual’s ability to work.
- Evidence from secondary sources should establish the daily effects of the condition. Statements from family, co-workers, public agencies and other medical practitioners are all permissible.
Following these guidelines is crucial for applicants. People who do not meet these standards may not be considered disabled, no matter how debilitating their conditions are.
Evaluating the condition
The SSA blue book also contains a list of impairing conditions. Each condition is accompanied by severity criteria or evidentiary requirements. If a person suffers from a listed condition and meets the associated requirements, the SSA will not evaluate how the condition affects the person’s ability to work. Instead, the SSA presumes the condition is disabling.
If a person suffers from a listed condition but fails to meet some criteria, the SSA may find that the person “equals” the impairment listing. The person’s symptoms and functional limitations must be equal in severity to those established in the listing. If a person “equals” a listing, the SSA will not directly consider the effects of the condition on the person’s ability to work.
If a person’s condition does not appear in the blue book or meet listing terms, the person may still qualify for benefits. The SSA will directly evaluate the functional limitations of the condition and determine whether those limitations preclude gainful employment. If so, the person will receive a medical-vocational allowance.
Applicants should understand which way their conditions are most likely to be evaluated. People with listed conditions should obtain evidence that fulfills the listing criteria. People with other conditions should provide documentation to show the disability prevents them from working gainfully.