What Medical Conditions Qualify for Disability Benefits?

by | Published on Feb 4, 2019 | Record Retrieval Services

Anyone can fall prey to a severe disability that limits one’s ability to work and lead a normal, pain-free life. Studies demonstrate that a 20-year-old worker has a 1-in-4 chance of becoming disabled before reaching full retirement age. Given the probability of disability, the disability benefit programs of the SSA (Social Security Administration) are highly significant. Medical chart reviews are an important part of disability determination, which in turn makes the service of medical record retrieval companies a major consideration.

The Blue Book Disability Listing

The SSA pays disability benefits through 2 programs – SSDI (Social Security Disability Insurance) and SSI (Supplemental Security Income). To receive the benefits, applicants will have to prove the gravity of their disability. It is important that applicants understand what qualifies for disability benefits so that they can increase their chances of getting approved. The SSA has an impairment listing manual called the Blue Book that lists physical and mental impairments or disabilities that qualify for benefits. For the year 2018, the list included:

  • Cardiovascular problems
  • Musculoskeletal conditions
  • Respiratory illnesses
  • Senses and speech issues
  • Mental disorders
  • Neurological disorders
  • Skin conditions
  • Immune system diseases
  • Problems of the digestive tract
  • Cancer
  • Kidney disease and genitourinary problems
  • Hematological disorders
  • Various syndromes such as Sjogren’s Syndrome and Marfan Syndrome

You Could Qualify for Unlisted Medical Conditions

Even if your specific conditions do not exactly match those in the Blue Book, you may be awarded disability benefits via SSA’s “equalling a disability listing” if the SSA considers aspects of your condition medically equivalent to the criteria in the listing or a related listing. Also, 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 carry out routine activities and work, and then determine if there is any kind of job you can safely be expected to perform. For instance, if you suffer from migraine headaches (not listed in the Blue Book) that are severe and well-documented, you may be granted disability benefits if the migraine makes it impossible for you to work a full-time job. Your condition must be medically determinable and reduce your RFC (Residual Functional Capacity) so much that you cannot do your earlier job or any other job.

Apart from migraine, other disabilities that are not listed in the Blue Book include fibromyalgia, carpal tunnel syndrome, reflex sympathetic dystrophy, degenerative disc disease, and celiac disease among others. The Blue Book does not have an exact listing for narcolepsy, but you may be approved for this condition if you can meet the Blue Book’s epilepsy listing – your inability to stay awake should be as frequent as the listing for those with seizures. Narcolepsy is not convulsive, which means you would have to meet one of the two Blue Book listings for dyscognitive seizures.

  • Dyscognitive seizures could qualify for benefits if you have at least one seizure per week for three consecutive months, even after following all prescribed treatments.
  • If you fall asleep unexpectedly at least once every other week, you may be eligible provided you have medical documentation that demonstrates challenges in one of the following areas of routine functioning.
    • Walking, balancing, performing fine movements, and so on
    • Understanding, memorizing and applying learned information
    • Interacting with co-workers and colleagues
    • Controlling your emotions while in a work environment.

Medical Chart Reviews and Doctor’s Written Statement Most Valuable

Medical documentation is most important when applying for disability benefits. Medical chart reviews should be able to provide details about your debilitating condition, a formal diagnosis from your doctor regarding the condition, details of all tests undergone that have confirmed your condition, details of prescription medication(s) you are taking. A written statement from your doctor regarding the severity of your disability can go a long way with the SSA. The doctor can clearly record details such as how long you have had the medical condition, the medications you have consumed, side effects of any medication, how your medications have helped or not helped, the physical activities you are no longer able to do, and so on.

A social security disability lawyer can help applicants evaluate their case and determine the chances of getting their claim approved. With a lawyer to take care of all claim submission related processes, applicants will be better equipped to deal with the prospect of a disability.

Discover our medical record review solutions and partner with us for your next case.

Related Posts

The Impact of AI on Medical Record Retrieval

The Impact of AI on Medical Record Retrieval

Medical record retrieval is an important, resource-intensive process for healthcare providers, insurers and insurance attorneys. A complete data collection and review process is vital to optimize the retrieval process and ensure the records are accurate, comprehensive...