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What are qualifying conditions for SSI?

Supplemental Security Income (SSI) is a type of need-based disability benefit, with payments available to people who have no work history.

This is why many disabled children and intellectually and emotionally disabled adults are often able to qualify for this disability program through the Social Security Administration (SSA). In addition to meeting financial need criteria however, applicants must also have medical records that show they have one of the many qualifying conditions for SSI.

Blue Book Listings and Disability Benefits

To qualify medically for disability, you must have a severe impairment. The SSA’s Blue Book lists conditions that meet severity level requirements, and each listing also provides information on the medical evidence necessary for proving disability.

This manual helps applicants and their doctors understand eligibility requirements, including the specific medical tests and other records that must be present in your medical history. Disability examiners use the Blue Book to review applicant medical records and to decide the outcome of SSI cases too.

They compare medical evidence and all the details you provide in your application to the listings in the Blue Book. Mental illnesses, intellectual disabilities, and emotional impairments are among the qualifying conditions for SSI and appear in Section 12.00.

Qualifying for SSI Under Another Listing

Mental illnesses and intellectual disabilities are often accompanied by physical complications or impairments. This means you may still be eligible for benefits under another listed condition, even if you can’t meet the requirements under one of the conditions in Section 12.00. For example, If you were born with intellectual disabilities AND kidney problems, then you may qualify for benefits under one of the listings in Section 6.00. This section covers kidney-related impairments.

Closely Matching a Listed Condition

Although the Blue Book contains listings for dozens of conditions, not every one of the qualifying conditions for SSI has a dedicated listing. If your specific impairment isn’t listed, the SSA can still find you eligible for benefits by matching your condition to the severity level of a different listing. In other words, if your condition is “equal in severity” to a listed impairment, you can be approved under that listing.

Medical Evidence Requirements

Every disability listing describes how severe a condition must be to qualify medically. At the beginning of each of the SSA’s 14 major Blue Book sections or chapters too, there is information about the kinds of medical tests and other proof required for each of the qualifying conditions for SSI.

These introductions can be difficult to understand without the help of your doctor though, because the SSA uses complex medical language and terms. Your doctor, psychologist, or psychiatrist can help you translate this information to know if you can be approved for benefits.

RFC Evaluations and SSI

If you can’t qualify by meeting or matching a disability listing, you may still get approved for benefits through an RFC or “residual functional capacity” analysis. During their RFC process, the SSA takes a closer look at all of your limitations to determine if they prevent you from working. If the RFC shows you’re severely impaired and unable to get and keep a job, then you can be approved for SSI. This is true even if you don’t have one of the standard qualifying conditions for SSI.

Applying for Social Security Disability Benefits

SSI benefit applications must be completed through a personal interview process. During the interview, you give information about your medical history, education, any previous employment, and your finances to an SSA representative. That representative fills out your application forms for you, and this is usually done at the local SSA office.

You can get help with your claim from a friend, family member, disability advocate, or Social Security attorney. You can even have another person with you during your interview who provides information for you or applies for benefits on your behalf.

The SSA knows that many people who have qualifying conditions for SSI need additional help with getting through the application process. This is why they allow you to have someone else help out through the application interview, so don’t be afraid to apply.