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What are qualifying conditions for SSDI?

Social Security Disability Insurance (SSDI) benefits are available to disabled workers that meet all medical and technical qualification rules.

To get benefits through this Social Security Administration (SSA) disability program, you must have worked and paid into the Social Security system through taxes. You must additionally be able to meet a disability listing for one of the many qualifying conditions for SSDI.

Disability Listings in the Blue Book

Disabling conditions that meet the severity level requirements for approval are found in the SSA’s Blue Book. Physicians utilize the Blue Book when helping patients know if they meet disability requirements.

Disability claims examiners additionally use this manual when reviewing applications for eligibility.

The Blue Book is broken into 14 major chapters or sections. Each section covers disabling conditions that are similar in nature or affect a specific body system. For example, Section 1.00 contains listings for conditions that affect the Musculoskeletal system, including back problems, broken bones, and soft tissue injuries, like severe burns.

Medical Evidence Requirements

In addition to listing qualifying conditions for SSDI, the Blue Book also outlines the medical evidence required for approval with disability. Essential pieces of medical evidence are detailed under the individual listing for each condition.

There is also information provided at the beginning of each major section of the Blue Book, describing how the SSA evaluates disabilities that fall under that body system. This introductory information commonly includes the tests and other crucial details the SSA must see in your medical records in order to grant approval for disability benefits.

For this reason, it’s important for you, your doctor, and/or your disability advocate or attorney to not only look at the qualifying conditions for SSDI, but also the introduction of the Blue Book section where your condition is listed. This will give you insight into how the SSA reviews claims like yours and it will often tell you the exact tests and other medical proof need for you to be approved for benefits.

Meeting or Matching a Listed Condition

Listed conditions include physical, intellectual, and psychological impairments. Regardless of which type of disability you have, there are standard processes the SSA uses in reviewing applications. They first compare your medical records to disability listings, attempting to determine if your condition meets the outlined criteria for one of the many qualifying conditions for SSDI.

If you’re unable to exactly meet Blue Book requirements, then the SSA will compare your medical records for a “severity level match” to a listed impairment. If your disability equals a qualified condition, then you’re eligible for benefits.

Approval Through an RFC

If you cannot meet or closely match a listing, you can still be approved for benefits through a “residual functional capacity” or RFC evaluation. During an RFC, the SSA looks at looks at your physical and mental limitations to determine if they prevent you from working. If this evaluation shows you cannot work in any job, then you will be approved despite not meeting or matching one of the qualifying conditions for SSDI.

Applying for Social Security Disability Benefits

You can apply for disability on your own or with the help of a friend, family member, disability advocate, or Social Security attorney. Applications for SSDI can be filled out and submitted online, via the SSA’s website, or you can apply in person at your local SSA office.

Your doctor is a ally of central importance when you apply for benefits as well. He or she can ensure your medical records are shared in a timely manner with the disability examiner that reviews your claim for benefits. Your doctor can additionally help you understand the various listings for qualifying conditions for SSDI and under which listing you’re most likely to be approved for benefits.