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How to Know if Your Condition is “Disabling Enough”

Receiving disability benefits can be life-changing for many Americans living with severe disorders. Unfortunately, applying for disability benefits can be a struggle. What do you do? How do you know what to prepare? And how do you even know if you qualify in the first place?

Below, we will go over the basics regarding disability qualification and what you can do to make the application process as painless as possible.

Using the Blue Book

When looking for a disability qualification, few resources are more important than the Social Security Blue Book. This “book” (which can be found online on the SSA’s website) gives detailed descriptions of every disorder that qualifies for benefits. To see if your condition qualifies, this is the best place to start.

Navigating Blue Book listings

Listings are broken up into 14 different sections, each corresponding to different categories of bodily disorders. Each of these sections contains various listings for specific disorders, as well as the requirements of each to get benefits. For instance, let’s look at how you would check the requirements for kidney disease.

Kidney disease falls under Section 6.00 of the Blue Book: “Genitourinary Disorders.” If we look here, we see that subsections 6.03, 6.04, and 6.05 deal with various forms of kidney disease. If you are looking to apply after going on dialysis, then section 6.03 states you can qualify for benefits by providing evidence of this.

How to Find Out if Your Condition is Disabling Enough

Those who have had a kidney transplant qualify for one year after their surgery under section 6.04. All others with kidney disease can refer to section 6.05, where various test results are outlined for you to determine if you qualify.

Speaking with your physician

While the Blue Book is very helpful, it can also be confusing to those who are unfamiliar with certain tests or medical terms. In this case, it is a good idea to speak with your physician to determine how your diagnosis compares to its Blue Book entry.

If your disorder is not represented in the Blue Book, this does not mean you don’t qualify — speak with your physician to see if your symptoms may qualify you under a separate similar listing, or if your disorder may be severe enough to qualify as an exception.

Preparing for the Application

If you believe your disorder qualifies you for benefits, then start preparing for the application. Compile all of your medical history and paperwork so you can see what you do and don’t have for your application. It's often better to prepare more evidence than less to give the SSA the best understanding of your condition.

This means you’ll need MRIs, CT scans, medical tests, general check-up history, therapist evaluations, boss or coworker testimonies, or any other evidence that gives an idea of your disorder’s severity. Financial paperwork, tax history, and other logistic information must also be included, so have that ready as well.

When you feel comfortable starting the application, you can begin on the SSA’s website or in person at your local Social Security office.

Considering a Disability Attorney

Disability applications can be overwhelming, especially when coping with your severe disorder through the process. While there are many resources available to help, a great one to consider is a disability attorney. They can keep paperwork in order, stay in contact with the SSA, and potentially get your application seen faster.

Should you need to go to a hearing later on, they can be especially helpful when presenting your case in court. And, perhaps the best news of all: attorneys are required by federal law to only take payment if they succeed in getting you benefits.

Before starting your application, think about scheduling a free consultation with a disability attorney near you.

Comments

How long after my child is considered disabled by social security do I have to wait for a income verification appointment? I have been waiting for over 2 months since she was considered disabled

Hi Jennifer,
That would depend on how busy your local SSA office would be, you may want to contact them if you are in dire need of benefits, they may be able to help you further.

The SSDI Blue Book is way out of date regarding Chronic Fatigue Syndrome disease (or ME/CFS/SEID).

SSA (SSDI Division) should read the Feb. 14, 2015 comprehensive expert government report by the Institute of Medicine (of the National Academy of Sciences) --- requested by many U.S. gov't agencies INCLUDING SSA!! Change the Blue Book with out-of-date inaccuracies enumerated below:

One example:

The new U.S. IOM-government-report-determined disease symptoms are not the same as the wrong ones in the Blue Book. The unique symptoms of this illness are: crushing exhaustion, collapse after any type of self-exertion, non-refreshing sleep, difficulty standing for very long (orthostatic intolerance) ... and in most cases body pain. This mistake by SSA/SSDI could prevent deserving ME/CFS/SEID sufferers from being awarded disability!!

Nor does the Blue Book make any mention of the latest findings from the current large-scale, in-depth, scientifically-rigorous medical studies on CFS across the world (many in the U.S. funded by NIH and top-known private university medical centers) building on solid eye-opening findings from preliminary studies. They point to: disease sub-sets (at least one being degenerative ... even life-threatening); metabolomics; genetics; the mitochondria (the where/how of energy production in every cell); immune deficiencies; brain and body-wide inflammation; Natural Killer cells; B-cell function; viral infection (e.g. HHV-6); immuno-senescence; cell cycle energetics; the brain's HPA axis (hypothalamic-pituitary-adrenal axis); p38 Map Kinase alterations; the pathophysiology of ME/CFS/SEID's marker symptom, PEM (Post Exertional Malaise); and many more. The nature of these findings show that ME/CFS/SEID is a "multiple system" illness ... not just one under the Immune System.

A third example: The Blue Book states that patients can improve if they get exercise. The 10M expert report explains that any exertion of ANY kind (including, of course, physical) in fact worsens ME/CFS/SEID disease. Its proposed new name, SEID, stands for Systemic Exertion Intolerance Disease.

A fourth example: The Blue Book states that depression is a symptom of ME/CFS/SEID. First of all: this is incorrect. This is also likely to confuse and mislead readers. The IOM report is very emphatic about the conclusive research findings that (in contrast to earlier years' mis-information): ME/CFS/SEID is in no way "psychological or psycho-somatic" -- "it is NOT a psychological illness." SSA's writing that depression is a symptom is essentially writing what IS NOT ACCURATE. Given that ME/CFS/SEID is such a "devastating disease" (IOM) -- one that is cell-deep, body-wide, often sudden, and has no cure; it comes as no surprise that its sufferers might feel sad, eventually even despairing. After all: consider virtually all of that sufferer's life that was suddenly "snatched away" ... virtually all of what is valued, sustaining, and even affordable to prevent excruciating results: losses ... one after the other. The RESULT of the disease.

-- You can see how this works. First, the symptoms: -- loss of energy, -- difficult sleep, -- body collapse after any form of exertion. This leads to results and reactions, including emotional ones: loss of job, loss of income, financial problems, beginning of anxious feelings, --> loss of ability to drive/travel, loss of energy for after-work important activities (e.g, grad school, starting a business, sports & recreation, church, dating), loss of friends/family who are not nearby or "true blue," beginning of sadness, --> loss of energy for getting up and doing what's needed each day (thus becoming bedridden...homebound), loss of daily human contact, loss of self-sufficiency, loss of feeling loved, one's situation and illness not being understood, frequent sadness --> need for home assistance and caregiving, --> loss of savings, caregivers no longer affordable, pain medicines / doctors / insurance no longer affordable, excruciating pain, chores not done, meals not provided, loss of life stability, extreme anxiousness, life despair, --> loss of apt or home, homelessness, no money to live on, deep life despair --> not enough energy to walk to shelters or to sit up to beg for money/food, homeless shelters do not allow sleeping there during the day, getting sicker living day and night on the streets with a crushing exhaustive painful illness, thoughts of suicide...

-- So you can see, this is not originally "primary depression: a clinical diagnosis." This downness about having the illness and (depending on disease severity and contextual circumstances) despair -- these are not the original symptoms of the disease, but are the SECONDARY results of having this PRIMARY disease: ME/SEID/Chronic Fatigue Syndrome. The unique symptoms of this illness are: crushing exhaustion, collapse after any type of self-exertion, non-refreshing sleep, difficulty standing for very long (orthostatic intolerance) ... and in most cases body pain. One's emotional reaction to this and to one's life results having it -- these are secondary.

SSA requested IOM's report ... hopefully you have read it. You will see clearly why the Institute of Medicine would thus criticize you: SSA should change these three mis-statements in the SSDI Blue Book description, and should list ME/CFS/SEID under a different disease category.

Thank you for changing SSA's SSDI Blue Book. These mistakes by could prevent deserving ME/CFS/SEID sufferers from being awarded disability!!

-- Ms. Alden

Hi Ms. Alden,
We are not affiliated with the SSA or the federal government and as such we do not have any input into the Blue Book's definitions of disability.

Hi Ms. Alden,

I'm going through this process for Chronic Fatigue Syndrome / SEID currently and all your points above illustrate my painful current situation. Are you a lawyer/doctor or someone suffering like myself?

I was,turned down because i didnt have enough credits for the past 10 yrs,i had a heart attack an died 10 yrs ago,i had no idea i would have qualified,an now you say it is to late,what can i do