Individuals applying for Social Security Disability Insurance (SSDI) benefits often have several health conditions, or co-morbidities, that may factor into their overall health. For example, an individual who requires an amputation due to peripheral vascular disease, might also have uncontrolled diabetes.
When determining disability eligibility, the Social Security Administration (SSA) looks to an individual’s functionality. In other words, specific diagnoses or illnesses are less important than how the actual impairments limit a person’s ability to function on a day-to-day basis.
How Will My Disabilities Be Evaluated During the Application Process?
Because there are many disorders and conditions that possibly result in disability, the SSA created a guide called the Blue Book to aid Social Security representatives, physicians, and applicants in deciding if a certain condition qualifies for disability benefits.
The various conditions contained in the Blue Book are sorted into categories, and each states the specific criteria and symptoms that must be present to receive disability benefits. The Blue Book additionally contains the different clinical and laboratory tests that are necessary for a condition to be approved.
When determining if an individual’s condition is disabling enough to earn benefits, the SSA will first consult the Blue Book. If it is determined that a person has a condition that meets the Blue Book listing, a person will be awarded disability benefits.
However, sometimes an individual has an illness, or a combination of illnesses, which are not explicitly listed in the Blue Book. If someone’s condition or constellation of symptoms is equivalent, or equal, to a listing in the Blue Book, the person is said to “match” the listing and is also approved for disability benefits.
The SSA is required to take into account the effect of a person’s combined impairments together. For example, if an individual has lupus that impacts their lungs and heart, but they do not suffer from malaise, fatigue, fever, or weight loss, they might not meet the Blue Book listing. At the same time, the individual also suffers from asthma, yet they have only had two severe exacerbations requiring hospitalizations in the last year, once again barely missing the Blue Book listing for asthma. The SSA must consider whether or not the combined effects of their lupus and asthma add up to an impairment as severe as lupus. If so, the individual could qualify for disability benefits.
Keep in mind that the SSA must also take into consideration both physical and mental impairments. Many individuals who suffer from a physical disorder also are impacted by psychological impairments, such as depression or anxiety. Claimants who are being treated for mental disorders, in addition to their physical health conditions, should be sure that both are carefully documented in their medical file.
What If I Don’t Meet or Equal a Blue Book Listing, But I’m Still Too Ill to Work?
If you do not meet a Blue Book listing, you will need to illustrate to the SSA the effects that your various conditions have on your ability to work. An RFC, or residual functional capacity, assessment will describe the many limitations that may result from your disabilities. The RFC will reveal, based on the current status of your health, how much work you can do and the duration for which you can perform it.
The SSA will then use your RFC assessment to determine what jobs, if any, that you can succeed at given your current health status. If your multiple health problems cause an RFC that is so restricted that you can’t perform your most recent job or any job that you have accomplished in the past, the likelihood of disability benefits approval is high.
How Can a Social Security Attorney Help Me Win Approval with My Multiple Conditions?
One of the ways that an experienced Social Security attorney wins cases is to develop individualized strategies for each of their clients. If you decide to hire a disability lawyer, he or she will carefully review your situation and come up with the best game-plan to present to the Social Security Administration on your behalf.
For example, a claimant might believe that presenting every single health problem will help them win sympathy points with the SSA and lead to a successful outcome. A qualified attorney well-versed in SSDI might realize that their client clearly meets a single Blue Book listing, and can present a clean and straight-forward argument to help win their case.