Social Security disability benefits provide financial assistance for millions of Americans each year. In order to qualify, applicants must show that their disability is severe enough to prevent them from working or living independently.
Because of Social Security’s in-depth application process, it can be tricky to figure out how to qualify. Below, we will show you how you can measure your medical qualifications by comparing your diagnosis to the Blue Book.
How the Blue Book Works
Disability applicants qualify as disabled when they can show that their condition:
- Is severe enough to prevent them from working or functioning normally
- Is expected to last longer than 12 months or result in death.
In order to evaluate these requirements, the Social Security Administration (SSA) created the Blue Book, which lists all disorders that can qualify to benefits. These disorders are broken up into two segments (one for adults and one for children) with each segment containing sections for different disorder types.
Depending on your condition, the Blue Book will detail exactly what symptoms must be present in order for you to qualify for benefits. Before applying, you can visit the SSA’s website to compare your diagnosis to the online Blue Book.
For example, say you are applying for benefits for coronary heart disease. This is listed under Section 4.00 “Cardiovascular - Adult” under subsection 4.04: “Ischemic heart disease”. According to this listing, applicants can qualify with coronary heart disease with an angiography test that shows the narrowing of a main coronary artery by more than 50%.
If angiography test results do not show this result, those with coronary heart disease can still qualify if it is shown that their condition severely limits their ability to independently initiate, sustain, or complete activities of daily living (getting from place to place, cooking, cleaning, dressing, etc.)
Understanding Confusing Requirements
Many disorders contain a variety of terms and phrases that are difficult to understand. The requirements are written this way to make sure that applicants are reviewed using the same exact, specific medical assessments. However, this can make it difficult for an applicant who is not well-versed in medical terminology.
For example, many musculoskeletal disorders (amputations, deep fractures, spinal disorders, etc.) discuss “effective ambulation” in their Blue Book listings. In most cases, applicants are found disabled if their condition is severe enough to keep them from ambulating effectively.
However, when simply put, this term just refers to a person’s ability to walk. Applicants who are unable to use prosthesis, who require the use of both hands to move around unassisted, or who cannot safely sustain foot travel are considered “unable to ambulate effectively”.
In some cases, Blue Book requirements can seem vague or hard to gauge. This can also make it difficult to determine whether or not you qualify. For example, many neurological disorders measure disability by referring to a person’s ability to function in five different ways:
- Physical functioning,
- Understanding, remembering, or applying information,
- Interacting with others,
- Concentrating, persisting, or maintaining pace
- Adapting or managing oneself.
Those who show a “marked limitation” in one or more of these areas often demonstrate a more severe disability — and thus, a stronger need for disability benefits. For any disability with these requirements, you can view the definitions of each category at the top of the corresponding Blue Book section.
For instance, if you are unsure whether or not your epilepsy qualifies as causing “marked limitations” on your ability to concentrate and think properly, you can refer to the top of Section 11: “Neurological Disorders” under subsection 11.00G3b(iii).
Speaking with Your Physician
While referring to the Blue Book on your own can be helpful, no one is better equipped to help you with your diagnosis than your physician. Before applying, it is always best to consult with your physician and compare your condition to its corresponding listing in the Blue Book.
Your physician will understand the medical terms used and be able to conduct whatever tests/assessments may be necessary to include on your application. In addition, physicians can point you in the right direction when looking for other resources you can explore throughout your disability application process.