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What Conditions Automatically Qualify You for Disability?

The Social Security Disability Insurance (SSDI or SSD) and the Supplemental Security Income (SSI) programs do not provide for impairments that “automatically” qualify for disability benefits. However,  some illnesses and conditions do qualify for accelerated consideration and receive “expedited rulings” determining whether their claim is approved or denied. The Social Security Administration (SSA) describes them as “certain cancers, brain disorders, and a number of rare disorders that affect children.”

This blog post explains how the Social Security Administration (SSA) publishes a list of injuries, illnesses, and conditions in what is referred to as the “Blue Book.” The manual includes many recognized disabling impairments along with their required qualifying criteria. We’ll also explain the Compassionate Allowance List conditions (CAL) that are widely recognized as so serious and so undeniable that the SSA attempts to approve the claim with little or no delay. Finally, we’ll discuss the impairments at the other end of the spectrum, those that seem to cause the claim to move slowly to the final decision.

How Does Any Impairment Qualify for Social Security Disability Benefits?

All Social Security Disability (SSD) and Supplemental Security Income (SSI) claims are judged by the same  standard to determine if they meet the SSA’s definition of a “disability”:

A disability is a medically determinable physical or mental impairment that lasts or is expected to last 12 months (or result in death) and prevents the person from performing substantial gainful employment.

Every claim, whether submitted as a Compassionate Allowance List (CAL) condition, a Blue Book-listed impairment, or a less categorical complex of impairments must meet that standard. The difference between each of these types of claims is the speed with which SSA processes, assesses fully, and issues a decision whether to grant or deny the claim for benefits.

Compassionate Allowance List(CAL) Conditions

Conditions listed as qualifying for Compassionate Allowance (CAL) include illnesses, diseases, conditions, and impairments that are considered to deserve more immediate attention from the Social Security Administration’s staff because the nature of the impairments are so destructive to the human body.

Many SSD and SSI claims for benefits include volumes of medical records, summaries, and supporting documents that clearly demonstrate the existence of a qualifying disability meeting Blue Book criteria. But the Blue Book listings describe diseases and illnesses in general terms, often referring to how limited a claimant must be, specific findings required by the treating physician, etc.

The CAL list “names” serious diseases, illnesses, conditions, and impairments that the claimant might be suffering with. When a claimant’s application identifies one of these named diseases, a predictive technology in the SSA’s processing system, and any Disability Determination Service worker who spots a claim identifying their CAL disease by name, is supposed to separate the claim from the mass of other applications. The special claim should then be given a special, speedier assessment by a claim examiner with knowledge about that disease. The current roster of Compassionate Allowance List conditions can be found at SSA.

 SSA’s Listing of Clearly Qualifying Disabilities — the Blue Book

The SSA’s Blue Book of listed impairments includes 14 groups of impairments, divided by the organs or bodily functions involved with the impairment. They include the following:

  • Musculoskeletal Disorders
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

Under each one of these subheadings the Social Security Administration lists several diseases, impairments, and conditions which are required to have specific features, measurements, lab test results, x-rays, or other usually objectively confirmable symptoms and limitations. If a claimant’s medical records show the presence of the required elements, then disability benefits are sure to be approved.

However, if a claimant’s impairment fails to meet one of the listed criteria, then they may not be approved unless other factors or other impairments claimed in the application weigh the scales in their favor. Often, this is one of the key values of having a skilled and experienced disability handle your Social Security disability claim.

The purpose of the Blue Book is to remove as much subjectivity from the claim evaluation process as possible. For example, if a listed disability requires medical records to include a lab test result equal to a set number, those claimants whose medical records include that test result will usually be approved for disability benefits. Of course, each impairment has specific criteria that the claim must meet to “match” a “Blue Book” listed disability.

Get Expert Help Qualifying for Social Security Disability

Any person thinking about filing a disability claim can become confused by the Social Security Administration. Even many lawyers who are unfamiliar with the forms, the terminology, and the process can make errors.

Our disability law team includes highly trained expert advocates who work with disability claims every day. We can help you or your family member find out all you need to know about disability benefits and then help you prepare, file for, and win approval of the SSD or SSI benefits to which you are entitled.