As you might have guessed, the Social Security Administration (SSA) has a set of procedures in place to identify disabilities that are medically eligible for benefits. These procedures are published in a handbook affectionately known as the “Blue Book,” and include a list of various disabling conditions known as “listings.”
“The Blue Book is a manual published by the Social Security Administration which summarizes many of the relevant statutes that apply to the evaluation of a Social Security Disability claim,” said Samuel K. Silverman, a disability law attorney in Michigan. “An adult can be found disabled if they meet [the criteria of] one of the listings in the Blue Book or if they cannot perform their past work or other relevant work in the economy.”
The Blue Book is broken up into two parts, one for adults and one for children. Each part is then divided into sections that contain the various disabilities by category. The adult manual currently features these 14 sections:
- Musculoskeletal Problems – e.g. back injuries
- Special Senses and Speech – e.g. blindness, deafness
- Respiratory System – e.g. asthma, cystic fibrosis
- Cardiovascular System – e.g. heart failure
- Digestive System – e.g. liver disease, irritable bowel disease
- Genitourinary Impairments – e.g. chronic kidney disease
- Hematological Disorders – e.g. sickle cell disease
- Skin Disorders – e.g. dermatitis
- Endocrine Disorders – e.g. diabetes, hyperglycemia
- Congenital Disorders that Affect Multiple Body Systems – e.g. Down syndrome
- Neurological – e.g. epilepsy, brain tumors
- Mental Disorders – e.g schizophrenia, anxiety
- Malignant Neoplastic Diseases – e.g. lymphoma, breast cancer
- Immune System Disorders – e.g. HIV/AIDs, Sjogren’s syndrome
Each condition in the Blue Book lists specific criteria and symptoms you must meet in order to qualify for an automatic disability approval. This is known as meeting the listing. Each listing will often include specific clinical and laboratory tests required to make an evaluation as well.
While going through the Social Security disability process, it’s a good idea to work closely with your doctor to review what medical evidence the SSA will want when determining whether your condition is disabling.
“I have recommended patients review Blue Book listings in the past,” said Dr. Shirin Peters, M.D., primary care doctor and owner of Bethany Medical Clinic of New York in Midtown Manhattan. “Often I refer my patients to an occupational or disability specialist to help navigate this process, as it can be complex.”
Silverman echoed that advice.
“In every case, a claimant should provide opinions from their doctors regarding their limitations and inability to sustain full-time employment without unscheduled breaks and/or days off. A treating doctor’s opinions are supposed to be given the most weight when a disability claim is evaluated. A doctor who is a specialist is supposed to be given more weight than a general doctor. If a doctor’s opinion is supported by objective medical evidence, the opinions are supposed to be given even greater weight. An experienced attorney can guide a doctor through that process,” he said.
However, if the SSA’s Blue Book doesn’t list your condition, that doesn’t mean you can’t qualify for benefits.
“Even if your condition is not specifically listed in the Blue Book, you can still equal a listing if you have a condition that can be evaluated by a listing in the Blue Book which is appropriate when applied to your condition,” said Silverman. “Many factors are taken in account when a decision is made regarding a disability case. Factors such as work history, the severity of your condition, the type of condition suffered from, as well as your age are taken into account.”
Even multiple conditions with varying severities will be evaluated when you are applying for Social Security disability benefits.
“The Social Security Administration does not look at a person’s conditions individually in a vacuum. It is very common that an individual can be found disabled without suffering from a condition that meets a Blue Book Listing. Vocational experts testify at hearings that even missing three days of work a month on a regular basis will preclude a person from performing gainful employment,” said Silverman
It’s important to work with your doctor to understand whether or not your condition meets the Blue Book listing criteria, or if there is a way you can show that you equal it. If not, you’ll have to work extra closely with her in order to document the ways in which your condition limits your abilities to work.
“I do recommend at times that patients apply for disability benefits,” said Peters. “You should seek advice from your primary care provider, but ask to be directed to an occupational or disability specialist to help navigate through the initial process of qualifying for disability benefits for the first time.”
For more information on the ways you can work with your doctor during the Social Security disability process, read our article on “How Your Doctor Can Help You Get Approved for Social Security.”