The Social Security Disability evaluation process may seem arbitrary to many people in Chicago. However, the Social Security Administration uses two specific tools to determine whether a person is disabled. “Blue Book” impairment listings contain guidelines for evaluating specific medical conditions, while medical-vocational grids establish rules for determining ability to work. People seeking SSD benefits should understand how disability is evaluated under both.
For every Blue Book condition, the SSA provides criteria used to determine whether the condition is disabling. In most cases, specific symptoms, tests or clinical findings are listed. For some conditions, including immune system and mental disorders, the SSA also establishes functional criteria an individual can qualify under. These typically include:
- Difficulty performing activities of daily living
- Inability to function appropriately in social settings
- Challenges maintaining focus or pace and completing tasks
If a person suffers from a listed condition and meets the related criteria, the person is automatically considered disabled from a medical standpoint. If a person does not meet every criterion, the SSA might find the person “equals” the impairment listing. This happens when a person suffers from unlisted symptoms or accompanying medical conditions that, collectively, are as disabling as a listed condition.
Many disabling conditions do not meet the Blue Book terms. Some conditions are not even listed in the book. If a person cannot qualify for disability benefits by meeting or equaling an impairment listing, the SSA considers the person’s functional capabilities. A person may qualify for a medical-vocational allowance if his or her condition significantly impedes daily activities and gainful employment.
When granting a medical-vocational allowance, the SSA analyzes the person’s Residual Functional Capacity, or remaining physical abilities. Based on RFC, the SSA decides whether the individual is capable of sedentary, light, medium, heavy or very heavy work. Then, the SSA evaluates whether the individual’s education, experience and skills support the work the individual can perform.
If an individual cannot perform past jobs but can theoretically perform a new type of work, the SSA consults the medical-vocational grids. The grids specify cases when switching to another line of work might not be reasonable, given an individual’s knowledge and capabilities. There are four grids, based on different age groups. Each grid indicates whether an applicant should be found disabled, based on educational level, relevant skill sets and RFC.
Under the grid guidelines, older individuals, particularly those with limited educations and a history of heavy work, are more likely to be found disabled. However, this is not a certainty, especially if an applicant’s medical condition and work history are not properly documented.