Social Security Disability benefits assist people who cannot work due to disabling impairments. Both physical and mental conditions may be considered disabling. However, the Social Security Administration follows strict standards when evaluating disability.
Disabling conditions must be expected to last at least 12 months or result in death. Additionally, these conditions must prevent substantial gainful activity, or work with monthly income over $1,070. If these criteria are met, the SSA has a few ways to determine whether a condition qualifies for SSD benefits.
The Social Security Administration lists conditions that it recognizes as disabling in the book Disability Evaluation Under Social Security. The “Blue Book” divides impairments into 14 categories:
- Impairments affecting the musculoskeletal, respiratory, cardiovascular, digestive or immune system
- Mental disorders, neurological conditions and disorders affecting speech or senses
- Hematological, endocrine, genitourinary and skin disorders
- Congenital disorders affecting various systems
- Malignant neoplastic diseases
Listed conditions are automatically considered disabling if the victim meets specified criteria. These criteria may consist of observed symptoms or objective findings from medical tests. For some conditions, the SSA additionally establishes criteria that describe the daily functional effects of the condition. SSD applicants must meet one set of criteria to qualify medically for benefits.
Many people’s disabling conditions do not meet the specific terms established in the Blue Book. Furthermore, some debilitating conditions are excluded from the book. Fortunately, the SSA has other means of evaluating these conditions.
If a condition does not exactly meet the listing requirements, the SSA may still find that it “equals” the relevant listing. The symptoms or limitations the applicant experiences must be equal in severity to those established in the Blue Book.
The SSA uses two criteria to determine whether unlisted conditions are disabling. First, the condition must be a medically determinable impairment. Laboratory tests and other clinical findings must support the existence of the condition and the diagnosis. Second, the condition must significantly limit the victim’s Residual Functional Capacity.
RFC indicates the level of physical or mental activity a person is capable of. The physical evaluation focuses on work-related tasks, such as lifting items repeatedly or standing for long periods. The mental evaluation details whether the individual can meet the cognitive demands of the workplace. The individual’s concentration, memory and learning ability may all be considered.
The SSA awards SSD benefits if an individual’s RFC prevents him or her from performing gainful work. Often, the SSA must also consider the individual’s education, age and work experience. Some SSD applicants may be physically capable of sedentary work yet not reasonably qualified for it. Thus, in some cases, an individual’s education and relevant skill set are decisive in determining whether a condition is considered disabling.