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What Conditions Automatically Qualify You For Disability?

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What Conditions Automatically Qualify You For Disability?

There are no impairments that “automatically” qualify for disability benefits, but some illnesses and conditions do qualify for accelerated consideration and receive “expedited rulings” about 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.”


In this blog post, we’ll explain how the SSA publishes a list of injuries, illnesses, and conditions referred to as “Blue Book” in which many disabling impairments are identified 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 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 the claim will be processed initially, assessed fully, and issued a decision whether to grant or deny the claim for benefits.


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:


  • 1). Musculoskeletal Disorders
  • 2). Special Senses and Speech
  • 3). Respiratory Disorders
  • 4). Cardiovascular System
  • 5). Digestive System
  • 6). Genitourinary Disorders
  • 7). Hematological Disorders
  • 8). Skin Disorders
  • 9). Endocrine Disorders
  • 10). Congenital Disorders that Affect Multiple Body Systems
  • 11). Neurological Disorders
  • 12). Mental Disorders
  • 13). Cancer (Malignant Neoplastic Diseases)
  • 14). 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 listed criteria, 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.


The purpose of the Blue Book is to remove as much subjective interpretation from the process of evaluating these claims 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 be approved for disability benefits. Of course, each impairment has numerous specific criteria the claim must meet to “match” a listed disability.


Compassionate Allowance List(CAL) Conditions


Conditions listed as qualifying for Compassionate Allowance (CAL) include illnesses, diseases, conditions, and impairments 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” diseases, illnesses, conditions, and impairments that the claimant is suffering with. By having a claim submitted that identifies the disease by name, 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, should separate the claim from the mass of others and designate the claim for special, speedier assessment by a claim examiner with knowledge about that disease. The current roster of Compassionate Allowance List conditions can be found here.


Get Expert Help Qualifying for Social Security Disability


Filing a disability claim can be very confusing, even for attorneys who are unfamiliar with the forms, the terminology, and process. At londondisability.com, Attorney Scott London maintains a full team of highly trained expert advocates who work with disability claims every day.


London Disability Advocates for Social Security Disability can help you or your family member find out all you need to know about your eligibility for disability benefits and then help you prepare, file for, and win approval of the SSD or SSI benefits to which you are entitled.