The “listed” medical conditions for social security disability – the so-called “Listings” – are a source of great confusion. Social Security maintains a so-called “Blue Book” of impairments and criteria regarding their severity that the Social Security Administration (SSA) considers severe enough to prevent an adult from doing substantial gainful activity – regardless of age, work background or education.
They include a set of criteria – medical findings, symptoms and sometimes functional limitations – that SSA uses to determine whether a condition is severe enough to meet a Listing. For example, a person with inflammatory arthritis can meet Listing 14.09B if they have inflammation or deformity in one or more major joints of an upper or lower extremity, involvement of two or more organs/body systems with at least one affected to a moderate level of severity, and at least two constitutional symptoms or signs: severe fatigue, fever, malaise, or involuntary weight loss.
There are more details about meeting the listing for inflammatory arthritis, but the Listings set out specific criteria that can establish disability without evaluating your ability to do past work or adjust to other work. The duration requirement and other requirements for benefits still apply.
The confusion about social security disability “listings” arises due to the following:
Not all conditions that could provide the basis for social security disability benefit approval are set out in the listings
Social Security disability applicants who do not find a “Listing” for their medical condition often wrongly conclude that social security disability benefits are not available to them. The Listings represent the most common impairments and illnesses but are not an exhaustive list of conditions that support disability benefit payment. You can still qualify for social security disability benefits even if your condition has no “Listing”. The Listings are not an all-inclusive list of all the impairments and diagnosed conditions that could provide the basis of social security disability benefits.
Just being diagnosed with a “listed” condition is not enough: your condition must have the specific diagnostic findings and evidence set out in the “Listing”
Disability applicants who find their condition is “on the list” often wrongfully conclude that their approval for disability benefits will be automatic. The “compassionate allowance” list has perhaps contributed to the wrong perception that a listing-based disability approval is all about the diagnosis of a given condition alone. Compassionate Allowances help SSA identify certain serious conditions for faster decisions; they are not a substitute for documenting the condition and meeting the other requirements for benefits.
OK—I am being a little lawyerly, aren’t I? Here is a perhaps silly but helpful way to look at it:
Imagine the listing for chronic venous insufficiency set out like a familiar TV commercial for a medication. The “paid spokesman” in my silly TV ad might say something like this:
“Did you know that 9 out of 10 medical experts agree you deserve disability benefits for your chronic venous insufficiency if you have:
Chronic venous insufficiency of a lower extremity with incompetency or obstruction of the deep venous system, AND one of the following:
- Extensive brawny edema involving at least two-thirds of the leg between the ankle and knee, or at least the distal one-third of the lower extremity between the ankle and hip; OR
- Superficial varicosities, stasis dermatitis, and either recurrent ulceration or persistent ulceration that has not healed following at least 3 months of prescribed treatment?”
OK, I did not say it would be a great commercial. Perhaps a better way to look at it is to focus on the key phrase “Listing”. We can say that a “Listing” is a list of the diagnostic findings, symptoms or limitations that establish the required severity for a given condition – not just the name of the condition.
Failure to Meet the Listing Criteria for your Impairment is not the End of Your Disability Case
This is perhaps the most common misunderstanding about the Listings. Many disability applicants look at the listing for their condition, find they do not meet the criteria, and wrongly conclude they cannot get social security disability.
A listed condition that does not meet the criteria for the Listing can STILL qualify for social security disability benefits.
The Social Security Administration uses a “sequential evaluation process” (see what I mean by “obtuse terminology”?): a step-by-step analysis of an adult disability claim.
“Meeting a listing” refers to the disability decisionmaker finding that the criteria for the listed condition are met. I like to analogize “meeting a listing” to the judge finding a “short cut” to a favorable decision.
SSA also considers whether your impairment, or combination of impairments, medically equals a Listing – meaning it is at least equal in severity and duration to the Listing’s criteria.
There is, however, widespread confusion about what NOT meeting or medically equaling a Listing means. It does NOT mean the case is denied. It simply means the decisionmaker must move on in the sequential evaluation process, assessing what you can still do despite your impairments and whether you can do your past relevant work or adjust to other work.