If you are applying for Social Security disability, there are three arguments you can use to claim benefits:
No matter what argument you use, your goal is the same: satisfy Social Security's definition of disability. SSA defines disability as the inability to perform substantial activity because of a medically determinable condition or conditions that has lasted or is expected to last 12 consecutive months or result in death.
This article will focus on the Social Security listing argument.
Social Security recognizes that certain medical conditions are so serious that if you are diagnosed with one of these conditions it is reasonable to assume that you would not be able to "perform substantial activity" (work at even a simple, entry level job reliably).
Social Security publishes its listings in something called the "Blue Book," which you can access by clicking on the link below.
The listings divide the body into 14 different "body systems." These include diseases of various organs (kidney, liver, heart), bones and joints, the immune system, cancer and mental impairments.
Generally, if you hope to meet a listing you will need to show:
My firm's experience has been that Social Security makes it very difficult to meet a listing by making the standards of the various listing level conditions very strict. For example, one of the cardiac listings requires that your heart function be 30% or less. One of the orthopedic listing requires proof that you cannot walk without a cane or walker for a year or longer.
We also find that most listing level cases are identified early on in the process and approved at the initial application phase. Occasionally judges approve cases on the listings at hearings but this is fairly rare.
Sometimes, a listing level case slips through the cracks because the Social Security adjudicator evaluating your case does not have all records from your treating doctor. Understand that these claims reps request records from all of the medical sources your identify but if your doctor does not send in these records, the adjudicator usually does not have the time to call or mail a follow-up request.
Further, your doctor's records are focused on your medical condition and treatment, not on Social Security's standards or language. One of the benefits of having a lawyer represent you will be the lawyer's followup and the lawyer's use of checklist forms and questionnaires to help the doctor speak SSA's language.
If you apply for disability benefits and are denied, do not give up! Even if the medical evidence in your case does not meet or equal a listing, you still may be eligible under a different argument.