When the Social Security Administration’s claims examiners review applications for disability benefits, they refer to a document called the “Blue Book,” or Listing of Impairments. The Listing of Impairments is precisely what it sounds like: a catalog of medical issues that can qualify you for assistance. While the Listing is quite extensive, it obviously does not cover every possible condition in existence. So, what happens if you have a rare disease which is not included in the Blue Book? Can you still be approved for disability? The short answer is “you could.” However, you will have to prove that your disability severely impacts your ability to work. Below, Ken Kieklak, an experienced Fayetteville Social Security Disability attorney, looks at rare conditions in more detail.
The Blue Book and Disability Benefits in Arkansas
The Disability Evaluation Under Social Security is the actual name of the SSA’s publication, commonly known as the Blue Book. This publication is designed for healthcare professionals to use when determining if a disability claimant is eligible for Social Security benefits. The Blue Book lists the qualifying medical conditions and impairments.
More specifically, the Blue Book contains an extensive list of medical conditions, broken down into two categories: adult and children. In addition to the list of conditions, the applicable evidentiary sources are detailed, including what types of reports and exams the SSA will consider.
Qualifying for Disability With Compassionate Allowances (CAL) in Arkansas
While fairly comprehensive, the SSA’s official Listing of Impairments tends to stick to the basics. You can easily find information related to common conditions like arthritis, asthma, or diabetes — but what if your condition is uncommon? What if your disability is so rare that it simply does not appear in the Listing of Impairments? Are you out of luck?
Fortunately, the answer is no. You may be able to qualify via the compassionate allowances (CAL) route.
Under the best of circumstances, SSA disability claims processing can take months at best and years at worst. The purpose of CAL is to prioritize extremely severe cases so that claimants with the greatest need receive expedited assistance. Many rare illnesses have a CAL classification, as the lack of ready medical familiarity could otherwise create debilitating or even deadly delays.
The National Organization for Rare Disorders, or NORD, works together with the SSA to help augment the existing list of CAL disabilities. A statement from NORD’s website says, “The rare disease community remains hopeful that the compassionate allowances program will be expanded to include every rare disease that prohibits substantial gainful activity. NORD will continue to support those hopes and work with our allies until this goal is accomplished.”
Uncommon Conditions That Can Qualify You For Benefits in Arkansas
The CAL list grows all the time. At the time of this writing, the list already includes several hundred conditions, many of which are uncommon.
Some of the new CAL disabilities recently added to the official list include:
• Coffin-Lowry Syndrome
• Hoyeaal-Hreidarsson Syndrome
• Joubert Syndrome
• Marshall-Smith Syndrome
• Pallister-Killian Syndrome
• Revesz Syndrome
• Seckel Syndrome
These are just a few of the latest additions. Other uncommon illnesses which can qualify you for benefits through the CAL program include:
• Alexander Disease
• Alstrom Syndrome
• Cornelia de Lange Syndrome
• Degos Disease (Systemic)
• DeSanctis Cacchione Syndrome
• Eisenmenger Syndrome
• Erdheim Chester Disease
• Gaucher Disease (Type 2)
• Hutchinson-Gilford Progeria Syndrome
• Hypoplastic Left Heart Syndrome
• Infantile Free Sialic Acid Storage Disease
• Jervell and Lange-Nielsen Syndrome
• Lewy Body Dementia
• Maple Syrup Urine Disease (MSUD)
• Ohtahara Syndrome
• Schindler Disease (Type 1)
• Walker Warburg Syndrome
• Wolf-Hirschhorn Syndrome
You can view the complete list of CAL conditions here.
If you or someone you love is living with a rare or uncommon medical condition, your claim could be approved through the CAL program. Unfortunately, qualifying for monthly benefits is an enormous challenge. In 2020, the average approval rate in Arkansas was a dismal 37% — meaning roughly two-thirds of applicants will be turned away.
Available Disability Benefits in Arkansas
The SSA administers two different types of benefit programs for induvial who suffer from a disability.
Social Security Disability Insurance (SSDI) is available to individuals who have worked and paid into Social Security through their employment taxes. To be eligible for SSDI, you must have accumulated enough work credits and suffer from a physical or mental condition that makes it impossible to earn a living. According to the SSA, your impairment must last at least 12 months or result in death.
Supplemental Security Income (SSI) is typically for people over the age of 65 who have limited income or resources. However, if you have a qualified disability, including a rare condition, you could also be eligible for SSI. Unlike SSDI, you are not required to have worked to receive SSI benefits. However, because SSI is need-based, you must have significantly limited income and resources.
Our seasoned Social Security Disability lawyer will work with you to determine if you meet the financial requirements for either program. However, for both SSI and SSDI, you will be required to provide sufficient evidence of your medical condition.
Proving That You Have a Rare Condition in Arkansas
Typically, to qualify for disability benefits in Arkansas, you must meet the criteria for a condition listed in the Blue Book. If your exact condition is not listed, as is the case with most rare conditions, you could symptoms could meet the criteria for a common impairment. An applicant would have to demonstrate that their condition had a similar impact to an already listed impairment.
For example, you might suffer from a rare condition that adversely impacts your vision. While your exact condition might not be listed in the Blue Book, you could find similar symptoms and criteria under Section 2.02 or Section 2.04, which cover loss of visual acuity and efficiency. Depending on the severity of your vision loss, you could qualify for Social Security Disability benefits because your medical qualifications are equal to a listed condition in the Blue Book.
Medical Documentation is Crucial in Being Approved for Disability Benefits in Arkansas
As stated above, over 60% of all disability applications are denied in Arkansas. These denials are not only people with rare conditions – they include individuals with impairments that are listed in the Blue Book as well. Because the process is challenging even if you have a listed medical condition, it is essential to have an experienced Bentonville Social Security Disability attorney at your side. Many claims are dismissed for omissions or errors committed during the process, such as missing an important deadline. Our office will help alleviate many of those common mistakes. However, one of the main reasons applications for benefits are denied is a lack of supporting medical documentation.
To be approved for disability benefits, it is critical to provide convincing and compelling medical evidence of your condition and its adverse impact on your ability to engage in a substantial gainful activity (SGA). SGA is the SSA’s financial threshold for qualifying for disability. If you are capable of earning $1,310 or more, as of 2021, you are not eligible for benefits.
One important document your treating physician will complete is a residual functioning capacity form (RFC). The RFC will detail what you are physically and mentally capable of doing or not doing. For example, your RFC might state that you are unable to stand for a period of more than ten minutes.
Your physician could also provide a written medical statement regarding your condition. The evidence you present to the SSA must support the fact that you cannot engage in SGA. Therefore, the medical statement should be more detailed than a doctor’s opinion that you “are disabled.” The statement should recount your medical history, treatments, hospital stays, symptoms, prognosis, and relate how your condition specifically impacts your ability to work. If you have multiple doctors, it is a good idea to provide statements from each. Our Rogers Social Security Disability attorney can provide guidance on exactly what a doctor’s statement should include.
Providing medical documentation and evidence is only part of the equation. You need to be sure to keep your medical appointments, especially if you are seeing any specialists. Additionally, it is vital to maintain any treatment or medication regimens. Keeping a record of these visits and treatments will also improve the chances of having your claim approved.
Rare Conditions Are Evaluated on a Case-By-Case Basis in Arkansas
There is no one answer or method to pursue when applying for Social Security benefits with a rare condition. The SSA will evaluate some cases of rare conditions on a case-by-case basis. You should have a knowledgeable Arkansas Social Security Disability attorney advocating for your interests. With experienced help, you increase the odds of having your disability claim approved. This is especially the case if when your condition is not listed in the Blue Book.
If You Have a Rare Medical Condition, Contact Our Experienced Arkansas Social Security Disability Attorney
Applying for disability benefits is challenging under the best of circumstances. If you suffer from a rare condition that is not listed in SSA’s Blue Book, you should have a skilled Social Security Disability attorney handling your claim. Ken Kieklak, Attorney at Law, will evaluate your case during a free and confidential consultation. To schedule an appointment, call our office at (479) 316-0438.
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