The Census Bureau reports that roughly one out of every five Americans is living with some sort of disability. Considering the total population of the country, that adds up to approximately 58 million individuals. Among them, millions receive monthly disability benefits through the SSA, or Social Security Administration. But what if your health condition is not included in the SSA’s “Blue Book,” or Listing of Impairments? Can you still qualify?
The SSA Blue Book serves as a guide for case specialists in their job of determining if an applicant is eligible for Social Security Disability benefits. Every medical condition or impairment includes a list of required criteria the applicant must meet. The specialist assigned to your case will review your application and medical evidence to see if your condition meets the listing’s required criteria. However, the Blue Book does not include every possible condition that impairs an individual’s ability to work. While you could still qualify without a listed condition, it is much more difficult. You should have our experienced Fayetteville AR disability lawyers handling your case.
The majority of Social Security claims are denied – including those from applications with listed conditions. If you do not take the application process seriously, your benefits will likely be denied. For individuals suffering from an unlisted condition, the road to approval is even more challenging. Our team of seasoned attorneys has been helping people obtain the benefits they desperately need. Call (479) 316-0438 to confidentially discuss your condition and options.
What is the SSA Listing of Impairments?
In order to qualify for benefits, it is not “enough” to have a health condition: that condition must be so severe that it constitutes a disability that stops you from working. (In other words, a medical issue that is mild and easily managed is unlikely to qualify you.)
In order to find out whether or not an impairment can be categorized as severe, the SSA uses a reference called the Listing of Impairments. The Listing lays out guidelines for evaluating many different disabilities… But not all of them.
What if Your Condition is Not Listed in the SSA’s Listing of Impairments in Arkansas
Unfortunately, it is not uncommon for someone to be entirely disabled yet not suffering from a condition that meets the requirements of a listed medical condition. For example, you might be experiencing symptoms from several different illnesses that severely limit your ability to work, but they do not meet one specific listed impairment.
When a condition does not match the listed requirements of a qualifying impairment, the SSA will have to determine if the condition is similar enough in severity to another listed impairment. To do this, our Arkansas Social Security Disability lawyers will have to gather medical evidence to establish your condition is “equal” to a listed impairment.
Proving that a condition is equal is usually accomplished in one of two ways.
First, an applicant must demonstrate that their unlisted condition is similar in severity to an impairment listed in the Blue Book. For instance, a person might be unable to work due to frequent and severe migraine headaches. Migraines are not listed in the SSA’s Blue Book. However, if you could establish that the effects of your migraines are comparable to the symptoms of non-convulsive seizures, a listed impairment, you might qualify for disability benefits.
It is possible to suffer from multiple minor conditions that have a similar effect as a more severe medical condition. For instance, you might not be able to perform your job duties because you have arthritis in your hands, are diabetic, and have severe high blood pressure. In nearly every case, none of these conditions would qualify for disability benefits. However, if someone suffers from all of the listed medical problems, the combined conditions might be severe enough to equal the severity of another listing.
The crucial component is providing sufficient medical evidence, including a statement from your treating doctor, to prove that your condition is equal in severity to a listed impairment and that your ability to work is compromised.
Qualifying for Disability With a Medical Vocational Allowance
Fortunately, not having a listed condition does disqualify you as a benefits candidate. You may be able to have your claim approved based on something called medical-vocational allowance.
A claims examiner from Arkansas Disability Determination will forward your application to an SSA medical professional. Your claim will be thoroughly evaluated, including:
- Medical Documentation
- Doctor Notes
- RFC (Residual Functional Capacity)
Essentially, “Residual Functional Capacity” is an elaborate way of phrasing the question, “What can you do? What sort of work can you perform or not perform?”
On the physical side, RFC is a scale with “functional capacities” ranging from sedentary work only, to very heavy physical labor. For example, an elderly individual with chronic heart problems may be restricted to sedentary work due to the health risks involved.
On the mental side, RFC is evaluated by a psychologist or a psychiatrist. Needless to say, the mental aspect of RFC is not concerned with bodily limitations. Instead, the mental component of RFC takes matters like memory, logic, and concentration into consideration.
Qualifying for Disability with Compassionate Allowances
In addition to medical-vocational allowances, the SSA also observes compassionate allowances.
The list of compassionate allowances includes many conditions which are disabling, but which are also so rare and uncommon that they simply are not mentioned in the Listing of Impairments. While claims processing normally takes months (or even years in some cases), CAL fast-tracks reviews to be completed within a matter of weeks.
Some CAL disabilities do also appear on the Listing.
At the time of this writing, there are hundreds of health issues that could qualify you for monthly benefits under compassionate allowances. To name just a small sample of covered rare conditions:
- Alpers Disease
- Batten Disease
- Creutzfeldt-Jakob Disease (CJD)
- Dravet Syndrome
- Erdheim Chester Disease
- Fatal Familial Insomnia
- Hepatorenal Syndrome
- Leigh’s Disease
- Lowe Syndrome
- Multicentric Castleman Disease
- Ohtahara Syndrome
- Wolf-Hirschhorn Syndrome
Reasons Why the SSA Denies an Application Based on an Unlisted Medical Condition in Arkansas
As stated above, more applications are denied by the SSA than are approved. While you might believe your application was denied because your condition was not listed in the Blue Book, this might not be the case. In some cases, an impairment could be severe enough to qualify for disability benefits but either the application was insufficient or the claimant made a mistake during the process. Fortunately, there is an appeals process in place to challenge a denial. The first step is to understand why your claim was denied.
One of the main reasons why Social Security Disability benefits claims are denied is because the applicant failed to provide enough medical proof that their impairment was severe enough to make it impossible to work. If your condition is not listed in the Blue Book, it is even more important to provide medical documentation that describes the symptoms of your condition and how those symptoms adversely impact your ability to perform the necessary tasks to perform your job.
Not Following Medical Treatment
Providing medical evidence of your diagnosis and symptoms is not enough. You also must prove that you are following your doctor’s treatment. If you are not following your doctor’s orders, the SSA might conclude that your condition could improve with medication, physical therapy, or other treatment. The Social Security Administration is not only looking at the present state of your condition; it needs to determine that your condition is unlikely to improve. If there was a specific reason why you could not follow through with a treatment plan, it needs to be addressed in your appeal.
Being Uncooperative With the Social Security Administration
When you apply for benefits, the SSA will review the information you provide to determine if you suffer from a qualifying condition. During this process, the SSA could ask for additional information or request that you undergo an additional medical examination. If you refuse to comply or are uncooperative, your claim will likely be denied. You should also comply quickly. Delaying sending requested documents could also result in a denial.
The list above is only partial. A claim could be denied because a claimant is capable of earning a living, filed an additional claim, or numerous other errors or omissions. Having our Arkansas disability attorneys representing you could help avoid some of the common mistakes that occur. Our office is also available to help you with the appeals process.
Our Experienced Arkansas Social Security Lawyers Can Help You, Even if Your Condition is Not Listed
If you are applying for Social Security Disability benefits with a listed condition, you should have a competent attorney at your side. If your condition is not listed, then it is even more critical to have our experienced Bentonville Social Security Lawyers assisting you. If you or someone you love is interested in having a claim approved, call our law offices right away at (479) 316-0438 to schedule your private legal consultation.