For many people in Arkansas, Social Security Disability benefits a vital part of their monthly income. However, many people are unaware that their condition or impairment makes them eligible for disability. The Social Security Administration (SSA) has a resource, known as the Blue Book, that lists the medical conditions that qualify for disability.
Knowing you have an eligible condition is only part of the process. You still have to prove to the SSA that your condition meets the listed requirements. This is true whether you are applying for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits.
Our Fayetteville disability lawyers have been representing people with medical impairments or medical disabilities for decades. Our office will help you gather medical evidence, complete an application, or file an appeal. Call (479) 316-0438 to see what we can do for you.
Do I Need a Work History to Qualify for Social Security Disability Income (SSDI) in Arkansas?
One way to think about SSDI is as an ordinary insurance policy. You pay monthly premiums through FICA taxes deducted from your paycheck. If you become disabled or have a medical condition that makes it impossible to work, you are entitled to monthly financial benefits under the insurance policy. Because you have to pay into the system, you need a work history to qualify for SSDI.
The SSA requires an SSDI applicant to have worked a certain number of years, paying into Social Security taxes, to qualify for benefits. An individual can earn up to four “work credits” per year. To max out your work credits in 2022, you will have to earn at least $6,400. Typically, an applicant must have at least 20 credits earned within the past ten years. However, the amount does vary depending on the applicant’s age.
Do I Qualify for Supplemental Security Income (SSI)?
Unlike SSDI, you do not have to have a work history to qualify for SSI. Because SSI is a needs-based program, the SSA will look at an applicant’s income and resources to determine eligibility. If you are single, your total resources and assets cannot exceed $2,000. The SSA defines assets and resources as any property that could be used for food or shelter. Basically, everything a person owns, property, savings accounts, or other valuables, are resources. There are some notable exceptions, such as your home or vehicle. For a married couple, the threshold increases to $3,000.
For both SSDI and SSI, you still must suffer from a medical condition or impairment that prevents you from earning a living.
What is the SSA’s 5-Step Disability Determination?
Whether you apply for SSI or SSDI benefits, the Social Security Administration will make a disability determination to see if you are eligible. The SSA employs a 5-step process to determine if an adult applicant qualifies.
Step One: Are You Working
If you are working, you might not be eligible for disability benefits. The SSA will determine if you are engaging in substantial gainful activity (SGA). If you make more than $1,350 (or $2,260 for blind applicants), you will not be eligible for Social Security Disability benefits.
Step Two: Do You Have a Severe Medical Condition
An SSA claims examiner will evaluate your application to determine if your impairment or medical condition interferes with your ability to perform basic activities, such as standing, walking, sitting, lifting, or speaking. If the medical evidence fails to establish this, your claim will be denied.
Step Three: Is Your Medical Condition Listed in the SSA’s “Blue Book?”
The Social Security Administration publishes a Listing of Impairments commonly referred to as the “Blue Book.” This listing contains over 100 physical and mental conditions that qualify for disability benefits. Along with the listed conditions are the criteria that must be met to prove that your impairment qualifies. When someone has a severe condition that is not listed, our Arkansas disability lawyers will try to show that it meets the requirements of one or more other listed conditions.
Step Four: Can You do Other Relevant Past Work?
If your medical condition does not meet a published listing, the claims examiner will evaluate whether your impairment prohibits you from performing the tasks associated with past work.
Step Five: Can You Do Any Type of Work?
If the claims examiner determines that your medical condition prohibits engaging in any past work, they will consider if your impairment prohibits all other types of work. When making this determination, the claims examiner will look at your medical condition, age, education, experience, and what transferable skills you might have. If it is determined that you could adjust to another form of employment, your claim will be denied.
What Qualifies as a Severe Impairment?
A severe impairment, as defined by the Social Security Administration, is an impairment or a combination of conditions that significantly limit a person’s physical or mental abilities. These limitations substantially interfere with the person’s ability to perform basic work-related tasks. If a medical condition or impairment does not significantly limit the person’s ability to work, it is not a severe impairment according to the SSA. If you do not suffer from a severe impairment, you will not be eligible for disability benefits.
How Does The SSA Evaluate the Level of Severity for a Disability?
A claimant could submit an application to Social Security by telephone, mail, or online. The application and other forms request a description of the medical condition, treatment sources, and other evidence or documentation that supports the alleged disability. The SSA field office is tasked with reviewing an application for non-medical requirements, including age, marital status, employment, work credits, and Social Security coverage information. Once completed, the applications are forwarded to Disability Determination Services (DDS) for evaluation of disability. The DDS is a state agency, funded by the federal government, responsible for developing and reviewing medical evidence in order to render an initial determination on whether a claimant’s medical condition qualifies as a disability for benefits purposes.
In most cases, the DDS will want evidence from the claimant’s primary medical sources. If the information is unavailable or inconclusive, the DDS could request a consultative examination (CE) to obtain additional medical evidence. To improve your chances of approval, it is best to provide the required medical evidence. Relying on the CE would likely result in a denial.
Once the DDS has evaluated the available medical evidence, it will make the initial disability determination. After the decision is rendered, the application is returned to the appropriate field office to take steps in accordance with the decision. If the DDS believes the medical evidence was sufficient to establish a qualifying disability, the SSA will compute the benefit amount and begin disbursing monthly payments. If the DDS denies the application, the file is maintained at the field office in case the claimant appeals the decision.
Listed Conditions that Qualify for Disability Benefits
The SSA maintains a published list of medical conditions that are almost considered automatically disabling. This list of impairments is often called the “Blue Book.” Each listing describes the condition, symptoms, and requirements a person must meet to qualify for the specific condition. Below is a list of the included disorders and impairments that could qualify you for SSDI or SSI benefits.
- Cardiovascular System Disorders
- Congenital Disorders
- Digestive System Disorders
- Endocrine Disorders
- Genitourinary Disorders
- Hematological Disorders
- Immune System Disorders
- Mental Disorders
- Musculoskeletal Disorders
- Neurological Disorders
- Respiratory Disorders
- Skin Disorders
- Special Senses And Speech
Medical Conditions That Automatically Qualify You for Disability
The SSA publishes a “Listing of Medical Impairments.” This comprehensive list is often referred to as the “Blue Book.” The listed impairments will automatically qualify an applicant for SSDI or SSI, provided specific conditions are met. In addition to a medical disability, there are income, age, and resources thresholds a claimant must meet, depending on the program.
Unfortunately, the application process could take months to years to complete. This poses a problem for people suffering from severely debilitating conditions or terminal illnesses. To address this issue, the SSA created the Compassionate Allowance program. Conditions that qualify for CAL are expedited. Instead of months or years, a claimant could have their benefits approved in a matter of weeks.
When originally implemented in 2008, the CAL listed approximately 50 specific conditions. Currently, the list of medical impairments numbers over 200. A claimant does not have to do anything special to qualify for Compassionate Allowance. When the SSA is reviewing an application, it will look to determine if the forms list a listed condition that is supported by medical evidence. If this is the case, the application will be expedited.
Some of the included conditions are listed below.
- Acute leukemia
- Inflammatory breast cancer
- Stage IV breast cancer
- Early-onset Alzheimer’s disease
- Pancreatic cancer
The above list is not exhaustive. If you have any questions about eligible conditions, contact our Arkansas disability attorneys.
How Can I Prove That I Automatically Qualify for Disability?
The only way to prove you have a qualifying condition is through extensive medical evidence. The primary reason applications are denied is because the claimant failed to provide sufficient supporting medical evidence. Even if your condition would automatically qualify, without medical documentation, your application will be denied.
Therefore, the key is to work with our Bella Vista disability lawyers and your medical providers to gather the necessary evidence and documentation. Having a diagnosis is not always sufficient to receiving benefits – you must prove that your condition prevents you from working. Having statements from your primary physician and any other specialists that are treating you could provide much-needed context to the medical evidence submitted. For example, your doctor could indicate that your condition prevents you from sitting for extended periods, standing, or grasping objects.
What if My Condition is Not on the List or I am Denied?
While the Blue Book only contains a seemingly small number of listed disabilities, each condition has additional criteria that could be used to qualify for benefits. For instance, melanoma is listed in the Blue Book. The listing includes various types of skin cancer, different stages of the disease, and skin carcinomas that have spread into the muscle or bone. If you have any form of skin cancer, you are likely to meet enough of the listed criteria to qualify for benefits.
However, there are situations where a claimant’s condition does not match a listed disability in the Blue Book. In this case, you will have to provide enough medical evidence to prove your condition is similar to one or more listed impairments.
Other claimants suffer from multiple conditions that, singularly, do not match any listing. However, when the symptoms are combined, the result is permanently debilitating. For example, a claimant who suffers from arthritis, diabetes, and hypertension might qualify for disability benefits if the SSA agrees that the combination of symptoms of these chronic conditions is similar to another listing. Our experienced Farmington disability lawyers will assist you in building a compelling body of evidence.
Arkansas Disability Lawyers Helping People With Severe Medical Impairments
To learn more about Social Security Disability benefits or the process, call (479) 316-0438. Our experienced Bentonville disability lawyers are available to assist you in all aspects of the application process.