What Conditions Automatically Qualify You for Disability?
If you have a serious illness that prevents you from working and earning an income, Social Security Disability benefits can help cover your expenses. Unfortunately, applying for benefits is often a complex and time-consuming process, and you may be wondering if some conditions can automatically qualify you for Disability and speed up your application process.
The most direct way could be the Compassionate Allowances program (CAL). CAL enables applicants to quickly indicate whether they have diseases or conditions that may qualify for Social Security benefits.
How Do Disability Benefits Work with Compassionate Allowances?
There are two types of Disability benefits you can pursue, each with their own application processes and criteria:
- Social Security Disability Insurance (SSDI)
- Supplemental Security Income (SSI)
The Social Security Administration (SSA) manages both programs. The purpose of the Compassionate Allowances program (CAL) is to help the SSA reduce waiting times for those with the most serious disabilities. It evaluates SSDI and SSI applications using rules called the Sequential Evaluation Process.
The Sequential Evaluation Process for Social Security Disability
The Sequential Evaluation Process is a series of steps the SSA uses to determine whether applicants qualify for SSDI or SSI benefits. It consists of these five sequential steps, meaning each step is evaluated individually before moving on to the next one:
- Substantial Gainful Activity (SGA) – Whether you’re unable to generate an income that meets a certain annually determined threshold.
- Severity of Impairments – Whether your disease or condition significantly limits your ability to perform basic occupational tasks such as sitting, standing, and understanding instructions.
- Listing of Impairments (Blue Book) – Whether your disease or condition is included in the SSA’s official “Blue Book” and matches the severity of the listing.
- Past Relevant Work – Whether you’re able to perform your relevant past work based on a residual functional capacity evaluation (RFC).
- Other Work – Whether you can perform any other work with significant demand in the economy, considering age, education, work experience, and the results of the RFC.
Which Conditions Are Included in the SSA’s Blue Book Listing of Impairments?
Tyes of conditions included in the SSA Blue Book include:
Musculoskeletal System and Connective Tissue Impairments
These include diseases that affect your nerves, muscles, tendons, and ligaments.
Arthritis
Arthritis is characterized by inflammation of the joints, which can cause pain, stiffness, and swelling that affects joint movement and overall mobility. To qualify for Disability benefits with arthritis, it must significantly limit your ability to work and generate income.
Back Pain
Back pain can be the result of a host of diseases as well as an abnormal curvature of the spine. If your back pain is severe enough that you’re unable to work, you may qualify for Disability benefits.
Mental Disorders
To qualify for Disability benefits due to a mental disorder, you must have a medically diagnosed condition that limits your ability to function.
Mood Disorders, Including Anxiety and Depression
Mood disorders are a group of mental health conditions that affect a person’s emotional state, temper, or mood. They can qualify for Disability benefits if they result in symptoms that severely undermine your ability to generate income or engage in social interactions.
Autism or Asperger’s Syndrome
Autism Spectrum Disorders (ASDs) are neurological conditions that impact one’s ability to communicate and interact socially. Symptoms typically involve difficulty understanding social cues, obsessive or repetitive behavior, and heightened sensory sensitivity. To qualify for Disability benefits, a person must have medical evidence showing significant deficits in their ability to communicate and manage themselves in day-to-day life.
Schizophrenia
Schizophrenia is a mental disorder with symptoms that may include hallucinations and delusions as well as an inability to organize thoughts or express emotion. To qualify for Disability benefits, the symptoms must be medically documented and must significantly impact a person’s ability to work.
Post-Traumatic Stress Disorder (PTSD)
PTSD is a mental disorder that typically develops after someone witnesses or experiences a traumatic event. It can be characterized as a traumatic brain injury, and symptoms may include intrusive thoughts, sleep disturbances, and unusually heighted emotional arousal to trigger stimuli.
Cardiac and Circulatory Disorders
Cardiac and circulatory disorders involve disruptions to the flow of blood to and from the heart throughout the body.
Heart Diseases
Heart diseases can include conditions that lead to high blood pressure, narrowing of arteries, and severe chest pains, including:
- Hypertension
- Chronic Heart Disease
- Coronary Artery Disease
- Some Types of Angina
Neoplasms (Cancer)
Neoplasms, also known as tumors, are masses of tissue that can develop throughout the body. They can be either cancerous (malignant) or benign (non-cancerous). To qualify for Disability benefits, the cancer or its treatment must cause severe functional limitations that prevent a person from generating an income.
Nervous System and Sense Organ Impairments
Neurological disorders affect the nervous system and sense organs, leading to severe problems that can affect multiple body systems.
Parkinson’s Disease, Epilepsy, and Multiple Sclerosis
Neurological disorders that affect a person’s ability to control movement, these diseases can severely limit someone’s ability to work and interact in daily life. Symptoms such as seizures, loss of consciousness, repetitive behaviors, and unusual emotional or sensory responses may be severe enough to qualify a person for Disability benefits.
Blindness and Hearing Loss
Vision problems that result in partial or total loss of vision can qualify you for Disability benefits if your vision cannot be corrected to better than 20/200 in your best eye. Benefits may also be available for someone who is “profoundly” deaf, meaning it affects their ability to generate an income.
Additional Conditions That Could Entitle You to Disability Benefits
Diseases that aren’t listed in the SSA’s Blue Book might still qualify for Disability benefits, depending on their severity, their impact on your ability to work, and their impact on your overall quality of life.
To pursue benefits for a condition not listed in the Blue Book, you must present a formal diagnosis that shows your condition is a “medically determinable impairment” that undermines your ability to function in daily life and generate an income.
If your condition meets the SSA’s requirements, you could receive Disability benefits in the same manner as if your condition were listed in the Blue Book.
For your condition to qualify for Disability benefits, it must be severe enough to cause significant impairment in your functional capacity. An experienced Social Security Disability attorney can help you determine if your condition might qualify.
Social Security Rulings
The Social Security Administration may also issue a Social Security Ruling (SSR) if a particular disease does not have a Listing but is still severely disabling. SSRs can also speed up the process by which one might receive Social Security benefits.
Conditions for which there are currently SSRs include:
Fibromyalgia
Fibromyalgia is a complex disorder that typically involves widespread musculoskeletal pain as well as tenderness in the nerves and overall fatigue. These symptoms often result in difficulty sleeping, cognitive impairment, and heightened sensory sensitivity. There is no known specific cause, but it is believed to involve the central nervous system.
Reflex Sympathetic Dystrophy (RSD)
Also known as Complex Regional Pain Syndrome, RSD is a rare neurological disorder that results in constant pain, changes in skin color and temperature, and other unusual behavior of the sympathetic nervous system. RSD typically develops after an injury or trauma.
How Presumptive Disability Can Provide Support
Presumptive Disability (PD) is a Social Security benefit that may allow you to receive expedited payments after applying for Supplemental Security Income (SSI). You may be eligible for PD if you have certain medical conditions that make you highly likely to qualify for SSI.
Payments can last for up to six months and don’t need to be repaid, even if your application is ultimately rejected. You don’t need to apply for PD separately – it’s included as part of your regular application.
Some conditions that may qualify for PD include:
- Leg amputation from the hip
- Total deafness or blindness
- Total immobility without a wheelchair
- Difficulty walking or using one’s appendages three months or more after a stroke
- Cerebral palsy, muscular dystrophy, and muscular atrophy
- Symptomatic HIV or AIDS
- Any terminal illness for which one is receiving hospice care
- Any spinal cord injury that prevents you from walking independently for more than two weeks
- End-stage renal disease (ESRD)
- Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease
Some parents of children with presumptive conditions may also qualify for Disability benefits. Examples include Down Syndrome and low birth weight.
How a Skilled Social Security Disability Lawyer Can Help You
A Social Security Disability attorney can help you with your application and throughout the entire process, including:
- Ensuring that all your paperwork is filled out accurately and in compliance with deadlines
- Collecting and organizing your medical records
- Fighting on your behalf with the Social Security Administration
- Representing you at eligibility hearings as needed
Contact an Experienced North Carolina SSD Benefits Lawyer
Our Social Security Disability team is led by Rick Fleming, a North Carolina State Bar Board Certified Specialist in Social Security Disability law – a distinction held by less than .5% of attorneys licensed to practice in the state.5 And several of our team members have other side experience from working in the Social Security Administration.
Don’t worry about cost because we work on a contingency fee basis, which means you pay nothing upfront. In fact, you pay no attorney’s fee at all if we don’t recover for you, and if we do, the attorney’s fee is capped by law – no matter how much in back-due benefits we may recover for you.
For a free professional opinion on your Social Security Disability case, contact us online or call 1-866-900-7078 now.
5 Figures provided by the NC State Bar as of 1/23.
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