This article looks at what is considered a medical condition for the purposes of Social Security Disability.
For those who are injured or impaired, Social Security can end up being a lifeline. While nobody ever plans on being unable to work due to a medical condition, the fact is that accidents and other misfortunes leave people suffering with a disability that makes them unable to maintain employment. Those who are hoping to receive Social Security Disability Insurance (SSDI) benefits to help them through the financial pressures caused by a disability are often concerned about how eligibility is determined for SSDI. As shown below, while some medical conditions are likely to lead to a claimant being approved for disability benefits, other serious medical conditions could lead to a claim being denied.
What Is A "Severe" Condition?
As the Social Security Administration (SSA) notes on its own website, for a claimant to be considered disabled his or her injuries have to be severe enough that they make employment difficult if not outright impossible. Determining what counts as a "severe" condition, however, is not always straightforward. The SSA does maintain a list of specific medical conditions that the agency considers to be severe. By way of example, listed conditions include extremely serious impairments and injuries, such as brain tumors, cerebral palsy, leukemia, and amputations. If a claimant has one of the listed conditions then he or she will be considered disabled for Social Security purposes.
What About Unlisted Conditions?
Just because a person's medical condition is not on the SSA's list of medical conditions, however, does not mean that he or she is ineligible for SSDI benefits. Unlisted medical conditions may make individuals eligible for benefits, but it is important to keep in mind that claimants are more likely to be denied their claim if their condition is unlisted. It will be necessary to determine whether the claimant's medical condition is as severe as those that are actually listed. As FindLaw points out, to do this it is first necessary that the claimant have a condition that is medically determinable, meaning that its existence is backed up by scientific and medical testing. Furthermore, the SSA will need to determine the claimant's residual functioning capacity (RFC). Generally speaking, an individual's RFC is a measure of the most demanding activity the claimant is capable of carrying out given his or her condition. A claimant's RFC helps the SSA determine whether that individual is capable of returning to work or gaining employment in some other industry. To determine one's RFC, the SSA will require updated medical records, such as blood tests, CAT scans, physician examination, and mental health records.
Appealing A Denied Claim
Unfortunately, people who are suffering from a disability that makes it impossible for them to work still get denied SSDI benefits. When their claim has been denied, individuals should contact a disability claims attorney to help them with their appeal. An experienced attorney may be able to help claimants gather the medical evidence necessary to prove to the SSA that their medical condition qualifies them for disability benefits.