Today continues the five questions used in making a Social Security or Supplemental Security Income (SSI) disability medical decision. Earlier posts covered the first question, Are you working?, and the second, Is your condition “severe”?
To be severe, the medical condition must significantly limit your ability to do basic work-related activities for at least one year. The state Disability Determination Services (DDS) goes to the third question only if your condition is severe.
Question three: Is your condition found in the list of disabling conditions?
Previously I mentioned that the medical requirements for Social Security disability and Supplemental Security Income (SSI) disability are essentially the same. This is for adults. SSI has a disabled child category that does not exist for Social Security because SSA benefits are payable to eligible young children under age 18 based on age, not health.
Separate for adults and children, there is a listing of medical conditions for each major body system. These listings describe impairments considered severe enough to prevent an adult from doing any gainful work activity. In the case of children under age 18 applying for SSI, impairments listed are severe enough to cause marked and severe functional limitations.
Most of the listed impairments are permanent or expected to result in death, or the listing includes a specific statement about duration. For all other listings, evidence must show that the impairment has lasted, or is expected to last, a continuous period of at least 12 months.
If the severity of your medical condition is on the Listing of Impairments, the usual result is to determine that you are disabled. Once medically approved, the Disability Determination Services (DDS) returns the application to the local Social Security office for completion of any non-medical development and payment.
For medical decisions, Social Security has initiatives designed to expedite processing of new disability claim. Through the Compassionate Allowance initiative, certain cases that usually qualify under the Listing of Impairments can be medically approved as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrig’s disease (ALS) and pancreatic cancer. The agency also uses computer screening to help identify cases with a high probability of medical allowance. More about these some other time.
If your medical condition is not on the list, the DDS examiner must decide if it is of equal severity to a medical condition that is on the list. If equal severity is met, disability is usually established. When discussing development of the second question, Is your disability severe?, I suggested including all your physical or mental medical conditions on the medical Disability Report even if one is the most important. Doing so could be important here.
If your condition is not on the list of disabling conditions and not of equal severity to a medical condition that is on the list, the Disability Determination Services (DDS) examiner goes to question four.
As will I in the future.