What Medical Conditions are Considered for SSDI?


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People who have certain disabling medical conditions may be eligible for Social Security Disability Insurance. But, with few exceptions, having a specific condition does not automatically entitle someone to benefits.

An applicant for SSDI must show evidence that the disability is expected to last 12 months or longer and is severe enough that gainful employment is impossible (or, for children, that the disability severely limits one’s functionality).

The official Social Security Administration Listing of Impairments defines 14 categories of disability for adults and children and one category specific
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to children. Each category includes several conditions, along with the criteria an applicant must meet to be eligible for Social Security disability benefits; criteria vary, depending on whether the applicant is an adult or a child.

Disorders of the Musculoskeletal System

This category includes a broad range of conditions – amputation, severe burns, spinal disorders, and major dysfunction of a joint or joints. A severe fracture in a major bone is also included in this category (but the applicant must show evidence that the fracture is not expected to heal properly in 12 months’ time).

Special Senses and Speech Disorders

Sensory and speech-related disabilities include blindness, severe visual disorders, deafness, and inner-ear disorders that affect balance. The loss of speech is included in this category, although that may be a symptom of another qualifying disability (such as traumatic brain injury).

Respiratory Disorders

Respiratory disorders may be congenital (such as cystic fibrosis) or conditions that develop over time (such as chronic pulmonary hypertension).

Cardiovascular System Impairments

Heart failure, heart disease, and diseases of the veins and arteries are all cardiovascular system impairments.

Digestive System Disorders

Liver disease, inflammatory bowel disease, and gastrointestinal hemorrhaging requiring a blood transfusion are included in this category.

Genitourinary Disorders

This category includes chronic kidney disease, including some of its symptoms, and kidney transplants.

Hematological Disorders

This category of disorders includes sickle cell anemia, bone marrow failure, thrombosis, hemostasis, and associated complications.

Skin Disorders

Conditions that cause extensive long-lasting skin lesions, such as genetic photosensitivity impairments, atopic dermatitis, or burns, are considered skin disorders.

Endocrine Disorders

This category includes disorders of the endocrine glands, including thyroid, adrenal, pituitary, and pancreatic disorders.

Congenital Disorders That Affect Multiple Body Systems

These disorders include non-mosaic Down syndrome, chromosomal disorders, congenital abnormalities, infectious perinatal diseases that affect development, and fetal alcohol syndrome.

Neurological Disorders

Types of neurological disorders include Parkinsonian syndrome, epilepsy, muscular dystrophy, multiple sclerosis, cerebral palsy, coma, and degenerative diseases, such as Huntington’s disease. Brain injury and certain types of brain tumors are included in this category

Mental Disorders

Schizophrenia, major depressive disorder, bipolar disorder, and autism are all considered mental disabilities.

Cancer

One might expect that a cancer diagnosis is an automatic qualifier for SSD benefits, but that’s not the case. If the SSA thinks cancer will respond to treatment, it may not consider cancer a disability.

Immune System Disorders

Vasculitis, lupus, inflammatory arthritis, and human immunodeficiency virus (HIV) are types of immune system disorders.

Low Birth Weight and Failure to Thrive

This condition is applicable only in children, from birth to age 3. Children with this condition may be underweight, smaller than the other children their age, have severe developmental delays, and be prone to developing other health problems, such as seizure disorder and lung disease.

The SSA has a Compassionate Allowances Program, which recognizes certain diagnoses as an automatic qualifier for SSD benefits, without the need for extensive supporting evidence. These conditions – such as pleural mesothelioma, pancreatic cancer, and acute leukemia – are usually fatal, so the SSA fast-tracks SSD applications for people with these conditions. However, even with a fatal disease, a Title II SSDI applicant can receive benefits no sooner than the fifth month after the disability began.

Because of the 5-month waiting period, anyone suffering from a disability should apply for Title II SSDI benefits as soon as possible.

ABOUT THE AUTHOR: John R. Colvin
The Law Offices of John R. Colvin focus primarily in the areas of Personal Injury, Wrongful Death, Workers’ Compensation, and Social Security Disability. They represent clients in the Tennessee Valley region, including Tennessee and Alabama.

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Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.

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