If you have a disability you will need to prove the severity of it with the SSA’s Blue Book if you wish to qualify for disability benefits. The Blue Book 2021 lists medical conditions which are applicable for claimants who wish to receive disability benefits.
However, it is often difficult to match your disability with a medical condition found in the Blue Book. There are other options available if you cannot find your disability in the Blue Book such as qualifying for disability benefits under a “medical vocational allowance”.
Why is the Blue Book Important?
The quickest but most difficult way to qualify for disability benefits is to meet an official SSA description of an illness or impairment. If your condition exactly meets one found in the Blue Book it may not take long to be approved for disability benefits. However, so often a medical condition doesn’t match precisely and it is necessary to find further medical evidence to prove you qualify for disability benefits with your medical condition.
How to Meet a Listed Impairment
If you find your impairment is in the Blue Book list, to prove you meet the requirements you must submit all medical evidence to show you have the same symptoms/laboratory findings which are on the Blue Book List.
For example, if you suffer from a respiratory disorder that result in an obstruction across cell membranes in the lungs so that you have difficulty moving air out of the lungs or a restriction which is means you have difficulty moving air into the lungs such as chronic bronchitis and emphysema you may qualify for disability benefits.
Symptoms and signs of a respiratory disorder include dyspnea (shortness of breath), chest pain, coughing, wheezing, sputum production, hemoptysis (coughing up blood from the respiratory tract), use of accessory muscles of respiration, and tachypnea (rapid rate of breathing).
You will need to provide medical evidence so that your case can be assessed for the severity of your respiratory disorder. Medical evidence needs to include the following:
- ABG tests which measure the partial pressure of oxygen, PaO2, and carbon dioxide;
- descriptions of any prescribed treatment and how you are responding;
- pulse oximetry which measures the oxygen saturation level, (SpO2), of peripheral blood, i.e. in your hemoglobin;
- results of imaging such as x-ray and computerized tomography;
- results of physical examinations;
- results of pulmonary function tests such as spirometry, which measures ventilation of the lungs;
- your medical history.
If you suffer from obesity it is also evaluated for your chronic bronchitis and emphysema because obesity is a medically determinable impairment that is often linked to respiratory disorders. It makes it more difficult for the chest and lungs to expand, which may lower the supply of sufficient oxygen to your body.
The combined effects of obesity with chronic bronchitis and emphysema could be greater than if the effects of each of the impairments is considered separately. Any additional and cumulative effects of your obesity are considered when the SSA determines whether your bronchitis and emphysema are severe enough to award you disability benefits.
If you use supplemental oxygen, you will still need to provide medical evidence which confirms the severity of your respiratory disorder.
Medical Evidence for Disability Benefits
You are responsible for providing the medical evidence to the SSA but you must ensure that you have seen your doctor regularly because doctors are in the best position to provide a detailed health assessment and reliable history of your medical condition. If you have not received regular treatment, the SSA will order a "consultative examination" to supplement your record. A consultative exam is any medical exam that the SSA orders for a disability benefits applicant to provide more information and context for a disability claim before it is approved or denied.
What to Do If You Don’t Meet a Blue Book Listing
Many people who receive SSD benefits do not exactly match one of the conditions listed in the Blue Book. If your medical condition does not match a listing, but you are still seriously disabled and unable to perform any type of work, you may still qualify for disability benefits under a “medical vocational allowance.”
A medical vocational allowance includes an in depth evaluation of your medical records. Your Residual Functional Capacity (RFC) test conducted by your physician who assesses your physical and mental abilities will also be reviewed to see if there is any work you can do with your disability.
The Residual Functional Capacity test assesses what work you could do after taking into account all of the limitations your severe medical conditions cause you. This includes the following physical limitations:
- whether you experience any problems with seeing, hearing, and speaking;
- whether you can tolerate environmental conditions like high or low temperatures, wetness; humidity, noise, dust, fumes, odors, gases, poor ventilation and vibrations;
- whether you can reach and handle large objects;
- whether you can kneel, crouch or crawling;
- use your fingers to feel, climb stairs or ladders;
- if you can work in hazardous working conditions like with or around machinery;
- if you can work at heights without the need for protection;
- if you can stoop;
- if you can balance;
- how long you walk;
- how long you can stand;
- how long you can sit.
The RFC also assesses your mental limitations and whether you can do the following:
- maintain concentration and attention at work for long periods of time;
- understand and remember instructions;
- carry out your duties throughout the whole day;
- get along with people in your workplace or the general public;
- cope with changes in the work environment;
- respond in the right way to supervisors and co-workers in usual conditions.
Qualifying Under the Medical Vocational Allowance
Under the medical vocational allowance factors such as age, education, and job history are all considered.
- Your age is the most important factor when determining whether your RFC allows you to do any other type of work. The older you are, the more likely your age will be viewed as an impairment for taking on any new type of work. So if you are between 50 and 54 years or over 55 years the SSA will consider you have a lower likelihood of adjusting to new work.
- Your educational level is assessed on the less education you have the lower the chance you have of finding work. The level of education falls into being illiterate so that you can’t communicate satisfactorily in English. A marginal level is having completed less than 7th Grade or limited education level is less than 12th Grade.
- Your job history is assessed based on you having no work experience at all, unskilled, semi skilled or skilled work experience.
The SSA has formulated a Medical Vocational Grid, or guidelines for determining your ability to work. It is based on combining the results of the following:
- the results of your RFC,
- your age,
- your education,
- your work experience.
For example, if your RFC is based on you doing sedentary work and you are over 50 years of age, you didn't graduate from high school, and your only work has been unskilled, you will be classified as disabled, using the medical-vocational allowance. If you are 45 years old with a similar background, you won't be classified as disabled.
If your factors don't exactly match the criteria of a rule, for example, your RFC results make you suitable for more than sedentary work but not for the complete range of light work, the claims examiner at the SSA will use the medical vocational grid to decide if your disability qualifies you for disability benefits. It is only used if your impairment causes difficulties in meeting the exertional, or strength, demands of a job. If you only have non-exertional limitations (for example, you must use the restroom frequently) or mental limitations (for example, you have a reduced ability to follow direction due to a mental impairment), the SSA will use the medical-vocational grid just as a frame of reference for the disability determination.
If the SSA makes the decision that you are unable to perform any job with your medical condition, even though your impairment doesn’t meet a Blue Book listing you may be approved for SSD benefits under a medical vocational allowance.
If you aren’t sure what medical evidence you need to match a blue book impairment listing, you should talk to an attorney soon. Evidence such as a detailed medical report compiled by your physician is a key to the SSA arriving at decision to award you disability benefits due to your disability. However, to ensure your evidence is sufficient you should work with an attorney.
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