Is Your Condition Severe Enough to Qualify for Disability Benefits?

Under SSA guidelines, a sustained basis consists of working a 40-hour workweek, which translates to 8 hours a day, five days a week. Employees whose conditions require them to stop working to massage or rest their arms, legs, back, knees, or other extremities are unlikely to be retained. Even so, employees who can only work 2-3 days a week due to a condition can still file a claim for benefits, arguing they suffer a “severe impairment” for which the SSDI program was designed to provide coverage. Social Security disability attorneys are well-versed in building these types of cases.

The definition of a “severe impairment” is more than being slightly affected by pain or minimally impacted by some form of discomfort. You must be able to show, based on objective medical evidence, that your impairment prevents your ability to sustain basic work activities. Examples of conditions that could prevent your ability to perform and sustain basic work activities under SSA’s rules include walking, lifting, bending, stooping, squatting, carrying, sitting, talking, and concentrating, among others.

While many claimants suffer from multiple severe impairments, it is important to understand that only one severe impairment is required. Although numerous symptoms, disabilities, or impairments affect humans on a daily basis, whether a particular impairment is considered severe enough to prevent an individual from working is the claimant’s burden to prove. This means that the claimant must have objective medical evidence as required in SSA’s “Listings of Impairments,” also known as the Blue Book, to determine the severity of their disability.

What is the “Listings of Impairments” Publication

The Listing of Impairments is a list of medical conditions and illnesses that SSA considers severe enough to be disabling. The Listing of Impairments is available on the SSA’s website and is divided into two parts: Part A addresses adult issues, and Part B addresses matters related to children under 18. If you or a family member are considering filing an SSDI/SSI disability claim, we encourage you to review SSA’s “Listing of Impairments” and compare the evidence requirements pertinent to your symptom or condition.

The “Listing of Impairments” describes, for each major body system, impairments considered severe enough to prevent an individual from working at “substantial gainful activity” (I.e., Working) and earning more than $1,620 in gross earnings per month. Most of the listed impairments are permanent or expected to result in death. The criteria in the Listing of Impairments apply to the evaluation of claims for disability benefits under either SSDI or the SSI program.

The Listings each have specific medical criteria that must be satisfied before SSA considers an individual to be disabled. Those records and forms of evidence are also used by SSA when it applies its five-step sequential evaluation process. The five-step evaluation process is applied to EVERY claim for benefits.

The Five-Step Sequential Evaluation Process

Step One: Is the claimant working at or above the SGA level?

If the claimant is working at or above the SGA, the claim will be denied.

Step Two: Does the claimant have a severe impairment?

In Step 2, SSA considers whether the claimant has a medically determinable impairment. If the impairment is considered severe, the application moves to Step 3. If the impairment is not severe, the application is denied.

Step Three: Does the impairment meet or equal the criteria in the Listing?

If a claimant meets the criteria for a listed impairment and satisfies Steps 1 and 2, they will be considered disabled at Step 3 and eligible for SSDI benefits. If the claimant does not meet the requirements of Step 3, SSA permits further evaluation and proceeds to Step 4.

Step Four: Does the impairment prevent the claimant from performing any work the applicant has done in the past five (5) years?

Past work must have lasted long enough to have allowed learning and acquiring the basic skills, and the work must have involved the appropriate physical and mental activities. Step Four also consists of an assessment based on a claimant’s residual functional capacity (RFC). This means that even if your impairment prevents you from performing any past work activities, you may still be able to do something based on a claimant’s current functional abilities. For example, even if you cannot perform your previous job, based on your training, education, and skills, can you still work? If this is the determination, SSA goes to Step 5.

Step Five: Can the claimant do any other kind of work?

SSA/DDS must determine if a person can adjust to any other type of work. This does not mean that any local jobs would fit your particular circumstances or that you would even get hired. It simply means that there is a sufficient number of jobs in the national economy that you should be able to find work. Under this analysis, an individual suffering a severe impairment might still be able to take a sitting job with little or no physical demands.

At Step 5, the burden of proof lies with the SSA. On the other hand, if you are capable of working based on your age, education, experience, training, or transferable skills and are not limited by a physical or mental impairment, benefits may be denied.

Key Takeaways

• Compare your impairment with SSA’s Listing of Impairments (Blue Book) and review the evidence requirements.
• Get legal assistance to help guide you through the SSA maze.
• Learn how to ask your doctor about your symptoms, and be sure those discussions become part of your medical records.
• Have thorough and detailed discussions with your Social Security attorney.
• Obtain the best medical evidence that analyzes your pains and symptoms and explains how they limit your activities.

Objective Medical Evidence

The most significant evaluation method SSA uses to determine the severity of a condition is a claimant’s medical records. However, the most common reason claims are denied is the lack of sufficient medical evidence.

SSA requires comprehensive medical evidence, which has been defined as “objective medical evidence.” This means that if your medical records fail to provide specific details about how your impairment (disability) limits your ability to perform past work activities or how to adjust to other new work based on your age, education, past work experiences, and transferable skills, the claim may be denied. This is because SSA believes some people can work at most types of jobs even if they do no more than sit in a chair and collect money. However, these types of decisions are overturned every day with good lawyering practices. Contact our office to learn how we can assist you with your claim.

Working With SSA’s Definition of “Severe”

Even with a specified definition of a “severe” impairment, SSA recognizes that every claimant has a unique set of circumstances. Additionally, the Blue Book does not encompass every illness, injury, symptom, disease, or condition; it is not an exhaustive list of all severe disabilities. This means that if your condition or the symptoms you are experiencing do not exactly follow one of the Listings, you may still obtain benefits. Of course, this will involve a thorough review of your claim file and may require referring you to new or different doctors. We realize this is a disruption, but in the end, it is well worth the time.

If you fall into any of the categories or have been denied and want a free claim evaluation, please get in touch with The Law Office of Dan Wimmer at 833-833-2026. We are ready to get started today.