The Social Security Administration (SSA) awards disability benefits to people who have medical disorders that keep them from working full-time for at least one year. Under the agency's five-step sequential evaluation process, once the SSA determines that you haven't been engaging in substantial gainful activity and your condition substantially interferes with your daily routine, you may be able to qualify for disability automatically if the condition is in the "listing of impairments."
In order to qualify automatically for disability, your condition must be serious enough to be included in the SSA listings and you must have evidence in your medical record matching the requirements of the listing description. When that happens—known in Social Security lingo as "meeting a listing"—the SSA will approve your application without having to determine that your residual functional capacity rules out all work.
For example, if you've had a liver transplant, the agency doesn't have to go to the trouble of assessing your functional limitations (like not being able to lift over 10 pounds or walk more than 50 feet), comparing them with your past job duties, deciding whether you could do that work today, and figuring out if other jobs exist that you could perform. Instead, the SSA can simply approve your application automatically under listing 5.09.
The SSA maintains a list of all of the impairments that can qualify for automatic approval. These impairments are referred to collectively as the "Blue Book" (as a nod to the historical color of the manual), the "listing of impairments," or just "the listings". The listings are updated every few years in order to reflect changes in medical technology and diagnostics.
On average, the SSA listings cover about 100 individual impairments, organized into 14 categories representing the part of the body affected by the disorder. For example, Section 4.00 of the Blue Book covers impairments of the cardiovascular system. The section contains nine specific disability listings all having to do with disorders of the heart, such as chronic heart failure or peripheral arterial disease.
Each listing in the Blue Book has a set of criteria that the SSA needs to see in your medical record before you can "meet the listing" and qualify for disability automatically. If you think you might meet a listing, you can review the section that addresses the major body system affected by your impairment.
The SSA can evaluate impairments of the spine, bones, and joints under the following listings:
The SSA can evaluate abnormalities of the eye, ear, and voice under the following listings:
The SSA can evaluate difficulty breathing under the following listings:
The SSA can evaluate heart diseases, disorders, or illnesses under the following listings:
The SSA can evaluate gastrointestinal impairments under the following listings:
The SSA can evaluate certain stages of kidney disease under the following listings:
The SSA can evaluate abnormal blood production or functioning under the following listings:
The SSA can evaluate skin pathologies under the following listings:
The SSA evaluates endocrine (hormonal imbalance) disorders under the listing for the body part or organ affected by the imbalance. This varies by the type of gland responsible for the hormone imbalance. For example, pituitary gland disorders often lead to electrolyte imbalances in the kidneys, which the SSA would then evaluate under Section 6.00 for kidney dysfunction. Adrenal gland disorders can cause heart arrhythmias that may meet the criteria of a Section 4.00 cardiovascular listing.
This section contains only one listing, 10.06 for Non-mosaic Down syndrome. (Mosaic Down syndrome doesn't qualify for automatic benefits.)
The SSA can evaluate dysfunction of the nervous system under the following listings:
The SSA can evaluate mental health disorders (such as mood dysregulation, anxiety, or cognitive difficulties) under the following listings:
The SSA listings for cancers are organized based on the primary site of the malignancy, but they almost always require evidence that the cancer has metastasized (spread) to another region. The listings are as follows:
The SSA can evaluate disorders that compromise the immune system under the following listings:
The Blue Book has separate listings for adults ("Part A") and children ("Part B"). The impairments themselves are typically the same—for example, asthma is found under listing 3.03 in Part A and listing 103.03 in Part B—but the criteria often aren't, reflecting the need for different medical standards of disability in children and adults. For more information, see our articles on getting disability benefits for children.
Receiving a diagnosis of an impairment listed in the Blue Book isn't enough to establish that you're disabled. You'll also need to provide medical evidence of the criteria set forth by the specific listing. This means submitting documents showing that you have the same symptoms, clinical signs, and laboratory findings required by the listed impairment.
The exact documentation you'll need to show the SSA will vary depending on the listing. For example, meeting a musculoskeletal listing typically requires having an X-ray, CT scan, or MRI showing that you have severe degeneration or other dysfunction of your spine, joints, or bones. Respiratory listings often require stress tests demonstrating a significant reduction in lung functioning, while kidney listings require lab results that show decreased levels of certain proteins in your blood.
Many listings require that you show significant functional limitations in addition to objective medical findings. Some neurological listings, for example, may be met if you're unable to perform basic motor functions independently, while mental listings typically require that you're significantly limited in interactions with other people.
The SSA sets criteria for each listing to make sure that only the most severe impairments are automatically approved for disability. But you can still qualify automatically even if you don't meet the listing requirements exactly if your medical evidence shows that your condition is "medically equivalent" to the listing criteria. This is called "equaling a listing."
You can also equal a listing if you have multiple impairments, none of which meets a listing on their own—but when taken together are equal in severity to a listed impairment. For example, you may have diabetes and back pain that combined to cause functional limitations that are essentially the same as the requirements of listing 11.14, peripheral neuropathy.
The best way to equal a listing is to get your doctor to write a medical source statement discussing why your clinical signs and symptoms meet or equal a listing in the Blue Book. The SSA values the opinions of doctors who see you regularly for your condition, so it's important to establish care with a treating physician or psychologist and follow up with routine visits. Having a "longitudinal history" of treatment strengthens your claim that your impairment is disabling.
If the SSA doesn't find that you have an impairment severe enough to meet or equal a listing, it's not the end of the line. Under the sequential evaluation process, the agency must still evaluate your residual functional capacity to determine whether your limitations keep you from working. Most people who ultimately receive benefits are found disabled at this step of the process—either because an approval was directed under the "grid rules" or because their functional limitations ruled out all full-time work.
You can find the entirety of the Blue Book listing of impairments online at Social Security's website. Closely read the criteria for the impairment that you think you may meet or equal. The listing requirements can get very technical, so you may want to consult your doctor. Ask your doctor if they think your condition is severe enough to meet or equal one of the listings. If they don't, ask them what evidence is missing that you'd need to satisfy the listing. For example, if you haven't had spirometry (breathing tests) for a chronic respiratory disorder, arrange to have the tests performed.
Generally, the SSA requires quite a bit of medical evidence to decide if your impairment is as severe as one listed in the Blue Book—and you're responsible for providing them with the information they need. Make sure to give the SSA the names and locations of your medical providers, and follow up with regular visits so that you can establish a longitudinal history of treatment for your condition. Keep the agency in the loop about any tests, exams, or imaging that you've undergone.The more medical evidence you can provide, the better your odds are of winning your disability claim.
Updated April 8, 2024
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