Applying for Social Security Disability Insurance (SSDI) can be overwhelming, especially when you’re unsure if your medical condition qualifies. The Social Security Administration (SSA) has strict standards for eligibility, and not every health issue meets their criteria. However, understanding which types of conditions generally qualify and how the SSA evaluates them can help you navigate the process more confidently.
Social Security Disability Insurance is a federal program designed to provide financial assistance to individuals who can no longer work due to a significant, long-term disability. To be eligible, applicants must have worked for a sufficient number of years and paid into the Social Security system through payroll taxes. In addition, the medical condition must be expected to last at least twelve months or be terminal.

The SSA uses a five-step process to evaluate disability claims.
1. First, they consider whether the applicant is currently working. If an individual earns above a certain monthly threshold, known as Substantial Gainful Activity, they are generally not eligible for benefits.
2. Second, the condition must be considered “severe,” meaning it significantly interferes with basic work activities.
3. Third, the SSA examines whether the condition appears on the official list of disabling conditions, which is a key component in determining eligibility.
4. Fourth, they assess whether the applicant can continue doing the work they’ve done in the past.
5. Fifth, they consider whether the individual is capable of adjusting to other types of work given their limitations, age, education, and experience.

One of the most important tools the SSA uses in this evaluation is the Listing of Impairments, commonly referred to as the Blue Book. This guide outlines a wide range of medical conditions that are considered severe enough to prevent someone from working. These listings are organized by body systems and include a wide range of disorders. For example, musculoskeletal disorders cover conditions like severe back injuries or degenerative joint disease. Cardiovascular conditions include chronic heart failure and coronary artery disease. Respiratory disorders such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis are also included.
Neurological conditions, including multiple sclerosis, epilepsy, and Parkinson’s disease, often qualify, especially if they cause significant functional limitations. Mental disorders such as major depressive disorder, schizophrenia, anxiety disorders, and post-traumatic stress disorder can qualify as well, provided the symptoms are well-documented and interfere with day-to-day functioning. Immune system disorders like lupus, rheumatoid arthritis, and HIV/AIDS are also included in the listings. Cancer, depending on its type, stage, and the treatment required, can qualify. Digestive conditions such as inflammatory bowel disease, chronic liver disease, and severe gastrointestinal issues may also meet the SSA’s criteria. Finally, endocrine disorders such as advanced diabetes, particularly when it leads to complications like neuropathy or vision loss, are considered.

Even if a person’s condition is not explicitly listed in the Blue Book, they may still be approved for SSDI through what is known as a medical-vocational allowance. This involves assessing how the condition limits the person’s ability to function and whether they can perform any type of work, not just the job they previously held. Factors such as age, education, transferable skills, and the severity of medical symptoms all come into play in these decisions.

There are several medical conditions that frequently result in approval. Chronic and severe back problems, such as spinal stenosis or herniated discs, often qualify if they significantly reduce mobility. Arthritis and joint disorders that impair movement and function are also commonly approved. Conditions involving chronic heart disease, such as arrhythmias or congestive heart failure, may qualify when symptoms are severe enough to limit physical activity. Some forms of cancer, particularly aggressive or late-stage types, typically meet the SSA’s standards. Diabetes can be a qualifying condition, especially when it leads to organ damage or other serious complications. Mental health conditions like bipolar disorder or severe depression may also qualify when they substantially impair a person’s ability to concentrate, interact socially, or maintain employment.

Proving a disability to the SSA involves more than just receiving a diagnosis. The application must be supported by detailed and consistent medical documentation, including doctor’s notes, lab test results, treatment history, and imaging studies. Applicants may also be asked to attend a consultative medical exam arranged by the SSA. In addition, functional reports and personal statements that explain how the condition affects daily life and the ability to work are often critical to a successful claim.

Navigating the intricacies of Social Security Disability benefits can be made more manageable with the assistance of the expert North Carolina disability specialists, Golson, McCracken Inc. Our team specializes in advocating for the rights of the disabled and offers our clients comprehensive support throughout the application and appeals process.

Golson, McCracken Inc. provides services across North Carolina including Raleigh, Sanford, Mebane, Greensboro, and Charlotte. If you suffer from a disability in North Carolina,  contact North Carolina SSDI and SSI advocate to enhance your chances of successfully securing the benefits you need.