Scales of Justice

Impairments Covered by Social Security Disability Insurance

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For the purposes of establishing eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the Social Security Administration (SSA) defines a disability as “a physical or mental impairment that prohibits substantial gainful activity and has lasted, or is expected to last, for at least 12 months or result in death.”

The application and evaluation process for SSDI benefits can be complicated and frustrating. If you need help filing an SSDI application or appealing a denied SSDI claim in Oklahoma, the attorneys at Carr & Carr are here to help.

Please call us today at 866-510-0580 or contact us online for a free, no-obligation consultation.

Impairments Covered by SSDI Benefits

In most cases, applicants will undergo medical evaluation during the application process to ensure that they have a qualifying impairment. It’s important to remember that there are additional qualifying requirements in each impairment category, and not every condition that falls under the SSA’s categories is considered severe enough to receive benefits. Understanding the different types of conditions and symptoms that are most frequently covered by SSDI benefits can help you determine whether you may be eligible.

Cancer (Malignant Neoplastic Diseases)

Cancer is the second-largest leading cause of death in the U.S., and many forms of cancer are covered by the SSA. This category is evaluated based on where the cancer originated, how extensive the cancer is, treatments received, and the effects of any therapy. Qualifying evaluations for cancer are made on a case-by-case basis because the conditions and treatments surrounding this category vary greatly.

Eligible forms of cancer may include:

  • Brain cancer
  • Breast cancer
  • Leukemia
  • Lymphoma
  • Melanoma
  • Prostate cancer
  • Spinal cord cancers

Cardiovascular System Disorders

Cardiovascular conditions is a broad category covering heart function and the circulatory system. This includes arteries, veins, capillaries, and lymphatic drainage. These types of conditions are more likely to qualify in cases where the disorder impacts major arteries and overall heart function. Examples of cardiovascular conditions eligible for benefits include:

  • Chronic heart failure
  • Coronary artery disease
  • Ischemic heart disease
  • Heart transplant
  • Recurrent arrhythmias

Congenital Disorders

Congenital disorders are hereditary and generally occur at or before birth. However, only congenital disorders that affect multiple body systems are qualified in this category. Each person’s congenital disorder may present differently, which will impact the eligibility ruling by the SSA.

Congenital disorders that may qualify you for disability benefits include:

  • Congenital heart disease
  • Chromosomal abnormalities
  • Down syndrome
  • Fragile X syndrome
  • Non-mosaic Down syndrome
  • Spina bifida

Digestive System Disorders

Digestive disorder often entails a number of organs within the body. Documentation of disorders within this category often require specific medical evidence, such as imaging studies, reports of endoscopy, operations, and pathology reports. The digestive condition must also be life-threatening and prevent you from working full-time in order to qualify.

Digestive disorders eligible for benefits may include:

  • Chronic liver disease or liver transplant
  • Gastrointestinal hemorrhage
  • Inflammatory bowel disease
  • Short bowel syndrome
  • Weight loss due to a digestive disorder in which the applicants’ BMI is less than 17.5%

Genitourinary Disorders

Genitourinary system disorders affect the urinary and genital organs. These conditions can range from asymptomatic to disorders that manifest as an array of signs and symptoms in different body parts. Similar to the other categories of impairments, specific documentation or evidence is required to meet the criteria outlined by the Social Security Administration.

Eligible genitourinary disorders include:

  • Chronic kidney disease
  • Kidney transplant
  • Nephrotic syndrome (kidney disorder)
  • Conditions or injuries that result in the need for dialysis
  • Cancer of the bladder, prostate or genitals

Hematological Disorders

Hematological disorders can severely limit or prohibit someone’s ability to work, as well as disrupt the normal function of their white blood cells, red blood cells, platelets, and the proteins involved in bleeding and clotting.

Eligible disorders in the hematological category include:

  • Bone marrow failure and/or transplant
  • Hemolytic anemias
  • Sickle cell disease
  • Stem cell transplant
  • Thrombosis and hemostasis

Immune System Disorders

Disorders in this category cause dysfunction in the immune system, resulting in recurring infections, inflammation, and/or dysfunction in body organs. There are three categories of immune system disorders: autoimmune disorders, immune deficiency disorders, and human immunodeficiency virus (HIV) infections. Applicants who need a bone marrow or stem cell transplant may also qualify for SSD or SSI benefits depending on their circumstances.

Eligible disorders in the immune system category include:

  • HIV
  • Inflammatory arthritis
  • Inflammatory disease
  • Meningitis
  • Sjögren’s syndrome
  • Systemic sclerosis or scleroderma

Mental Disorders

Mental disorders are the largest category of impairments; nearly 3 million people per year draw social security benefits due to these ailments. There are currently 11 categories for mental disorders, covering a wide variety of different mental and neurocognitive disorders. Due to the stigma surrounding mental illness, as well as the difficulty in getting a clear diagnosis and treatment, can make eligibility in this category difficult. As an applicant, it’s important to provide documented care and reports of ongoing symptoms.

Conditions that may land under this category of impairments include:

  • Addiction
  • Alzheimer’s disease or dementia
  • Autism spectrum disorders
  • Borderline personality disorder
  • Bipolar disorders
  • Manic depression
  • Schizophrenia
  • Severe anxiety and panic disorders
  • Tourette syndrome

Musculoskeletal System Disorders

These disorders affect the muscles, bones, and joints. In order to qualify for benefits under this category, the musculoskeletal disorder must cause “major dysfunction.” The disorder itself, however, may result from causes such as hereditary, congenital, developmental events, or repetitive trauma.

Eligible disorders under the musculoskeletal category include:

  • Amputation
  • Burns
  • Degenerative disc disease
  • Major fractures and breaks
  • Osteoarthritis
  • Soft tissue injury
  • Vertebral fracture

Neurological Disorders

Neurological disorders affect the nervous system, and these impairments affect the brain’s function, as well as how it processes movements. An applicant must be able to prove significant limitations have resulted from their neurological condition to be eligible for disability benefits under this category. Both medical and non-medical evidence is used in the evaluation process.

Limitations caused by a neurological disorder must persist despite treatment and/or medication and result in a “disorganization of motor function.” This would include the inability to stand, balance, or use the upper extremities like hands, fingers, or arms.

Eligible neurological disorders can include:

  • Amyotrophic lateral sclerosis (ALS)
  • Benign brain tumors
  • Coma or persistent vegetative state
  • Cerebral palsy
  • Epilepsy
  • Multiple sclerosis (MS)
  • Muscular dystrophy
  • Traumatic brain injuries (TBI)

Respiratory Disorders

Respiratory disorders affect the lungs, and respiratory conditions may qualify a person for benefits if the disorder is severe enough to impede regular activities of daily life. The respiratory condition needs to cause obstruction or restriction of the lungs in order to qualify for disability benefits.

Examples of possibly eligible respiratory disorders include:

  • Chronic bronchitis or asthma
  • Chronic pulmonary hypertension 
  • Cystic fibrosis
  • Hereditary disorders
  • Lung transplant
  • Ongoing need for oxygen supplementation
  • Respiratory failure

Skin Disorders

Skin disorders are evaluated based on how debilitating the skin lesions are, the frequency they appear, how the symptoms limit a person’s ability to work, and what treatments are available to them. In many cases, the skin disorder has to persist for at least three months despite treatment or medication in order to qualify for SSD or SSI benefits.

Some of the skin disorders that might be eligible include:

  • Chronic skin infections
  • Malignant skin cancer
  • Photosensitivity
  • Psoriasis or dermatitis
  • Severe acne
  • Severe burns

Special Senses and Speech Disorders

This category includes disorders that affect the five senses, such as vision, speech, and auditory impairments. In these cases, the sense impairment must inhibit daily activities and a person’s ability to obtain employment. Special senses and speech disorders may start at birth, or they may be acquired as a result of trauma.

Eligible disorders in this category include:

  • Blindness
  • Hearing loss
  • Loss of central visual acuity
  • Loss of speech

Applying for SSDI With the Help of a Disability Lawyer

This extensive list of SSDI impairments is just a snapshot of potentially eligible conditions, so it’s easy to imagine how the Social Security Disability application process can overwhelm first-time applicants. If you’re seeking help with your initial SSD application, or if you’ve been denied and are working towards an appeal, a knowledgeable disability lawyer can help.

While you are not required to have legal representation to seek SSDI benefits or to appeal a denied claim, a qualified disability attorney can greatly improve your chances for approval and help you gather evidence to support your claim. At Carr & Carr, our extensive experience in disability law and the SSA appeals process can help you thoroughly document your initial application or fight for benefits if your claim is rejected.

With offices in Oklahoma City and Tulsa, Carr & Carr’s disability attorneys are ready to help you seek the benefits you need to care for yourself. If you are seeking assistance with your SSD or SSI claim, please call 866-510-0580 or contact us online.

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