I have been representing Hoosiers in their claims for Social Security Disability Benefits for more than 23 years. Over that time I have run into several people who have rare diseases that cause them to be disabled. These diseases are just as problematic as the diseases we all know about such as cancer, so why do they cause issues when you have a claim for disability benefits? The answer is in the regulations of the Social Security Administration. The first question asked is the claimant working. If the answer is no, the next question is does the claimant have a severe medical impairment. The third step is whether the impairment meets a listing. The fourth step is if the impairment does not meet a listing the Social Security Administration determines the claimants residual functional capacity ( a fancy way of saying what the body can still do despite its impairments). Finally, the fifth step is to determine whether there are any jobs in the national economy the claimant can still do despite the impairment. The precise cite to the controlling law is 20 C.F.R. Sec. 404.1520. (CFR stands for Code of Federal Regulations).
I want to talk about the second step. I know you are asking yourself what are these impairments. Well, the answer is again in the regulations. The Social Security Administration, with the help of medical experts, has created a list of medical conditions that they call impairments. We call them the listings, for short. They are a list of injuries, illnesses and diseases. If the claimant has one of these injuries illnesses or diseases, AND the symptoms are severe enough, the claimant will be found to be disabled. The exact cite for the Lists is 20 CFR 404, Subpart P. Appendix 1. The general categories for the listings are Musculoskeletal, Special Senses and speech, Cardiovascular, Digestive, Genitourinary, Hematological, Skin, Endocrine, Multiple Body Systems, Neurological, Mental, Cancer, Immune system. As you might guess, the listing include the more common problems. So what Happens when you have one of the rarer diseases that is not listed in the Listings?
Again we have to look at the rules. In this case we have to look specifically at 20 CFR Sec. 404.1526, Medical Equivalence. If your impairment is medically equivalent to a listed disease in severity and duration. You will be found to be disabled. The SSA uses 3 ways to determine medical equivalence. This is a rather complicated process that requires consideration of the rules and your medical records. If you find that you have a disease, and it is not a common problem, give me a call. I will sit down with you, look at your records and let you know what I think about whether your impairment is medically equivalent to the listings.