What Medical Conditions Qualify For Social Security Disability?

Being unable to work due to medical conditions can be very stressful, worrying about how to maintain your life and pay the bills, as well as medical costs. Social Security Disability Insurance (SSDI) is there to ensure people do need to find themselves in those situations, but what conditions qualify for SSDI benefits? 

While there is no set and firm answers regarding what conditions are covered by social security disability or not, there are guides and a baseline definition that can act as a rule of thumb:

SSDI recognizes an illness or injury that prevents a person from working for at least a year or that will likely cause death. 

Social Security Disability & the Administration Blue Book

As mentioned, there is a guide the Social Security Administration uses and people can look through to know whether they qualify for SSDI benefits: The Social Security Blue Book. Officially known as the Disability Evaluation Under Social Security, it lists the medical impairments the SSA considers severe enough to prevent someone from working and lists the medical criteria for determining if a person can receive disability benefits.

You can find the Social Security Blue Book here:

Disability Evaluation Under Social Security

Medical Conditions that Qualify for Social Security Disability

If a condition is listed in the Blue Book, it automatically meets the definition set by the SSA and qualifies a person for social security disability insurance. Here are some of the impairments and conditions listed that automatically qualify someone:

1. Musculoskeletal System: Conditions that affect the bones and muscles, such as back injuries and other dysfunctions of the joints and bones.
2. Special Senses and Speech: Conditions affecting vision, hearing, and speech.
3. Respiratory Disorders: Such as asthma, chronic pulmonary insufficiency, and cystic fibrosis.
4. Cardiovascular System: Including chronic heart failure, coronary artery disease, and recurrent arrhythmias.
5. Digestive System: Conditions like liver disease, inflammatory bowel disease, and gastrointestinal hemorrhaging.
6. Genitourinary Disorders: Kidney diseases and other conditions related to the reproductive and urinary systems.
7. Hematological Disorders: Disorders of the blood, such as anemia, hemophilia, and bone marrow failures.
8. Skin Disorders: Eczema, burns, and other dermatological conditions.
9. Endocrine Disorders: Conditions related to hormone-producing glands, such as thyroid, adrenal, and pituitary gland disorders.
10. Congenital Disorders that Affect Multiple Body Systems: For instance, Down syndrome.
11. Neurological: Epilepsy, Parkinson’s disease, multiple sclerosis, and cerebral palsy, among others.
12. Mental Disorders: Such as schizophrenia, autism, depression, anxiety, and intellectual disorders.
13. Cancer (Malignant Neoplastic Diseases).
14. Immune System Disorders: Including lupus, HIV/AIDS, and rheumatoid arthritis.
     

It’s important to remember that only being diagnosed doesn’t guarantee approval for disability benefits and that the SSA requires specific medical evidence, and documentation before benefits are approved. 

Secure Your Medical Benefits 

The application process for SSDI is complex, and many applications are denied the first time. When that happens, a person can pursue the appeals process, which many find success with, especially if legal representation has been secured.

Here at Marken Law Group, we understand how stressful getting your rightful SSI benefits can be and don’t want to add to your plate during such an uneasy time. We have represented hundreds of claimants in Washington, Idaho, Montana, Oregon, and California to obtain what is rightfully theirs. We focus on your individual needs rather than treat all cases as the same, bringing our extensive experience to help guide you through. 

If you want to better ensure you get the SSDI benefits you’re owed, contact us below and work with social security attorneys who know how to navigate the system and fight for you. 

Marken Law | Social Security Disability

How Long Does It Take To Reinstate SSI Benefits?

If your SSI benefits are ended, you can reinstate them by applying for expedited reinstatement of benefits (EXR). This process typically takes up to six months. During this period, you will be provided with monthly provisional benefits.

However, if your SSI benefits are suspended, there’s a different process for reinstatement. SSI benefits can be reinstated within 12 consecutive months without needing a new application.  You can also appeal for reinstatement after the 12-month suspension period ends. The Social Security Administration (SSA) will decide within a month whether to reestablish your SSI benefits. Understanding these timelines and procedures is essential for individuals navigating SSI benefit suspensions and reinstatements. Understanding these timelines and procedures is essential for individuals navigating SSI benefit suspensions and reinstatements.

When Your Benefits are Ended: What is Expedited Reinstatement of Benefits? 

Expedited reinstatement of benefits (EXR) is the process through which recipients can have their SSDI or SSI benefits reinstated without the need to submit a new application. This option is available to individuals whose benefits were discontinued for specific reasons:

• You stopped receiving benefits due to earnings from work.
• You are unable to perform SGA or substantial gainful activity.
• You have a disability resulting from an impairment similar to or related to the impairment that initially qualified you for benefits.
• You request reinstatement within five years from the month your benefits were discontinued.

Once you apply for EXR, the Social Security Administration (SSA) evaluates your case and, during this process, provides provisional or temporary benefits while determining whether to reestablish your SSI benefits.

What Are Provisional Benefits? 

As mentioned earlier, provisional benefits are temporary payments that can be granted to you while the SSA assesses whether to reinstate your benefits. These benefits are made to provide financial support during the decision-making period. Provisional benefits will cease if:

• You receive notification that your benefits have been reinstated.
• You engage in substantial gainful activity.
• You reach full retirement age.

Understanding the availability and conditions of provisional benefits is essential for recipients navigating the reinstatement process, as they can provide crucial financial assistance during this period.

What Is The EXR Process?

Expedited Reinstatement of Benefits (EXR) involves a series of steps to evaluate your eligibility for reinstating your SSI benefits. The Social Security Administration (SSA) manages this process by sending your EXR application to the Disability Determination Services (DDS). DDS plays a crucial role in reviewing your case, primarily focusing on your medical records and assessing whether your medical condition has undergone any significant changes since you were initially approved for benefits.

If DDS finds that your medical condition has indeed changed, they will then proceed to determine whether you still meet the requirements for SSI benefits. This meticulous evaluation ensures that individuals requiring SSI benefits receive the necessary support. 

When Your Benefits are Suspended: Understanding the Suspension Period 

In some cases, SSI benefits are suspended, not ended. In most cases, SSI recipients have 12 months from the date of suspension to have benefits reinstated without applying again. There is a different procedure for reinstating benefits after the 12 months of suspension.

But in other cases, recipients have 24 months to have their SSI benefits reinstated. These cases include situations where recipients are:

• Blind and disabled children of overseas military personnel.
• “Military-related” recipients who have become ineligible due to their spouse or parent(s) being called to active military duty (including the Reserve or National Guard).

Procedure For Reinstating Benefits Before The Suspension Period

For example, a recipient is incarcerated for a whole calendar month. Upon being released in less than 12 months, they can reinstate their benefits by bringing their official release papers to their local Social Security office.

Procedure For Reinstating Benefits After The Suspension Period

Reinstating SSI benefits after a suspension involves several procedures, depending on the specific circumstances. Here are three different procedures for reinstating benefits after a suspension:

1. Appeal of a Suspension During the Administrative Period or Civil Suit: If a recipient receives a notice in December 2020 indicating that their benefits have been retroactively suspended starting in January 2020, they have a 60-day window to appeal this decision and provide evidence demonstrating their ongoing need for SSI benefits during that time. If their appeal is successful, their benefits will be reinstated, and they will receive support starting from January 2021.
2. Standard Suspension with Favorable Appeal Decision: After a 12-month suspension period, recipients can file for the reinstatement of their benefits. If their appeal results in a favorable decision, whether from the Social Security Administration (SSA) or even the federal court, their SSI benefits will be reinstated.
3. Administrative Finality or Reopening: In cases where a reconsideration request for the reinstatement of benefits is denied, the recipient still has an option. They can request a review from an Administrative Law Judge (ALJ) within the prescribed time limits. If the ALJ reverses the initial reconsideration determination, SSI benefits can be reinstated.

Knowing these different procedures for reinstating SSI benefits after a suspension is essential for individuals who may find themselves in such circumstances. Each procedure has specific requirements and timeframes, making it important to navigate this process with the appropriate steps in mind.

Working with an SSI Lawyer for a Smooth Process 

With the complexities of reinstating your SSI benefits, An experienced lawyer can skillfully navigate the complex reinstatement process, ensuring that your case is handled with the utmost care and expertise. When you choose to work with Marken Law Group, you benefit from aggressive representation and a personal response to your inquiries and calls, which can make all the difference during this critical time.

We encourage you to take the first step towards a smoother process by contacting us for a free consultation. Discover how working with Marken Law Group can be the key to a successful SSI benefit reinstatement by clicking the link below.

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