How do I know if I meet a Blue Book listing?

The Social Security Blue Book is a list of medical impairments that automatically qualify a claimant as disabled when the impairment requirements are met. As long as the medical evidence meets the requirements of the listing, you will automatically be considered disabled.

This sometimes gets confusing, because a doctor’s diagnosis of a certain condition does not necessarily mean that the SSA will find that you meet the total impairment requirements. These requirements are typically more extensive than a simple diagnosis. For example, the SSA’s impairment requirements for spinal stenosis are as follows:

“Disorder of the spine (e.g. spinal stenosis), resulting in compromise of a nerve root (including the cauda equine) or the spinal cord. With:

• Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);

Or

• Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;

Or

• Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.”

You can see here that there are strict qualifications that must apply to a claimant’s diagnosis in order to automatically qualify for a listing. However, should your diagnosis not match up exactly to the blue book listing, there is still hope, due to the fact that claimants typically suffer from multiple ailments or conditions. In its evaluation, the SSA is not allowed to examine each of the claimant’s listings separately, but must consider the combined effect of all the medical conditions.

A common example of this is seen in diabetes diagnoses. The Social Security Administration’s blue book used to require that a diabetes diagnosis also required evidence of neuropathy, acidosis, or retinitis proliferans. Many of those with diabetes did not have any of those conditions, but did suffer from morbid obesity and hypertension. The SSA would have to view the combined effect of the diabetes, morbid obesity, and hypertension, and then assess whether the combined effect equaled an impairment as severe as diabetes with the other three blue book listings.

The Social Security Administration will also assess the combined effects of physical and mental conditions, as required by law. This means that even if a claimant doesn’t have a rock-solid blue book listing, their combined mental and physical conditions may prevent them from engaging in substantial gainful activities. For example, one may have a lower back ailment that prevents them from bending over or lifting heavy objects, but may also have a mental condition, such as anxiety or depression, that both decreases their tolerance for pain and limits them from properly engaging with supervisors or coworkers at their job. In this case, the combination of the two will greatly limit what that claimant is capable of performing (residual functional capacity) and greatly limit the jobs they could possibly fill. This will result in a greater chance of the SSA declaring that claimant disabled.