SSDI Step 3: The Listings of Impairments

So you think Steps 1 & 2 were a little complicated? Well hold on tight for Step 3.  This one is a real doozy.

Basically, what you need to know is that there is a part of Social Security’s Regulations called the Listing of Impairments.  It runs about 50 pages, and it contains highly technical information about most every type of medical condition you can imagine.  It is divided into sections, such as “Digestive System” and “Mental Disorders.”  Each section is broken down into different specific illnesses or impairments.   These sections have lists of symptoms and signs.  If your illness matches up precisely with these symptoms, you may have a quick winner of a case.

The idea behind the Listing of Impairments is that Social Security wants to have a black-and-white set of standards of what they think a disabling condition should look like.  This way, if you can prove beyond any doubt that your condition equals their description, they can award you benefits and send you on your way. The problem is that their standards are pretty tough.  For them to give you benefits quickly, you had better have an impairment that is off the charts. Otherwise, they will have to move on and take other information into account. 

Just to give you an idea of the type of medical criteria you are up against, let’s examine a sample section.  You may think that your chest pains are enough to get you benefits but take a look at this actual listing from the Listings of Impairments: 

It goes on from there, but you get the point.  These listings can be as hard to figure out as they are to qualify for. So, as you can see, your opinion about whether you have a severe impairment is not really what Social Security is looking for. They want very precise medical evidence – stuff that only your doctor, and maybe your advocate will understand.

Of course, there are some listings that are not that hard to understand, but they are really hard to prove. Take multiple sclerosis, for example. WE all know multiple sclerosis can be disabling but for Social Security, that’s not enough.  First you have to prove you have multiple sclerosis. A doctor’s opinion on that issue is probably sufficient, But then you have to show that MS causes these limitations: 

11.04(B) Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C).

Notice the word “persistent.”  Is “persistent” daily, monthly, or annually?  Most multiple sclerosis cases are the relapsing/reoccurring type, which means that you may have a symptom that affects your vision one day but not the next.  You might have trouble walking, but maybe that only occurs when you over-exert yourself or during a particularly acute episode.  It would be a disorganization of motor function in two extremities (the legs) and could result in disturbance of gait and station, but is it persistent or sustained?  When it is relatively quiet, the primary function may just be fatigue. And fatigue, like pain, is impossible to measure as real as it is to patients and as real as it is to doctors.

By comparison, some listings are relatively easy to prove. If you are unfortunate enough to have Lou Gehrig Disease, for instance, that condition is considered so severe that once a diagnosis is made, you have to prove nothing else. 

In general, listings impose a very high standard that is difficult to meet and almost impossible to meet without solid medical evidence.

Step 3 Bottom Line

Step 3 is a special step because if you fail to meet its rules, your case is still allowed to move on.  It is designed for the most severe and most well-documented cases, and even then there are no guarantees whatsoever.  If you “meet a Listing,” you win your case:  if you don’t. you still move on to Step 4.

Previous blog: SSD Step 2: Do You Have a Severe Impairment?