Social Security provides a steady stream of income from which workers can build a retirement plan. It also provides valuable social insurance protection to disabled workers and families whose breadwinners died.
Almost all workers contribute to Social Security through payroll taxes, and nearly all older adults receive Social Security benefits. According to Social Security Administration (SSA) estimates, 97 percent of older adults, aged 60 to 89, either receive or will receive Social Security benefits.
Nevertheless, there are certain factors and medical conditions to be considered by the SSA when evaluating Social Security disability claims, including the Social Security Blue Book. Read on to learn more about the basic information on the Blue Book, along with its primary contents and its role in assessing disability claims.
What Is The Blue Book?
The Blue Book, formally known as Disability Evaluation Under Social Security, lists mental and physical impairments considered severe enough to prevent someone from working and lays out the medical criteria for determining whether that person is eligible for disability benefits.
If you have a condition that meets the requirements for a Blue Book listing, you will be considered disabled regardless of your education or work history. To receive SSDI benefits, you must still meet the work history requirements.
Parts Of The Social Security Blue Book
The Blue Book is divided into two sections. Part A addresses disabilities for adults over the age of 18 while Part B focuses on conditions affecting children under the age of 18.
For adults, the sections of the Blue Book are:
- Musculoskeletal system
- Special Senses and Speech
- Respiratory Disorders
- Cardiovascular System
- Digestive System
- Genitourinary System
- Hematological Disorders
- Skin Disorders
- Endocrine Disorders
- Congenital Disorders That Affect Multiple Body Systems
- Neurological Disorders
- Mental Disorders
- Cancer (Malignant Neoplastic Diseases)
- Immune System Disorders
For children, the sections of the Blue Book include the following:
100. Low Birth Weight and Failure to Thrive
101. Musculoskeletal System
102. Special Senses and Speech
103. Respiratory Diseases
104. Cardiovascular System
105. Digestive System
106. Genitourinary System
107. Hematological System
108. Skin Disorders
109. Endocrine Disorders
110. Congenital Disorders that Affect Multiple Body Systems
111. Neurological Disorders
112. Mental Disorders
113. Cancer (Malignant Neoplastic Diseases)
114. Immune System Disorders
Each Blue Book entry describes the specific symptoms that would lead to a diagnosis. Objective medical evidence such as X-rays, MRIs, and psychological tests are emphasized. The SSA relies on medical chart notes from your treating doctor or a doctor who has examined you in the past for requirements that cannot be measured scientifically, such as those requiring limitations in focus and interactions with others.
Main Chapters Of The Social Security Blue Book
The Blue Book has three main chapters:
Chapter I — General Information
This chapter provides an overview of the disability benefit programs and Social Security's claim-processing procedures, including the role of medical experts and professionals.
Chapter 2 — Evidentiary Requirements
This chapter provides a rundown on the kinds of paperwork, examinations and other evidence officials use to make assessments of people's disability claims.
Chapter 3 — Listing of Impairments
This chapter details the conditions or families of related conditions that meet the disability standard in adults (Part A) and children (Part B), as well as the evidence considered by officials in evaluating claims based on them. It is broken down by types of disorders or affected bodily systems, such as respiratory illnesses, neurological disorders, hearing and vision loss, and so on.
The listings are intended for healthcare professionals. Medical standards are stringent and specific, and the language is frequently dense and complicated. However, the Blue Book can be a valuable resource in determining if you meet the requirements for disability benefits and is eligible for application.
The Blue Book, which was previously printed and bound but is now only available online, is an essential resource for Social Security examiners who assess applications for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). It serves as a fundamental benchmark for the two disability benefit programs administered by the SSA, as well as medical professionals who provide evidence to support patients' disability claims.
Suppose a condition is listed in the Blue Book. In that case, it inherently meets the Social Security Administration's definition of disability, which is an illness or injury that prevents you from performing "substantial gainful activity" for at least a year or that will likely result in your death. For children eligible for SSI, the test is not work-related but rather whether a condition causes "marked and severe functional limitations."
Being diagnosed with one of the conditions listed does not automatically qualify an applicant for SSDI or SSI. The Blue Book explains in detail the symptoms, test results, or other information that demonstrate your condition is severe enough to be genuinely disabling in the eyes of the agency, as well as the records you must submit to prove it.
SSA examiners compare your medical evidence to the Blue Book listing as part of the disability-determination process to see if you meet the requirements. If you do, your claim will almost certainly be approved. However, having a condition not listed in the Blue Book is not necessarily disqualifying.
How To Apply For Disability Benefits If Your Condition Is Not Listed In The Blue Book
It would be impossible to list all of the medical conditions that cause impairments in the Blue Book because there are thousands of them. Only the most common conditions are covered. If your condition isn't listed in the Blue Book, but you believe it causes impairments that make it impossible for you to work, you may still be eligible for disability benefits. To be approved, you must demonstrate that your condition meets or equals one of the conditions listed.
Consider an applicant who is suffering from frequent migraine headaches that have not responded to treatment. Migraines are not listed in the Blue Book, but if there is evidence that the effects of the headaches are similar to what is described in the Blue Book listing for non-convulsive seizures in the neurological section, the application may be approved.
If you plan on filing a disability claim, read this Disability Help article on how long the Social Security disability review usually takes.
